Health insurance usually does not fully cover surrogacy, but some pregnancy-related medical care may be covered, depending on the surrogate’s insurance plan.
For most intended parents, insurance is one of the most confusing parts of the surrogacy journey.
You may hear that insurance “covers the pregnancy,” only to later discover exclusions, limitations, or unexpected out-of-pocket costs.
This article explains how health insurance works in surrogacy, what it may and may not cover, and why coverage varies so widely.
Why Doesn’t Health Insurance Usually Cover Surrogacy?
In most cases, health insurance does not fully cover surrogacy.
This is because health insurance is designed to cover medical treatment, not third-party reproductive arrangements. As a result, coverage depends on the surrogate’s individual health insurance policy, how that policy defines maternity benefits, and whether it includes a surrogacy exclusion.
A surrogacy exclusion is a clause in a health insurance policy that specifically denies coverage for medical care related to a surrogate pregnancy.
Even if a plan otherwise covers maternity care, a surrogacy exclusion means the insurer can deny claims once the pregnancy is identified as part of a surrogacy arrangement.
If a surrogate’s existing health insurance can’t be used, there are also maternity-only insurance policies designed specifically for surrogacy.
These plans can be purchased when private insurance isn’t available or approved, and may be used on their own or alongside another policy as a backup or temporary solution.
What Health Insurance May Cover in a Surrogacy Journey
In some cases, a surrogate’s health insurance may cover certain medical aspects of pregnancy.
Prenatal Care and Routine Appointments
Some insurance plans will cover routine prenatal care, such as:
- OB-GYN visits
- Ultrasounds and lab work
- Standard pregnancy monitoring
This typically applies only if the policy does not include a surrogacy exclusion and treats the pregnancy like any other maternity case.
Labor and Delivery
Hospital labor and delivery costs may be covered under the surrogate’s insurance, including:
- Hospital admission
- Vaginal or cesarean delivery
- Standard postpartum hospital care
Coverage is subject to deductibles, copays, and plan limits.
Pregnancy-Related Complications
Some policies may cover medical complications that arise during pregnancy or childbirth, such as:
- Gestational diabetes
- Pre-eclampsia
- Emergency interventions related to delivery
What Health Insurance Does Not Cover in Surrogacy
Many of the largest and most expensive parts of a surrogacy journey fall outside standard health insurance coverage.
Health insurance does not cover:
- Surrogate compensation: Payments made to a surrogate for carrying a pregnancy are never considered medical expenses.
- Agency or coordination fees: Costs related to matching, support, and case management are not covered.
- Legal fees: Contracts, parental rights, and court filings required for surrogacy are not covered by insurance.
- IVF and embryo creation: This includes fertility treatments, embryo transfer cycles, and related medical procedures.
- Egg or sperm donation: Donor compensation, screening, and associated medical costs are excluded.
- Travel and lodging expenses: Any travel related to medical appointments or delivery is not covered.
These costs are considered part of the surrogacy arrangement, not treatment for a medical condition, which is why health insurance does not apply.
Whose Health Insurance Is Used in Surrogacy?
In a surrogacy journey, the surrogate’s health insurance is typically used for pregnancy-related medical care, not the intended parents’ insurance.
This distinction is one of the most common sources of confusion for intended parents.
The Surrogate’s Health Insurance
If the surrogate has an active health insurance policy and that policy does not exclude surrogacy, it may be used to cover eligible pregnancy-related care, such as prenatal visits, labor, and delivery.
However:
- Coverage is never automatic
- Surrogacy exclusions are common
- Claims can be denied if surrogacy is identified
For this reason, an insurance review usually happens before a surrogate is matched.
The Intended Parents’ Health Insurance
In most cases, the intended parents’ health insurance does not cover the surrogate’s pregnancy or medical care.
Some plans may cover:
- Fertility treatment prior to surrogacy (such as IVF for the intended parent)
- Medical care for the baby after birth
But they generally do not apply to the surrogate’s prenatal or delivery expenses.
Health Insurance for the Baby After Birth
After delivery, the baby must be enrolled in the intended parents’ health insurance plan within the required enrollment period.
Newborn coverage does not automatically transfer from the surrogate’s insurance, even if the delivery took place under her policy.
Frequently Asked Questions About Surrogacy and Insurance
How do I know which maternity insurance plan is the best?
At Hatch, we rely on third-party insurance professionals to help us determine if an insurance plan can be used for a surrogacy journey or if an additional plan needs to be purchased. This is a step that shouldn’t be skipped, as these professionals would be able to tell you about your specific plan and what it will and won’t cover.
Common questions regarding some well-known insurance providers
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Will Tricare cover a surrogate’s care as the covered member? |
No |
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Will Kaiser insurance cover surrogacy? |
Yes* |
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Will Aetna insurance cover surrogacy? |
Typically, yes |
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Will Medicaid cover surrogacy? |
No |
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Will Blue Cross/Blue Shield cover surrogacy? |
Sometimes |
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Will Cigna cover surrogacy? |
Yes |
*Kaiser insurance and other plans like Sutter Health will typically cover a surrogacy with the possibility of a lien. A lien indicates that the insurance company reserves the right to require Intended Parents to pay up to or all of the surrogate’s compensation back to them in exchange for covering the maternity medical bills.
These plans have been used successfully in the past, but being prepared ahead of time with the necessary funds in escrow to cover the lien before the journey begins fully is vital and will be required as per your contract.
What Happens If You Can’t Afford Surrogacy?
If the cost of surrogacy feels out of reach, there are still paths forward. Many intended parents explore options such as:
- Financing or payment plans
- Grants or assistance programs
- Adjusting timelines to allow for financial preparation
- Speaking with an agency about cost planning and expectations early on
How Much Do You Need to Pay for Surrogacy?
In the U.S., surrogacy typically involves high out-of-pocket costs that may reach up to $200,000. Total surrogacy costs vary depending on factors such as medical needs, insurance coverage, legal requirements, the number of IVF cycles needed, and whether complications arise.
