Can You Buy Fertility Insurance?

Stand-alone fertility insurance is more widely offered alongside an employer’s group health insurance, and these plans aren't sold to individuals. But in some states, you can choose insurance with fertility services through the Health Insurance Marketplace. For some people, the best option might be buying a Marketplace health insurance policy with better fertility treatment coverage on top of employer coverage.

Does Insurance Help with Fertility?

Some private insurance plans cover diagnostic services regarding infertility but rarely pay for more expensive fertility treatments. In 2024, 21 states and Washington, D.C., have laws requiring some coverage for forms of fertility services in some circumstances. For example, the insurer must be based in the state to be required to offer coverage. States with fertility coverage laws are Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas, Utah, and West Virginia. Contact your plan administrator to determine if your private insurance covers fertility services.

Is Fertility Insurance Expensive?

Fertility treatments are expensive, but more regular health insurance plans are starting to cover treatments. In all, 21 states mandate that some fertility treatments be covered, and more states are moving to legislate fertility coverage. A more expensive policy may help cover fertility treatments if you live in a state without these mandates. Costs vary significantly. But it's typically less expensive than paying for fertility treatments out-of-pocket because just one IVF cycle costs an average of $12,000. Many people who don’t have coverage take out an IVF loan to cover the costs.

Why Is Fertility Treatment Not Covered by Insurance?

Fertility treatments are costly and typically don't fall into the "medically necessary" category. Your health and life aren't endangered if you don't receive the treatment. This mandatory versus non-mandatory guideline is observed by many health insurance companies, so they obligate you to pay for a secondary policy or additional provisions to cover some or most of these costs.

Which State Has the Best Fertility Insurance Coverage?

According to the National Infertility Association, the following states have laws requiring both IVF and fertility preservation coverage: Connecticut, Colorado, Delaware, Illinois, Maryland, Maine, New Hampshire, New Jersey, New York, Rhode Island, and Utah, plus Washington, D.C. You’ll find the most comprehensive coverage from ACA plans in these states.

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The Best Fertility Insurance for 2024

Blue Cross Blue Shield is the best overall fertility insurance

Lindsay Frankel

Updated August 30, 2024

Reviewed by Eric Estevez

Fact checked by

Betsy Petrick

In looking for the best fertility insurance, we found that Blue Cross Blue Shield generally offers the most coverage at the lowest price in many states. Kaiser Permanente has top customer satisfaction ratings and, in some states, coverage includes fertility facilities. And UnitedHealthcare offers access to an extensive provider network and certain plans provide fertility nurses for one-on-one consults.

Coverage for fertility treatment may be available through your employer-sponsored plan, particularly if you are working for a larger employer. Some states' Affordable Care Act (ACA) plans may also offer limited infertility coverage, as 21 states and the District of Columbia mandate some sort of infertility coverage. However, this coverage can vary widely based on state. The mandate may only apply to some insurers, only cover some treatments, only cover certain patients, or come with cost limitations.

Fertility coverage varies by state, employer, and plan, so it’s important to evaluate your individual options. That said, we evaluated our list of the best major health insurance providers to find companies that offered fertility insurance and stood out for their third-party ratings, provider networks, covered services, out-of-pocket costs, additional resources, and more.

We used National Committee for Quality Assurance (NCQA) annual ratings to evaluate plan quality and customer satisfaction. The NCQA is a private nonprofit organization that evaluates health plans for patient care quality, patient satisfaction, and health plans' efforts to improve.

Here are our top picks.

The Best Fertility Insurance for 2024

Best Value: Blue Cross Blue Shield
Best for Customer Satisfaction: Kaiser Permanente
Best for Wide Acceptance: UnitedHealthcare

Best Value : Blue Cross Blue Shield

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Why We Chose It

Blue Cross Blue Shield’s ACA plans have the best average cost scores of the insurers we reviewed when considering premiums, deductibles, and copays.

Overview

We found Blue Cross Blue Shield companies to offer the best pricing. The company was our top pick for the best affordable health insurance companies. The insurer maintains a nationwide list of Blue Distinction Centers for Fertility Care providers, which must meet BCBS standards for quality, cost, and access.

Plans in some states include robust coverage for a range of diagnostic services and treatments, including IVF and embryo transfer. For example, some Illinois ACA policies cover up to four cycles per year plus donor medical expenses.

In some states, group BCBS plans have partnered with the app Ovia, which offers fertility tracking and pregnancy tools.

BCBS companies offer plans nationwide, but not all plans offer fertility coverage. Make sure to evaluate your employer’s plan or state ACA plan carefully since coverage varies. For example, in 2024, federal government employee plans may come with additional fertility benefits and low physician copays for IVF visits without a deductible.

BCBS companies other than Anthem have an average 3.6-star NCQA rating. J.D. Power rankings vary widely by company and region.

Best for Customer Satisfaction : Kaiser Permanente

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Why We Chose It

Kaiser Permanente has the highest NCQA rating, a measure of quality and customer satisfaction, of the major health insurance providers we reviewed. It also was the top-ranked company by J.D. Power in most regions where it offers coverage.

Overview

Of the ACA plans we reviewed, we found that Kaiser Permanente offers relatively low out-of-pocket costs for infertility treatment. Coinsurance of 20% or 30% or a flat office copay was standard across metal tiers, with low copays for physician consultations.

Some group and ACA plans also offer coverage for infertility drugs. In addition, Kaiser Permanente provides the lowest average premiums of the providers we reviewed, making it one of our top picks for affordable health insurance.

While Kaiser Permanente plans are only available in eight states and the District of Columbia, many states are well-populated. In those states, you may find your Kaiser benefits include specialized in-network Kaiser fertility services, such as California’s Kaiser Permanente Centers for Reproductive Health. Services offered include IVF, gestational surrogacy, male fertility, and fertility preservation. Your benefits will vary by Kaiser plan.

Kaiser Permanente was our top pick for the best quality plans on our list of the best health insurance companies. That’s because the insurer is highly ranked in all regions by J.D. Power and has a stellar 4.2-star NCQA rating—the highest of the major insurance providers.

Best for Wide Acceptance : UnitedHealthcare

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Why We Chose It

With ACA plans available in 22 states, UnitedHealthcare offers a large network of more than 1.3 million healthcare providers, including dozens of Fertility Solutions Centers of Excellence providers. While you’ll need to check that the fertility clinic of your choice takes the plan you choose, we found that large fertility clinics in several states accept multiple plans (HMO, PPO, POS) from UnitedHealthcare and plans from affiliates.

Overview

With UnitedHealthcare, ACA plans in some states cover a wide array of services, from in vitro fertilization to artificial insemination, and may cover up to six cycles of egg retrievals. Injectable medications may also be covered in some workplace plans.

In the plans we reviewed from UnitedHealthcare, your out-of-pocket costs for infertility treatment could range from 40% to 50%.

You can get one-on-one contact with trained fertility nurses if your insurance includes UnitedHealthcare’s Fertility Solutions program. These nurses connect you with treatment options, including Centers of Excellence fertility centers and providers. These centers follow evidence-based practices and meet critical measures, including high pregnancy rates.

The nurses also provide information and emotional support, in addition to helping you weigh fertility solutions.

In general, we found costs for UnitedHealthcare’s 2024 ACA health care plans were about average for the nine providers we researched. When it comes to quality and customer satisfaction, third-party ratings tell a mixed story. UHC has a relatively strong rating of 3.5 stars out of 5 from the National Committee for Quality Assurance (NCQA), but the company’s ratings in the 2024 J.D. Power U.S. Commercial Member Health Plan Study vary by region.

The Bottom Line

For great value, robust coverage, and additional resources, consider your local Blue Cross Blue Shield company—but evaluate the plans offered in your area before choosing. Kaiser Permanente may be a good fit if you value excellent customer satisfaction and the company offers plans in your state. And UnitedHealthcare is widely accepted, but out-of-pocket costs may be high.

Other Fertility Insurance Options

Some other notable health insurance companies may cover infertility treatment, either through employer-sponsored plans or through plans on the Marketplace in states with infertility coverage mandates. Treatments such as IVF can be quite costly and might require multiple rounds of treatments.

Aetna: Some company plans with Aetna fertility benefits offer an infertility support program. In addition, Aetna maintains the National Infertility Unit (NIU), which answers members’ infertility care and coverage questions and authorizes treatments such as IVF and genetic testing.
Cigna: Some employer plans may cover medically necessary infertility drugs and other treatments.

In addition, some employers work with benefit providers specializing in fertility insurance. You’ll only have access to these companies through your job:

Progyny: Offers a large network of providers and specialists and a dedicated Patient Care Advocate
Maven: Offers access to virtual coaching and other resources for members
Carrot: Supplements other health insurance plans with customized coverage and offers access to the Carrot card to pay for services

Compare the Best Fertility Insurance Providers

Insurer	State Availability	Average NCQA Rating	Other Features
UnitedHealthcare	22 states	3.5	Large provider network
Kaiser Permanente	8 states + D.C.	4.2	Low premiums
Blue Cross Blue Shield	Nationwide	3.6	Access to free digital tools with some plans

How to Choose the Best Fertility Insurance

In some cases, you can choose between several group medical plan options your employer offers, or select an ACA plan if your employer’s coverage is inadequate. Here are some of the things you should consider.

Treatments Offered

Coverage is one of the most important factors to look for. Lisa Becht, MD, a board-certified reproductive endocrinologist at HRC Fertility, said that when considering IVF, get as much information as you can.

“Find out exactly what is covered,” said Dr. Becht. “Beyond IVF, does it include testing, medications, ICSI, genetic testing, and storage? Do you need to meet certain criteria, including lab values, age, and previous treatments?”

You may be able to find this information in the plan details or by calling the insurer directly.

Providers in Network

Check whether your area’s fertility centers accept the insurance you’re considering, and ensure all associated facilities are in-network. “Often, the surgery center where you get your egg retrieval and procedures may still be out of network,” Dr. Becht said.

Rounds Covered

Be sure to check for limitations on rounds or attempts at a procedure.

“Some insurance will cover multiple cycles, but various restrictions could exist. For example, some insurance companies will not allow you to do another cycle if you have a usable embryo, even if it would be more favorable to the patient to bank more embryos upfront,” said Dr. Becht.

Copays, Limits, and Deductibles

Understand that you’ll likely need to meet a deductible before your fertility coverage kicks in. Evaluate copays and coinsurance for fertility care so you understand your out-of-pocket costs. Workplace plans may also have dollar limits to how much they’ll cover.

Frequently Asked Questions

Can You Buy Fertility Insurance?

Stand-alone fertility insurance is more widely offered alongside an employer’s group health insurance, and these plans aren't sold to individuals. But in some states, you can choose insurance with fertility services through the Health Insurance Marketplace. For some people, the best option might be buying a Marketplace health insurance policy with better fertility treatment coverage on top of employer coverage.
Does Insurance Help with Fertility?

Some private insurance plans cover diagnostic services regarding infertility but rarely pay for more expensive fertility treatments. In 2024, 21 states and Washington, D.C., have laws requiring some coverage for forms of fertility services in some circumstances. For example, the insurer must be based in the state to be required to offer coverage. States with fertility coverage laws are Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas, Utah, and West Virginia. Contact your plan administrator to determine if your private insurance covers fertility services.
Is Fertility Insurance Expensive?

Fertility treatments are expensive, but more regular health insurance plans are starting to cover treatments. In all, 21 states mandate that some fertility treatments be covered, and more states are moving to legislate fertility coverage. A more expensive policy may help cover fertility treatments if you live in a state without these mandates. Costs vary significantly. But it's typically less expensive than paying for fertility treatments out-of-pocket because just one IVF cycle costs an average of $12,000. Many people who don’t have coverage take out an IVF loan to cover the costs.
Why Is Fertility Treatment Not Covered by Insurance?

Fertility treatments are costly and typically don't fall into the "medically necessary" category. Your health and life aren't endangered if you don't receive the treatment. This mandatory versus non-mandatory guideline is observed by many health insurance companies, so they obligate you to pay for a secondary policy or additional provisions to cover some or most of these costs.
Which State Has the Best Fertility Insurance Coverage?

According to the National Infertility Association, the following states have laws requiring both IVF and fertility preservation coverage: Connecticut, Colorado, Delaware, Illinois, Maryland, Maine, New Hampshire, New Jersey, New York, Rhode Island, and Utah, plus Washington, D.C. You’ll find the most comprehensive coverage from ACA plans in these states.

How We Chose the Best Fertility Insurance Companies

To create our list of the best fertility insurance companies, we focused on providers that offer fertility insurance and are on our list of the best health insurance companies.

In choosing which health insurance companies to review for that list, we analyzed business and market insight databases, considered health insurance company market share, and researched user-generated data from Google to determine public interest and trends in health insurance companies and plans.

We collected data from the National Committee for Quality Assurance (NCQA), an independent organization that rates health care plans on quality and patient satisfaction. We also gathered data from state and federal government insurance marketplace websites and databases, and directly from companies via websites, media contacts, and existing partnerships. The data collection process took place between Sept. 29 and Oct. 23, 2023.

We then developed a quantitative model that scores each health insurance provider based on 27 criteria that fall into four major categories and are crucial in evaluating the company’s offerings and benefits. We weighted the four categories as follows for this article:

Plan Quality & Customer Satisfaction: 20%
Plan Features: 40%
Cost: 25%
Availability: 15%

Thoughtful mother looks out the window as she holds her newborn baby — McKinsey Jordan / Stocksy

Article Sources

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KFF. "Coverage and Use of Fertility Services in the U.S."
National Committee for Quality Assurance. "Report Cards/Health Plans."
National Committee for Quality Assurance. “Blue Cross Blue Shield.”
J.D. Power.“Customer Experience Chasm Grows between Highest- and Worst-Performing Health Plans, J.D. Power Finds.”
National Committee for Quality Assurance. “Kaiser Permanente.”
National Committee for Quality Assurance. “United Healthcare.”
Pasquale Patrizio, David F. Albertini, Norbert Gleicher, and Arthur Caplan. "The Changing World of IVF: The Pros and Cons of New Business Models Offering Assisted Reproductive Technologies." J Assist Reprod Genet. 2022 Feb.