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Insurance Coverage of Infertitlity Treatments

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The one thing the majority of these procedures have in common is that they are quite expensive. The average cost of an IVF cycle in the United States is $12,400.26 Using a surrogate may cost around $60,000; eggs can go for anywhere from $2,500 to $50,000 or even $100,000; and screening embryos for genetic traits adds approximately $3,500 to the price of assisted reproduction. For most people then, having health insurance coverage of some or all infertility treatments may make the difference between accessing those services or not.

This section will cover two areas of the law: state statutes that require health plans to cover or offer infertility services and court cases that determine whether federal antidiscrimination laws  are violated by employer health plans that do not cover infertility treatments.

Embedded in the statutory requirements are judgments on who qualifies as “deserving” of coverage, which reasons for excluding coverage are deemed legitimate, and what types of treatments are considered valid. In the court cases, judges have tried to answer whether infertility is a disability, whether lack of coverage for infertility treatments that only women can use constitutes sex discrimination, and whether discrimination against the infertile is pregnancy discrimination.

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