Does Health Insurance Cover Surrogacy?

Surrogacy is a beautiful journey and can be an insurance labyrinth. Insurance; one of the most misunderstood (and critical) elements.

As the CEO of ART Risk Solutions and having been a part of this community for 15 years, we have seen how the right insurance strategy can save families tens or even hundreds of thousands of dollars. Unfortunately, we have also seen the financial heartache caused by poor planning or a misunderstanding of different types of insurance. So, whether you are an intended parent, a professional, or a gestational carrier, this is your must-read guide to understanding how insurance can support and safeguard the journey.

How Insurance Might Help Offset Surrogacy Costs

Insurance won’t erase the cost of surrogacy, but it can dramatically reduce your exposure to unexpected expenses. The key is having a properly reviewed and structured plan.

Here is what insurance is most likely to cover … and what it won’t.

What’s Most Likely Covered Under the Surrogate’s Health Insurance

Once a gestational carrier (GC) is released from the fertility clinic (typically around 8–10 weeks), she transitions to standard OB/GYN care. If her health insurance doesn’t exclude surrogacy, the following is generally covered:

• Prenatal Care: OB visits, Ultrasounds and fetal monitoring, Prenatal labs, gestational diabetes testing, Cervical checks, NSTs in the third trimester
• Labor and Delivery: Vaginal or cesarean delivery, Hospital facility and provider charges, Anesthesia (e.g., epidural), Monitoring and labor management
• Postnatal Care: Postpartum OB visits (usually 1–2 within 6–8 weeks) and Treatment of complications (e.g., hemorrhage, infection)
• Complications of Pregnancy: preeclampsia, placenta previa or abruption, preterm labor and hospitalization, gestational diabetes and hyperemesis gravidarum, cerclage, bed rest, or other necessary interventions

Pro Tip: These services are billed under standard pregnancy codes. However, a surrogacy code (ICD-10 Z33.3) is often used as a secondary or tertiary code, which can trigger review by insurance carriers. This makes proactive planning and expert guidance essential.

What’s Not Typically Covered:

• Agency fees
• Escrow fees
• Mental health screenings
• Legal fees for contracts or parentage
• Embryo creation and IVF processes (check your policy—some IPs may have coverage)
• IVF medications or procedures
• Lost wages, childcare, or housekeeping for the surrogate

These gaps may be filled through specialty insurance products, and only if planned in advance.

Baby’s Coverage After Birth

Here’s where many IPs get caught off guard: the baby is not covered under the surrogate’s insurance. Coverage depends on where the IPs live:

If Intended Parents Are Domestic: their policy typically kicks in at birth and should provide coverage for the following: Nursery care, bilirubin checks, feeding support, Vaccinations (Hep B, Vitamin K), NICU services and, Birth-related complications (e.g., prematurity, infection)

If Intended Parents Are International: then a special newborn insurance is required. Procuring this coverage is crucial to avoid NICU bills that can exceed $250,000.

Why Early Insurance Review Is Crucial

Insurance planning should start before embryo transfer. Why?

• Policies can exclude surrogacy, especially self-funded employer plans.
• You should know what policies and services will support your journey before it begins
• It will create a timeline so that you have access to all available policies.  The longer you wait to address insurance, the less coverage options may be available.
• Without an expert guide, you could be relying on google, what your friend did, or what you saw posted in a group - there are no two journeys alike and what works for one - may not work for you. You and your journey are unique.

The Risks of Self-Funded Employer Plans

These policies look like traditional insurance, but they’re funded by the employer and governed by ERISA. That means:

• They often exclude surrogacy outright.
• They’re not subject to state regulations.
• They may require reimbursement (subrogation) from the surrogate or intended parents.

Pro Tip: Just because your surrogate has a health plan doesn’t mean you’re covered. Always get a professional policy review before finalizing your match.

Insurance Options if the Existing Plan Won’t Work

If a surrogate’s insurance excludes surrogacy or she has no coverage, here are the alternatives:

• Surrogacy-Specific Plans (Lloyd’s of London market)
• Short-Term Medical Plans (June–December)
• ACA Plans (available during Open Enrollment or with pregnancy as a qualifying life event in certain states like CO, CT, DC, KY, MD, ME, NJ, NY, RI, VA, VT, 2026 - IL)

Costs can range from $5,000–$30,000+, so understanding your options early makes all the difference.

Additional Insurance Options

Depending on your legal agreement, consider these coverage layers:

• Life Insurance – (Always required) - is available during the matching process
• Loss of Reproductive Organs Insurance – For surgical complications
• Complication Insurance – Covers adverse reactions during IVF
• Contingent Policies – Failsafe if the Primary medical plan changes
• Short-Term Disability – Covers lost wages or support services during medically necessary bed rest
• Miscarriage, Stillborn, and Infant Demise - In the event of this travesty, this insurance allows intended parents to recoup monies that have been spent - agency fees, legal fees, escrow fees, surrogacy compensation, insurance premiums.  This also includes (10) mental health sessions.

When to Start Planning for Insurance?

The moment you match with a surrogate. Here’s a simple timeline to guide you:

Pre-Match

• Have any existing policies reviewed by a surrogacy insurance expert
• Identify risks or exclusions before finalizing a match

At Match

• Explore current health insurance policy vs. Lloyds/ACA/short-term options
• Explore Life Insurance, Loss of Reproductive Organs, Lost Wages, and IVF Complications
• Build your timeline around enrollment periods and premium schedules
• Budget for coverage and backups

During Legal Clearance

• Keep discussion open and talk through chosen policies
• Finish discussing any additional insurances based on journey
• Finalize policies
• Confirm effective dates and payment responsibilities
• Document all insurance in legal contracts

Throughout Pregnancy

• Monitor coverage and manage claims
• ART Risk can handle this through our claims management services
• Avoid billing surprises and compliance issues by having a team advocate for you

What Working With a Specialized Insurance Brokerage Offers

At ART Risk Solutions, we have curated insurance strategies for over 25 years in the surrogacy space. We understand the complexities, the critical timing, the hidden risks and we know exactly how to navigate them.

Utilizing A Specialized Brokerage Means:

• Early risk detection – We analyze existing plans for exclusions, subrogation, and red flags
• Tailored strategy development – Your journey, your timeline, your budget
• Simplicity and clarity – From enrollment to documentation
• Proactive management – We handle billing timelines, premiums, and appeals
• Peace of mind – Our team advocates for you every step of the way

Final Thought

Insurance doesn’t eliminate the cost of surrogacy, it creates a foundation of security that allows you to move forward with confidence. With a thoughtful plan in place and a team who truly cares by your side, you can focus your energy where it belongs: building your family with peace of mind and a financially sound start.