Does Insurance Cover Surrogacy? What You Need to Know

The question "Does insurance cover surrogacy?" isn't straightforward. When I started helping families with surrogacy in 2019, I naively thought insurance companies would have clear policies. They don't.

What I've learned from supporting over 250 families is that insurance for surrogacy is a minefield. Your standard health policy probably won't touch surrogacy arrangements. Your surrogate's personal insurance might exclude pregnancy for someone else. And specialist surrogacy policies? They exist but come with eye-watering premiums.

This matters because surrogacy isn't cheap to begin with. Without proper insurance coverage, you might face unexpected costs that blow your budget apart. I've seen intended parents remortgage homes or take second jobs just to cover medical bills they never saw coming.

Let's cut through the confusion and look at what you really need to know about insurance and surrogacy before you start this journey.

What Types of Insurance May Cover Surrogacy?

When I first explain insurance options to my clients, I often see the same look of confusion. The truth is that surrogacy insurance isn't just one thing - it's several different types of coverage that work together (or sometimes don't).

Health Insurance

Your surrogate's personal health insurance is the first place to look, but don't get your hopes up. I worked with a couple from Manchester last year whose surrogate had excellent private health coverage. They thought they were sorted until we read the fine print: "pregnancy services for third parties specifically excluded." This exclusion is common.

Some private health policies will cover a surrogate pregnancy, but most have caught on to surrogacy arrangements and added specific exclusions. If your surrogate's policy does cover the pregnancy, consider yourself lucky - but verify this with the insurance company directly, not just with your surrogate. Ask specifically about surrogacy, not just pregnancy coverage.

Employer-sponsored insurance sometimes offers better options. Large companies with self-funded plans might provide coverage that commercial insurers won't. I've had several clients whose surrogates worked for progressive tech companies or universities with inclusive policies.

Government insurance like the NHS in the UK will cover basic prenatal care for the surrogate as a patient, but won't recognize the surrogacy arrangement itself. In the US, Medicaid generally excludes coverage if the pregnancy is for someone else.

Surrogate-Specific Policies

This is where surrogate insurance comes in. These specialized policies are designed specifically for surrogacy arrangements and typically cover:

• Pregnancy complications

• C-section if needed

• Hospital stays

• Newborn care until discharge

These policies aren't cheap - expect to pay £15,000-£30,000 depending on coverage limits. But compared to paying out-of-pocket for complications (which can easily reach six figures), they're often worth considering.

Fertility Insurance

Separate from the pregnancy itself, fertility treatments like IVF might have some coverage under specialized fertility insurance. These policies sometimes cover:

• Egg retrieval

• Sperm collection

• Embryo Grading

• Embryo transfer procedures

The coverage varies dramatically based on your location. Some European countries provide partial coverage through national health systems, while in the US it's almost entirely dependent on your private insurance policy.

Does Insurance Cover Surrogacy and the Surrogate Mother's Medical Costs? A Global Overview

The question of whether insurance covers a surrogate's medical costs reminds me of a patchwork quilt – it looks different depending on where you stand and which corner you're examining.

Last year, I worked with a surrogate in California who had excellent insurance through her employer. Her policy covered the entire pregnancy without issue, saving the intended parents nearly $50,000 in medical expenses. Just two months later, I helped another family in Arizona whose surrogate had seemingly similar coverage, but their insurer denied every claim once they learned it was a surrogate pregnancy.

Common Exclusions to Watch For

Most insurers who do exclude surrogacy pregnancies use specific language. Look for terms like:

• "Pregnancy services when acting as a gestational carrier"

• "Maternity services when the insured is serving as a surrogate"

• "Pregnancy for the benefit of another"

These phrases are red flags that the policy won't cover your surrogate's medical costs. And don't assume an absence of these exclusions means you're covered – some insurers deny claims even without specific exclusions by arguing the pregnancy isn't for "medically necessary" treatment of the insured person.

International Variations in Coverage

Surrogacy in the USA offers the most developed insurance market for surrogacy, but it's still complex. Some states like California and Illinois have more surrogate-friendly insurance environments, while others like New York have only recently legalized gestational surrogacy and their insurance market is catching up.

The average cost of surrogacy in the US ranges from $100,000 to $150,000, with insurance playing a major role in that variation. When a surrogate's insurance covers the pregnancy, costs stay on the lower end. Without insurance coverage, medical expenses can push total costs to the higher range or beyond.

Surrogacy in the UK operates under different rules. The NHS provides basic care for pregnant women regardless of surrogacy status, but this doesn't cover IVF or other fertility treatments for intended parents. Surrogacy arrangements themselves aren't covered, and commercial surrogacy is prohibited, meaning surrogate fees are limited to "reasonable expenses."

Surrogacy in Mexico has become popular partly due to lower costs, but insurance coverage there is minimal. Most clinics require payment upfront for all medical services, and intended parents typically purchase short-term international medical insurance for their surrogate. This approach generally costs less than US surrogacy, but offers fewer protections if complications arise.

In Eastern European countries, the story changes again. Some clinics offer packages with basic medical coverage included, but these rarely cover serious complications. I always advise clients considering these destinations to budget for additional insurance or emergency medical funds.

The takeaway? No matter where you pursue surrogacy, never assume insurance will cover the medical costs. Verify coverage directly with the insurer, get everything in writing, and have backup funds available for unexpected medical situations. The pros and cons of surrogacy often hinge on these financial considerations, which vary dramatically by location.

What About Fertility Treatments and Surrogacy?

"But I have fertility coverage on my insurance!" a client from Bristol told me recently. She was disappointed to learn that her policy covered her own IVF treatments but wouldn't pay a penny toward the same procedures when used for surrogacy.

This disconnect between fertility treatment coverage and surrogacy coverage frustrates many intended parents. Let me break down what I've seen across hundreds of cases:

Fertility Treatment Coverage Reality

Fertility coverage, when it exists at all, typically focuses on treating infertility in the policyholder. This means your insurance might cover:

• Diagnostic testing to determine infertility causes

• Medication to stimulate egg production

• Egg retrieval procedures

• Sperm analysis and preparation

• Embryo creation and embryo grading

• Embryo transfer – but only to the policyholder's uterus

The moment you introduce a surrogate, most fertility policies hit a wall. The insurance company often views this as elective rather than medically necessary, even when surrogacy is your only option for having a genetic child.

I worked with one couple from Manchester whose insurance covered six rounds of IVF when the wife was the recipient. When they needed a surrogate after her cancer treatment, the same insurance wouldn't cover a single procedure.

Exceptions Worth Exploring

Some employer-provided insurance plans, especially from large international companies or progressive tech firms, have begun including surrogacy benefits. These rare policies might cover:

• IVF procedures specifically for surrogacy

• Medications for the egg provider and sometimes the surrogate

• Embryo transfer to a surrogate

These policies remain the exception rather than the rule. If you work for a large company, it's worth asking HR directly about surrogacy benefits – they may exist but aren't advertised widely.

Regional Variations in Fertility Coverage

Fertility coverage for surrogacy varies dramatically by location:

• In parts of Australia, some IVF procedures receive partial government funding, but this stops when surrogacy enters the picture.

• In Canada, provincial health plans cover some fertility diagnostics but rarely cover IVF for surrogacy.

• Some European countries with national health services cover fertility treatments up to a point, but exclude surrogacy-related procedures.

When Fertility and Surrogate Insurance Work Together

The best-case scenario I've seen is when fertility coverage handles the embryo creation process, and separate surrogate insurance covers the pregnancy. This combination can significantly reduce out-of-pocket costs.

Insurance for the Intended Parents

While much of the insurance conversation focuses on the surrogate, intended parents need protection too.

Medical Insurance Considerations

As an intended parent, you need to consider several insurance angles:

• Travel insurance for international surrogacy journeys that explicitly covers surrogacy-related travel

• Health insurance for yourself that doesn't exclude surrogacy-related consultations and treatments

• Insurance for the newborn from the moment of birth until you return home

That last point catches many parents off guard. In most countries, the newborn needs medical coverage from birth, even before legal parentage is established. Regular infant policies often won't apply because of the surrogacy arrangement.

Legal Insurance Protection

Beyond medical concerns, intended parents should consider:

• Legal expense insurance that covers parentage proceedings

• Insurance for potential disputes with surrogates or agencies

• Coverage for additional legal costs if international custody issues arise

These specialized policies aren't widely advertised but exist through brokers who work specifically with surrogacy options. They typically cost £2,000-£5,000 but can save tens of thousands if legal complications develop.

Psychological Support Coverage

Mental health support during surrogacy is valuable yet often overlooked. Some comprehensive international health policies will cover:

• Counseling sessions for intended parents

• Family therapy during transition periods

• Support for managing relationships with surrogates

Travel and Accommodation Coverage

For international surrogacy, consider insurance that covers:

• Extended stays abroad if the birth happens earlier or later than expected

• Emergency accommodation changes

• Flight cancellations or changes related to the surrogacy timeline

I advise all my clients to be explicit with insurance providers about the purpose of travel. Saving a few pounds on premiums by obscuring the surrogacy connection can lead to denied claims when you need coverage most.

What to Do If Insurance Doesn't Cover Surrogacy?

Most families I work with face significant costs that insurance won't cover. When a couple from Leeds discovered their surrogate's insurance excluded surrogacy pregnancies, they needed to find an extra £30,000 quickly.

Financial Alternatives Worth Considering

If you're facing insurance gaps, here are practical options that have worked for my clients:

1. Personal Funding Sources

• Home equity loans (better interest rates than personal loans)

• Retirement funds (some allow penalty-free withdrawals for medical expenses)

• Family loans (with formal agreements to protect relationships)

A couple from Glasgow created a "surrogacy sabbatical" plan, working extra hours and saving aggressively for three years before starting their journey.

2. Surrogacy Grants and Financial Aid

• Men Having Babies (grants for gay men)

• The Baby Quest Foundation (assistance for various fertility treatments)

• Religious organizations (some provide family-building support)

Competition is fierce, but I've had three clients receive partial funding for specific aspects of their journey.

3. Medical Tourism for Affordable Surrogacy

• Eastern European countries (40-60% of UK/US costs)

• Latin American destinations like Mexico and Colombia

• Asian countries with comprehensive packages

Lower costs sometimes mean different standards and fewer protections. Always research thoroughly and speak with previous parents.

Working With Specialized Professionals

• Financial advisors with fertility experience can structure payment plans

• Legal experts sometimes successfully challenge insurance denials

• Independent consultants can help maximize potential coverage

The average cost of surrogacy without insurance coverage ranges from £60,000 to £150,000. Rather than hoping for insurance coverage, I advise clients to assume minimal coverage in their budget and consider any insurance payments as unexpected bonuses.

As one client told me: "We planned for the worst financially but hoped for the best. When some costs were covered by insurance, it felt like finding money we didn't know we had."