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The Center for Fertility and Gynecology

Is IVF Covered by Insurance?

By Paula Hovell on October 22, 2021

fertility evaluationIn vitro fertilization, or IVF, is one of the most commonly performed fertility treatments. IVF’s popularity is largely due to its success and versatility. IVF assists throughout the stages of conception to address the most common causes of infertility. While IVF offers promising results, potential patients often have concerns about treatment costs.

IVF is a multi-stage procedure, so it is more costly than many other fertility techniques. The cost of treatment makes many question if IVF is covered by insurance. Fertility specialists at the Center for Fertility and Gynecology explore insurance coverage for their Los Angeles, Tarzana, and Bakersfield, CA, patients, so that they have a better idea of how much IVF will cost them out-of-pocket.

State Insurance Mandates

Insurance mandates are established on the state level. As of January 1, 1990, the state of California requires insurance and health care service plans to offer coverage of infertility treatment. However, the mandate falls short of specifying that IVF treatment must be covered. Instead, insurers and health care plan providers must offer coverage for “procedures consistent with established medical practices in the treatment of infertility by licensed physicians and surgeons.” Under these guidelines, covered services may include:

  • Fertility evaluation and diagnostic testing
  • Fertility medication
  • Surgical treatment

Understanding Your Insurance Benefits

Even though insurance providers are not required to offer coverage for IVF treatment, it doesn’t necessarily mean that they don’t. The specific benefits provided by insurers and employers are dependent on the type of plan each person has. Individuals in need of fertility treatment should carefully explore their benefits. 

Some insurers provide coverage for a single cycle of IVF treatment, while others may provide a specific amount of infertility coverage that can be used on any fertility services, until coverage runs out. Even if the IVF procedure itself is not covered, if insurance covers the cost of diagnostic testing and fertility medication, that can significantly decrease out-of-pocket expenses for patients. The financing team at the Center for Fertility and Gynecology works with patients to explain their insurance benefits and estimate out-of-pocket costs for IVF treatment.

Covering Out-of-Pocket Expenses

Infertility treatment insurance mandates are beneficial, but most patients who undergo IVF can expect to have some out-of-pocket expenses, especially if they require more than one cycle of treatment. For some, the costs of IVF can be overwhelming, but that shouldn’t deter them from looking into this potentially life-changing treatment.

Our fertility team works closely with patients to personalize IVF treatment based on the patient’s specific needs, including their budget. And people should understand that insurance is not the only option available to those looking to afford the costs of IVF. Some of the financing services that can make IVF more affordable for our patients include:

  • Flexible in-office payment options
  • Personal or medical loans
  • Credit plans
  • Fertility treatment grants

Contact Our Fertility Specialists

If you are struggling with infertility and would like to learn how fertility treatment can help, the fertility specialists at the Center for Fertility and Gynecology would be happy to provide you with more information about our services. To schedule a personal consultation, send us a message online, or call (818) 881-9800 at your earliest convenience.

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