When you hear the words “health insurance,” do you immediately feel stressed out? Health insurance is rarely anyone’s favorite topic, but when it comes to your surrogacy journey, understanding your options is absolutely essential.
We’re here to break down the specifics of what kind of insurance you need, what it may cost, and how to go about getting it.
What is surrogacy medical insurance and why do you need it?
Pregnancy is uncertain and Intended Parents bear the responsibility of medical costs for their surrogate. From the routine, such as ultrasounds and prenatal appointments, to the unexpected, such as c-sections or hospital stays, costs add up quickly. An insurance policy can provide financial protection for both routine and unexpected healthcare needs of a surrogate.
Surrogacy medical insurance options
Affordable Care Act (ACA)
In most cases, you can only purchase an ACA policy during Open Enrollment, which ends on December 15th. When gauging the maximum budget for your surrogate’s medical cost, the most important elements for Intended Parents are the premium and the out-of-pocket maximum: the premium is the monthly fee you would pay from the beginning of the year until three months post-birth (or up to six months if your surrogate experiences complications). Premiums can range from $350 to $600 a month, depending on a number of factors.
The out-of-pocket maximum is the maximum dollar amount the insurance company can require you to pay in a year; out-of-pocket maximums are typically from $4,000 to $8,000. For example, if your premium is $500 over the course of a two-month preparation for transfer, a nine-month pregnancy, and a three-month recovery, and the out of pocket maximum is $6,000, then you would budget for approximately $13,000.
It’s worth noting that there are no ACA policies specifically designed to cover a surrogate’s medical expenses; instead, you’re purchasing a comprehensive health insurance plan that happens to not have an exclusion to maternity benefits while acting as a surrogate.
Private medical insurance
Outside of Open Enrollment, there are two common private insurance solutions for a surrogate’s medical expenses. These are insurance policies that specifically designed for Intended Parents who need to purchase a policy for their surrogate’s pregnancy and delivery.
- Universal Family Insurance: Underwritten by Lloyd’s of London, they charge around $2,500 to $3,000 upfront to enroll. Depending on whether your surrogate is carrying multiples, they charge an additional flat fee of $23,000 or $40,000. This policy is very expensive, but it offers the significant benefit of not having a network; the surrogate can use virtually any healthcare provider.
- PregnancyCare: Underwritten by AXA Insurance Company, they charge a flat monthly rate of $1,150 if you enroll prior to an embryo transfer with your surrogate. They cover 100% for in-network providers and 80% for out-of-network providers, and they work with all 50 states. This plan can get costly when a second or a third transfer is needed, or when intended parents need time to create more embryos, due to its high premium.
Note: These pricings are an estimate and reflect 2018 to 2019 data.
The majority of Intended Parents purchase insurance for their surrogacy journey. However, a few choose to settle medical expenses by paying cash. This route is not without its risks. But, Intended Parents may save money because hospitals are frequently willing to negotiate medical bills for patients paying with cash. If you are thinking about going to the “cash pay” route, please note we strongly advise you to purchase a back-up plan. This is for catastrophic or unforeseen circumstances. Two commonly used back-up plans are through Universal Family Insurance and Brown & Brown.
Surrogate’s own insurance
Some surrogates may already have insurance through their or their spouse’s employer. In some cases, this may cover surrogacy costs and doesn’t have a lien against the Intended Parents. This is typically the best scenario since the intended parents don’t need to pay premiums. Instead, you pay the co-pay, the deductible, and any portion not covered under the insurance.
However, there are two points to keep in mind:
- Surrogates with own surrogacy-friendly insurance are hard to come by and they often request a higher compensation.
- Even if the insurance policy itself covers surrogacy, an employer may still refuse to pay out the medical bills. Some insurance professionals would advise you to purchase a back-up plan just in case.
Still have questions about surrogacy insurance? You’re not alone. If you choose to work with Love & Kindness, know that we work closely with insurance brokers. Brokers to help you select the best insurance option for your surrogacy journey.
If you are an Intended Parent and have embryos ready to go, don’t miss out on Open Enrollment this year. Meet them on our Available Surrogates page to start your journey to your family today.