Best Fertility Insurance Companies

Blue Cross Blue Shield companies are the best fertility insurance option

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Fertility insurance is a specialty benefit offered by employers or purchased through a private insurance company that covers the cost of fertility treatments like medications to stimulate sperm and egg production, and the procedures, both internally through natural insemination (IUI) or using surgical or external procedures to help facilitate pregnancy.

The best fertility insurance varies by carrier, but in general, employer and private health insurance companies can offer benefits that diagnose infertility, provide assisted reproductive technologies (ART) like in vitro fertilization (IVF), and even reproduction storage of sperm or eggs.

Best Fertility Insurance of 2021

Best Overall : Blue Cross Blue Shield


Blue Cross Blue Shield

Blue Cross Blue Shield

  • Policy Types:
  • Providers In-Network: 1.7 million
  • States Available: 50, plus D.C. and Puerto Rico
Why We Chose It

We selected Blue Cross Blue Shield, one of the largest health insurance providers in the U.S.m as best overall due to its network size, variety of benefits, and nationwide availability.  

Pros & Cons
Pros
  • Insures 1 in 3 Americans

  • Large provider network

  • Maximum infertility services based on state law

Cons
  • Fertility benefits limited by state law

  • Individual policies not available in all states

Overview

Blue Cross Blue Shield (BCBS) Association companies include Anthem, Wellmark, Highmark, and state-based BCBS in addition to other carriers under different names. Founded in 1929, the companies have evolved over the decades to serve up to 100 million members by the 2000s.

We chose BCBS due to the number of fertility insurance benefits, although you’ll need to check state laws regarding fertility insurance to see what is required and what services are covered. For example, the state of California requires group insurance companies to offer coverage for the treatment of infertility, except in vitro fertilization is excluded. In Texas, independent health insurance is required to offer coverage of IVF. Yet in both of these states, individual health insurance plans are not required to cover any fertility treatment by law.

Monthly insurance premium costs are determined by ZIP code, the medical deductible, coinsurance and copayment options, and the level of benefits an employer offers or what is selected if buying an individual plan. A 30-year-old woman living in Atlanta and buying her own unsubsidized health insurance plan would pay $332 per month for a Bronze plan with a $6,750 deductible. The maximum out-of-pocket is $8,550 for covered in-network services. However, Georgia doesn’t have laws pertaining to infertility, so the expense of IVR and other treatments would most likely be out-of-pocket 100% if not covered by a group plan with special concessions. 

In Little Rock, the same 30-year old woman would pay $305 a month for an $8,550 deductible plan. However,  IVR coverage is required with prior approval by both individual and group plans under Arkansas law. In most cases, deductible and coinsurance would be required before BCBS would start paying for any IVR treatment related to fertility. 

Because BCBS operates in all states as independent companies, the AM Best rating (which indicates a company’s ability to pay claims) may vary but overall the majority of BCBS companies have an “A” rating or better.

Best for IVF Coverage : UnitedHealthcare


UnitedHealthcare

UnitedHealthcare

  • Policy Types: 8
  • Providers In-network: 1.3 million
  • States Available: 50
Why We Chose It

UnitedHealthcare (UHC) is one of the largest health insurance carriers in the U.S., offering employer group, individual, short-term medical, and supplemental plans nationwide, and has a program in place to specifically cover a number of IVF procedures.

Pros & Cons
Pros
  • Infertility benefits for women up to age 44

  • Coverage for treatment of underlying cause of infertility

  • Some surrogate services covered

Cons
  • Preservation of eggs not covered unless mandated by state law

  • ART is not covered unless candidate qualifies

  • Stringent qualification rules for coverage

Overview

When employers have the option to add fertility services to their employee benefits package, they can offer anything from diagnosis to extensive treatment. If a state-mandated rule requires employer-group providers to offer IVR coverage, UHC has a program in place that can consist of ovulation induction (or controlled ovarian stimulation), insemination procedures, intrauterine insemination, and assisted reproductive technologies (ART) as needed.

UHC has a large national provider network for its fertility services. For example, in the state of Illinois, employers with more than 25 employees are required to provide diagnosis of infertility, IVF, uterine embryo lavage, embryo transfer, artificial insemination, and more. These highly specialized treatments require access to specialists, and in Illinois, employees can select from multiple UHC plan types to get the largest network (PPO, HMO), depending on the coverage their employer selected. 

However, the coverage depends on your state, so check with your employer or state laws to find out what options you have. 

For Affordable Care Act (ACA) individual insurance, UnitedHealthcare provides private health insurance coverage in seven states, but the cost and coverage may vary by state. For example, the state of Maryland requires both individual and group insurance (employers with 50 employees or more) to cover three IVR attempts per live birth. All treatment or fertility services outside of this law (like sperm storage) would go against the deductible or would be out-of-pocket. An unsubsidized ACA plan for a 30-year-old woman living in Baltimore starts at $214 per month for the average premium with a $5,900 deductible for an individual. 

States that require either individual plans or employers to cover IVR in some form include Arkansas, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, and New York. In Texas, insurers are required to offer IVF benefits but are not required to cover IVF. Benefits are subject to plan type (like a PPO plan) and population (size of employer).

AM Best ranks UnitedHealthcare with a financial strength rating of A (Excellent).

Best for Assisted Reproductive Technologies : Aetna


Aetna

Aetna

  • Policy Types: 3
  • Providers In-network: 1.2 million
  • States Available: 16
Why We Chose It

Aetna has demonstrated a commitment to the betterment of women’s health through its Institutes of Excellence Infertility Network which specializes in assisted reproductive technologies and offers proven alternative treatments. 

Pros & Cons
Pros
  • Personalized infertility network

  • CVS pharmacy network

  • Large coverage network

Cons
  • Only offers employer-group coverage

  • Not available in all states

Overview

Assisted reproductive technologies have a 30% higher multiple birth rate than births that are conceived naturally, and Aetna has reported to the CDC that its Institutes of Excellence clinics, compared to the national average, have higher live birth rates, lower numbers of embryos transferred, and lower rates of twins and triplets born.

Deductible options vary depending on employer-group benefits. Out-of-pocket responsibilities also vary, but for some plans, Aetna will cover 90% of select fertility insurance services after the deductible or 80% depending on employer coverage. Depending on state law, some employer-group benefits are required to provide up to three ART cycles per lifetime. 

States that require either individual plans or employers to cover ART treatment in some form include Arkansas, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, and New York. Benefits are subject to state law, plan type (like a PPO plan), and population (size of employer).

Aetna, a CVS Health company, offers programs and services that help control costs and improve health quality in addition to tools and resources to make better health care decisions. Coupled with the CVS pharmacy network, members get access to nearly 10,000 CVS pharmacies in over 40 states plus MinuteClinic locations.

Aetna has a financial strength rating of A (Excellent) by AM Best.

Best for Fertility Resources : Kaiser Permanente


Kaiser Permanente

Kaiser Permanente

  • Policy Types: 3
  • Providers in network: 875,000
  • States Available: 8 states and D.C.
Why We Chose It

Kaiser Permanente was selected for best fertility resources based on its online tools, apps to manage care, and its Centers for Reproductive Health in select states. 

Pros & Cons
Pros
  • Support apps for mental wellness

  • Specialized reproductive health centers

  • $0 deductible health plan options

Cons
  • Smaller provider network

  • Reproductive centers limited to California only

Overview

In some states, Kaiser Permanente members have coverage for IVF procedures if IVF is listed as a covered benefit in the Evidence of Coverage for the health plan. Effective January 1, 2020, certain fertility preservation services are also a covered benefit for some plans under California law.

The company’s Centers for Reproductive Health in the state of California offers IVF with options for genetic testing, use of donor eggs and sperm, and gestational surrogacy. Male infertility and fertility preservation services are also available. 

High deductible health plans do not exceed $8,550 for individual plans, and Kaiser also offers a $0 deductible plan with 20% coinsurance with a higher monthly amount. The $0 deductible plan includes certain benefits with set copays and other services that go towards the 20% coinsurance percentage. 

If you’re living in a state that requires IVR coverage, a $0 deductible could help with some out-of-pocket expenses. The maximum out-of-pocket for many private individual plans is $8,550 for in-network provider care, but this total might not apply to all fertility treatments. Always check the insurance policy to find out what isn’t covered.

With Kaiser Permanente, you’ll have access to additional insurance resources including free subscriptions to Calm and myStrength to help with sleep, anxiety and stress. Some plans also include free telehealth by phone, video, or email with 24/7 access to nurses for questions.

Kaiser Permanente is not rated by AM Best but is rated AA- by Fitch Ratings, one of the top three credit rating agencies for global international markets.

Best for Affordable Policies : Bright HealthCare


Bright HealthCare

Bright HealthCare

  • Policy Types: 3
  • Providers in network: 200,000+
  • States Available: 14
Why We Chose It

We chose Bright HealthCare for its low monthly premium pricing in the individual market,  its plan to offer additional resources through telehealth, and rewarding policyholders to track good health care behavior to earn up to $500 in rewards.

Pros & Cons
Pros
  • State-specific provider networks for lower costs

  • $0 primary care visit option

  • $0 deductible care option

  • Cash rewards program

Cons
  • Small provider network

  • Not ranked by AM Best

Overview

Bright HealthCare offers some of the lowest-priced individual health insurance in the states that it serves. One of the newer insurance carriers, Bright Health has acquired more than $1.5 billion in start-up dollars since launching in 2016. In 2021, the company acquired Zipnosis, a telehealth platform, to give members exclusive access to online medical services.

Bright HealthCare has built a care network of doctors and hospitals in each state it serves, and the company negotiates costs on the patient’s behalf for the lowest possible pricing on treatment. Knowing how much medical care is going to cost before a patient is serviced allows Bright HealthCare to determine its risk and in many cases, set health insurance rates at a lower price than its competitors. The company also gives members the opportunity to earn $500 in rewards during the year for tracking healthy habits. 

ACA coverage deductibles start at $8,550 and for higher-premium policies and have a $1,000 deductible option. Total out-of-pocket expenses for each calendar year range from $8,550 to $6,850. For example, in Denver, a 30-year-old woman could pay $234 for an $8,550 deductible Bronze plan, and a maximum of $346 for a Gold $1,000 deductible plan. In comparison, a competitor with an $8,550 deductible level would cost $240 more per year and another with a $1,000 deductible plan would cost $600 more every year. 

As one of the newest health insurance providers in the U.S., Bright HealthCare is not currently ranked by AM Best.

Final Verdict

Getting the most from a health insurance policy when facing expensive treatment can be daunting. Due to the expense, insurance carriers are not likely to cover fertility treatment unless mandated by state law. However, there are some options both through the ACA Marketplace and through employer-sponsored plans. 

We chose Blue Cross Blue Shield Association companies as the best fertility insurance overall because of its provider network and large nationwide coverage availability for both individual and employer group health plans. 

Compare the Best Fertility Insurance

Company Plans  Providers In-Network  Starting Deductible  States Available 
Blue Cross Blue Shield
Best Overall
7 1.7 million $8,550 50
United Healthcare
Best IVF Coverage 
1.3 million  $5,900  50 
Aetna
Best Assisted Reproductive Technologies 
1.2 million  N/A  16 
Kaiser Permanente
Best Fertility Resources 
875,000  $8,550  8 and D.C. 
Bright Health
Best for Affordable Policies 
200,000+  $8,550  14 

How to Choose the Best Fertility Insurance

Here are the most important factors and financial considerations when comparing the best fertility health insurance companies.

  • Deductible: The higher the medical deductible, the lower the monthly insurance premium. That can sound enticing, but if you have access to fertility insurance coverage, a more costly, lower deductible might be the better choice to help cover out-of-pocket expenses. 
  • Coinsurance: In addition to the deductible, some plans can have coinsurance. Coinsurance kicks in after you have met your deductible. If you have coinsurance, you then have to share a percentage of your medical costs with the insurance company. Coinsurance can range from 0%-50% depending on your plan. If the monthly cost is the most important priority, look at plans that have a higher coinsurance percentage to save on the policy premium. 
  • Copayments: Some health policies have copayments (copays) for doctor office visits. If you already have insurance with copays, check with your employer or contact the insurance company to determine if infertility appointments qualify for the “specialist” copay option. 
  • Prescription Drugs: Most health insurance plans have prescription drug coverage, but find out if your plan has a separate deductible before medications are covered. Some plans also have copays for prescriptions. Refer to the drug formulary issued by your insurance carrier to see if any fertility medications are covered with a copay.
  • Monthly Premium: The monthly cost for health insurance is called the “premium.” You are responsible for the premium each month to keep your health insurance active. When calculating your monthly budget, remember you are responsible for the monthly premium in addition to your deductible or your out-of-pocket maximum.
  • Out-of-Pocket Maximum: This is the total amount you are responsible for during the calendar year. Once you hit the maximum, the insurance company typically begins paying 100% for in-network services. This encourages in-network treatments. If you see an out-of-network provider, either willingly or accidentally, you are typically financially responsible for the entire cost of the service. 
  • State Availability: If you live in a state where there are mandated laws for fertility insurance and coverage, you are ahead of the game compared to other states that don’t force carriers to provide coverage. When shopping for fertility insurance, review the Summary of Benefits. You can also review the National Conference of State Legislatures website for more information. 

Frequently Asked Questions

How Much Do I Have to Pay Out-of-Pocket for Fertility Services? 

The total cost depends on the type of treatment, insurance coverage, and state laws. The average cost for an IVF cycle, including medications, consultations, and optional testing has surpassed $23,000, but pricing does vary by location. The average cost of an IVF cycle in Boston is around $20,000, while in L.A., IVF treatment can run nearly $26,000. Egg freezing will typically cost around $16,000. A second cycle brings the cost closer to $30,000.

Storage fees are extra. For simpler procedures like intrauterine insemination (IUI) that places sperm directly into the uterus, costs can average $300–$1,000. 

Can I Ask My Employer to Help Pay for Some of My Fertility Treatment? 

Your employer may be required to offer fertility coverage based on state law. In states like California, the employer is required to offer a fertility rider to the insurance policy, but they may not pay for the benefit unless requested by the employee. It’s always a good idea to check with your HR department to see what assistance they can provide. 

Is There a Limit to How Many Times I Can Try to Have a Baby Using Fertility Methods? 

There is a lifetime dollar amount maximum with most policies. Some plans have a $10,000 cap, while others will provide more than $30,000 in fertility coverage. In states like Maryland and Rhode Island, the law mandates a maximum of $100,000 coverage. 

Methodology

We analyzed a variety of health insurance companies to identify carriers that market employer-group and ACA-qualifying health plans that cover fertility health services. Next, we reviewed plan information including deductibles, services, and pricing. 

We also analyzed benefits schedules for policy details including exclusions. Other contributing factors to the review were state availability, financial strength ratings from credited financial institutions, provider network and online services, monthly premium pricing, and company-specific “extras” for infertility treatment.

Article Sources

  1. National Conference of State Legislatures. "State Laws Related to Insurance Coverage for Infertility Treatment." Accessed June 24, 2021. 

  2. Anthem. "Health Insurance Plans in Georgia." Accessed June 30, 2021. 

  3. AM Best. "AM Best Affirms Credit Ratings of CVS Health Corporation’s Aetna Subsidiaries." Accessed June 25, 2021. 

  4. Fitch Ratings. "Fitch Affirms Kaiser Permanente's (CA) 'AA-' IDR; Outlook Stable." Accessed June 16, 2021. 

  5. MedCityNews. "Bright Health acquires Zipnosis, enters telehealth market." Accessed June 27, 2021. 

  6. FertilityIQ. "Cost." Accessed June 30, 2021. 

  7. Planned Parenthood. "What is IUI?" Accessed June 30, 2021.