Buying Infertility Insurance: Primary & Supplemental Plans

Can you purchase infertility insurance? It depends on your perspective.

Issuing companies have no desire to pay out huge claims for a pre-existing condition in exchange for small premiums. It does not make business sense.

However, some couples can buy primary insurance covering infertility and In Vitro Fertilization (IVF) treatments.

Twenty states force insurers to cover pre-existing fertility problems, and a small but growing number of employers absorb the unprofitable deal voluntarily to attract and retain a competitive workforce.

Fortunately, all couples can purchase supplemental insurance covering the intended outcome (mom’s pregnancy and childbirth), regardless of where they live or work.

Purchasing Supplemental Fertility Insurance

Purchasing supplemental health insurance makes sense regardless of where you live because this extra coverage fills two enormous holes associated with intended infertility and IVF treatment’s intended outcome: mom’s pregnancy.

  1. Extended unpaid maternity leave before and after birth
  2. Left-over hospital bills from a lengthy NICU confinement

Buy Before Treatment

The number one rule is purchasing supplemental health insurance before your subsequent infertility or IVF treatment. Once you conceive, it will be too late. Your pregnancy will be a pre-existing condition excluded from coverage for twelve months.

Request a supplemental health insurance quote to get started. An agent licensed in your state will provide premium cost estimates and help you complete new policy applications should you decide to buy either of these policies.

Short-term disability replaces a portion of income when the mom cannot work.

  • Pregnancy disability leave before birth
  • Recovery from labor and delivery
  • Postpartum medical complications
  • Accidents and other illnesses

Hospital indemnity puts extra cash in your pocket when you need it most.

  • Covers hospital confinement for childbirth
  • Pays extra for NICU confinement
  • Doubles the NICU cash payments for twins
  • Triples the NICU benefits for triplets

Buy Nationwide

The second rule is that you can purchase supplemental health insurance nationwide because you do not need a state mandate to cover the outcome of infertility & IVF treatment. Mom’s pregnancy is not elective or experimental.

However, short-term disability is mandatory in seven states. Hence, purchasing income insurance is less critical for some women working in these regions unless the weekly maximum is too low or the duration is too brief.

StateLength in WeeksWeekly Maximum
New Jersey26$903
New York26$170
Rhode Island26$887

Buy for Multiples

The third rule is purchasing supplemental health insurance to address a secondary outcome of infertility and IVF treatments: twin and triplet pregnancies. Fertility drugs and multiple embryo transfers lead to a high incidence of exra babies.

  • A multiple pregnancy is more likely to experience complications requiring extended unpaid bed rest at home – a need addressed by short-term disability.
  • A twin pregnancy is more likely to deliver pre-term requiring an extended NICU stay for two or three infants – a need addressed by hospital indemnity.

Financial assistance for premature babies and NICU parents is sparse at best. You cannot count on the government bailing you from this predictable outcome. Take proactive steps now instead!

Purchasing Primary Infertility Insurance

For obvious reasons, purchasing primary health insurance to cover the foreseen upfront infertility and IVF treatment costs rather than the uncertain future outcome is the preferred option. However, this alternative is available to a small minority of couples and often requires creative problem-solving.

Buying Individual Plans

Some couples can buy primary health insurance covering infertility or IVF treatment as individuals outside their employers if they live in one of eight states with an applicable mandate.

Request a health insurance quote to get the process started. A licensed agent may contact you to review premium costs and take your application if you want to purchase the coverage, which you might do if your state has a legal mandate extending to individual plans.

  • Arkansas
  • Connecticut
  • Delaware
  • Hawaii
  • Illinois
  • Louisiana
  • Maine
  • Maryland

Non-group insurance that covers IVF begins with the same list and whittles it down further by eliminating Louisiana and Maine, which only address less expensive infertility treatments. Meanwhile, High-Deductible Health Plans beautifully work wherever you live or work

Buying Group Plans

Other couples can buy primary insurance covering infertility or IVF treatments through their employer – if offered. Contact your Human Resources department to verify coverage. Sign up during open enrollment and pay the premiums with pre-tax payroll deductions.

Mandated Coverage

Many couples can procure primary infertility insurance at work because the employer policy is subject to a state mandate requiring the coverage.

Twenty states have infertility insurance mandates regulating group healthcare plans, which contain limitations that come into play frequently.

  • Self-insured plans are exempt from state laws
  • Some mandates apply only to larger employers
    • 25 or more employees
    • 50 or more employees
  • The mandates pertain to group policies issued in the state

Voluntary Coverage

Other couples can procure primary infertility insurance at work because their employer offers the benefit voluntarily to attract and retain a competitive workforce.

Here are some of the companies offering fertility benefits.

American ExpressBain & CompanyBank of America

Changing Jobs

Couples working or living in the thirty non-mandate states can still procure primary infertility insurance by changing jobs to employers offering the desired benefits. Having coverage for two IVF cycles is like getting a $30,000 raise.

While not easy to identify, you have at least two strategies to pursue.

  1. Apply for a job with an employer offering fertility benefits voluntarily. Begin with the list of ten mentioned above and find others with satellite offices or stores in your area.
  2. Apply for a job with employers that do not self-insure and have headquarters in one of the twenty mandate states. The legal requirement extends nationwide because it is group coverage.

Purchasing Secondary Infertility Insurance

Almost nobody purchases secondary infertility insurance. Finding one plan is hard enough, so getting a second is more challenging. Plus, you would double your premium costs while getting much less in return.

Secondary insurance is a duplicate of your primary plan covering infertility & IVF treatments, making it challenging to get and a poor investment.

  • To get a second plan, your partner must live in a mandate state or work for an employer offering the benefit, which is rare.
  • A second plan doubles your premium costs but pays less in claims because it coordinates benefits with the primary insurance (covers deductible, copayments, etc.)

Finally, secondary insurance differs from supplemental coverage, which is a much better deal for couples trying to conceive. Do not confuse the two.

Coordinates benefitsYesNo
Covers infertilityTreatmentsOutcomes
Pays claims toProviderIndividual
Payment scheduleVariableFixed