5 Things You Should Know About Surrogacy and Medical Insurance

Many Intended Parents are surprised to learn that the insurance options for their surrogate are much more complicated than they anticipated. Let’s face it, insurance can be boring, hard to understand and frustrating.

It is, however, a crucial step that must be taken in order to protect the surrogate’s health and your financial exposure. While preparing for the cycle, it is important for your surrogacy agency’s insurance professional to perform a comprehensive insurance benefits analysis and look at the different options available for your particular situation.

If you are just getting started on your surrogacy journey, whether as a surrogate or Intended Parent, here are the answers to commonly asked questions about medical coverage during a surrogacy cycle.

What types of ACA surrogacy insurance are available or required?

Technically, none! There are no ACA medical plans that are specifically designed to cover a woman for surrogacy. She will need to have a medical insurance plan that does not have an exclusion for her using the maternity benefit of the policy while acting as a surrogate.

Can my surrogate just use her own insurance plan?

It may be possible.  Only careful evaluation of your surrogate’s personal policy by a qualified insurance specialist with knowledge of the fertility industry can determine whether your surrogate’s personal policy is suitable for use for a surrogate maternity cycle.  There are many variables to consider and pay attention to throughout a surrogate journey. It is important to work with someone who understands the challenges, changes, special qualifications requirements as well as the timeline of enrollment requirements.  Self funded, vs. fully funded policies, Employer Open Enrollment, or loss of employment are a few variables that may affect your cycle.

What types of insurance plans are available for my surrogate to use?

There are two solid options available for your surrogate’s maternity care. The first is a traditional medical insurance plan, usually purchased under the Affordable Care Act (ACA) and based on the zip code where the surrogate lives.

The second option is a Surrogate Maternity Contractual Liability Insurance plan. This plan is underwritten by Lloyd’s of London and is not a medical insurance plan. Instead, it only covers the Intended Parents’ contractual obligation to pay for the surrogate’s medical expenses. It functions similar to a traditional medical plan.

How much does medical insurance for a surrogate cost?

Medical insurance costs for a surrogate can vary dramatically! A traditional plan under the Affordable Care Act can run between $11,000 and $13,000, and out-of-network costs push the price even higher.

Costs will be a bit higher if a Surrogate Maternity Liability Insurance plan is purchased and used as the primary coverage. Only surrogates carrying a singleton or twin pregnancy are eligible for this type of plan; it is not available for a triplet or higher order multiple pregnancy.

Average costs for this type of plan range from $25,500 to $28,350 for women carrying a singleton pregnancy, and $42,500 to $43,350 for women carrying a twin pregnancy.

What about open enrollment?

The month for Employer plan Open Enrollment may vary based on the employer. The national Open enrollment for an Affordable Care Act (ACA) plans takes place once per year beginning on November 1st and ending on December 15th; few states allow an extension of this enrollment timeline until January 15th.  Unless there is a qualifying event, such as a job change, this open enrollment period is the only time your surrogate can sign up for a new health insurance plan. While it is definitely important to take your time in finding the right surrogate, it is necessary to keep this timeframe in mind, as you may need to wait to cycle until she can secure a plan under the ACA.

Who is covered under a surrogate’s medical policy?

Only your surrogate is covered by her medical policy. Your child is covered In Utero only. Your child once born, is not a dependent of the surrogate and will not be covered by her medical plan.  In addition, any expenses related to the IVF cycle are not covered under this plan.

If a Surrogate Maternity Liability Insurance policy is used, only the medical expenses related to the surrogate pregnancy can be processed through the plan. It cannot be used for other medical expenses unrelated to the pregnancy; it does not cover any costs related to the IVF cycle.

What about the baby?

It is also important to realize that only the surrogate and her pregnancy are covered under this plan. It will not cover the baby after birth. You’ll want to make sure that you notify your personal health insurance company to inform them of the coming birth. They will let you know what you need to do to have the baby covered at birth.

Will surrogacy insurance cover payments to the surrogate?

Nope! Medical insurance (including the Lloyd’s policy) will only cover medical treatment and does not cover the surrogate’s compensation.

It’s so confusing! How do I get started?

Yes, medical and surrogacy insurance can be a little confusing, which makes working with an experienced agency like Extraordinary Conceptions a huge benefit! We can help you evaluate her current health insurance plan and/or get a new plan if necessary. This brings you tremendous peace of mind, so you can focus on getting to know your surrogate and enjoying your journey together.

When beginning a surrogacy cycle, it is easy to forget about her medical coverage need, but it is a crucially important step. Please reach out to your Extraordinary Conceptions surrogacy caseworker for more information and to get started!