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.
In most cases, health insurance does not fully cover surrogacy.
Currently, 25 states and Washington, D.C. have laws requiring some form of private insurance coverage for fertility care, and 15 of those states plus D.C. specifically mandate IVF coverage. However, these mandates typically apply to the individual seeking treatment, not to third-party surrogacy arrangements, which is why surrogacy itself usually falls outside these protections.
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.
In the industry, a policy without a surrogacy exclusion is often referred to as 'surro-friendly.' A surro-friendly plan treats a gestational pregnancy exactly like any other pregnancy, with no additional restrictions. 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.
In some cases, a surrogate’s health insurance may cover certain medical aspects of pregnancy.
Some insurance plans will cover routine prenatal care, such as:
This typically applies only if the policy does not include a surrogacy exclusion and treats the pregnancy like any other maternity case.
Hospital labor and delivery costs may be covered under the surrogate’s insurance, including:
Coverage is subject to deductibles, copays, and plan limits.
Some policies may cover medical complications that arise during pregnancy or childbirth, such as:
Many of the largest and most expensive parts of a surrogacy journey fall outside standard health insurance coverage.
Health insurance does not cover:
These costs are considered part of the surrogacy arrangement, not treatment for a medical condition, which is why health insurance does not apply.
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.
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:
For this reason, an insurance review usually happens before a surrogate is matched.
In most cases, the intended parents’ health insurance does not cover the surrogate’s pregnancy or medical care.
Some plans may cover:
But they generally do not apply to the surrogate’s prenatal or delivery expenses.
After delivery, the baby must be enrolled in the intended parents' health insurance plan, typically within 30 to 60 days, as birth qualifies as a 'qualifying life event' under most insurance plans.
Newborn coverage does not automatically transfer from the surrogate’s insurance, even if the delivery took place under her policy.
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.
These answers reflect general patterns Hatch has seen across many surrogacy journeys, but coverage ultimately depends on your specific plan and employer group, not just your insurance carrier. A professional insurance review is the only way to confirm what your individual policy covers.
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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.
It's worth understanding why Medicaid doesn't apply here: Medicaid eligibility is income-based, and surrogate compensation typically exceeds Medicaid's income thresholds. This means surrogates generally need to transition off Medicaid before their compensation begins, and using Medicaid to cover a compensated surrogacy pregnancy can also create legal complications.
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.
If the cost of surrogacy feels out of reach, there are still paths forward. Many intended parents explore options such as:
In the U.S., surrogacy typically involves high out-of-pocket costs that may reach up to $250,000. 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.