Is IVF Treatment Covered In Health Insurance Policy?

Parenting is the most elated phase of a couple’s life, but not all are blessed with this blissful event. Infertility is a common issue for many couples these days, like Shefali and Aarav. Shefali and Aarav have been married for the past 10 years, but they have not become a parent till now. They have some fertility issues and are taking treatments as per the doctor’s advice. Seeing their conditions and issues, the doctor suggested doing an IVF treatment for pregnancy. Though they both are insured by their companies, still they are not sure whether their policies will cover the IVF treatment procedure or not. After completing research, they came to know that not many health insurance companies will offer coverage for IVF treatment for pregnancy. So, the couple has decided to bear the costs of the treatment, consultation, and medications by withdrawing their savings.

Here we are going to discuss if there is any health insurance for IVF treatment or not. But before that let’s take a look at what infertility is and what IVF treatment is?

Infertility is one of the biggest concerns these days among couples who are willing to become parents. The prime reasons for infertility are,

• Obesity and sedentary lifestyles
• Diabetes
• Excessive alcohol consumption
• Stress
• Irregular sleep patterns
• Poor eating habits
• Smoking habits
• Health conditions like PCOS or uterine fibroids, etc.( in women)
• Men’s reproductive problems like lower sperm count, quality, ejaculation issues, etc.
• Increase in women’s age
• Prolonged use of contraceptives in emergency
• Early abortions

IVF Treatment Process

IVF means In Vitro Fertilization. In Vitro Fertilization is a delicate process that is used to help couples to deal with fertility problems and help them in conception. In the IVF treatment process, mature eggs are retrieved from ovaries and then fertilized by sperm in a lab. The embryos are then implanted in a female body after fertilization.

1. IUI (Intrauterine Insemination): Here, sperms insert directly into the uterus at the time of ovulation.
2. IVF (In Vitro Fertilization): Eggs are collected from your ovaries and fertilized with the sperm of your spouse. The embryos are transferred and placed in the uterus.
3. Gift (Gamete Intrafallopian Transfer): The eggs are collected and infused with the sperm of the male in a lab and the embryos are placed into the fallopian tube of the female.
4. ICSI (Intracytoplasmic Sperm Injection): Here, a single sperm is injected into a single egg in the lab and the final embryo is transplanted into the uterus of the female.

Side Effects of IVF Treatment

• Multiple births (IVF enhances the risk of multiple births if more than one embryo is transferred)
• Premature delivery
• Miscarriage
• Birth defects
• Ectopic pregnancy
• Cancer
• Low birth weight

Is IVF Covered Under Health Insurance Policy?

Not many Indian health insurance companies offer IVF treatment costs in their plans. Though some insurers are offering the cost of the treatment, you need to have a long waiting time as the demand is rising these days. Due to medical inflation, the cost of IVF treatment has also increased manifolds. The starting price of IVF is nearly Rs.1.25 lakhs and it may go up to 2.5 Lakhs per cycle.

You may avail yourself of several health insurance benefits during the process of an IVF, such as newborn care, pre and post-hospitalization cost cover, maternity cover, emergency cover, and more. Some other covers are also available in IVF treatment, depending on the insurance company and the plan they offer.

Infertility Diagnoses Cover

This type of cover offers compensation only for infertility diagnoses. This cover includes the cost of the visit, the tests, and other related procedures. But you can’t utilize this cover to enjoy the benefits of IVF or any other procedures that you need to perform to combat infertility. Some health insurance policies also offer a certain amount of benefit involved for limited fertility treatment. The exact amount of the cover may vary from one insurance company to another. So, before purchasing the policy documents, you should clarify all these from your insurance provider.  

Full Infertility Insurance Cover

This type of cover compensates for the entire fertility treatment, including IVF. But this type of coverage is very rare. Only a handful of insurance companies offer the complete cost of the procedures. Moreover, only selective policies cover the procedures surrounding an IVF process. The coverage may differ from company to company, so you must clear all clauses at the beginning of your purchase.

Medication Coverage

Under this type of coverage, only the medications that are prescribed for infertility will be compensated by the policy plan. But this depends on the insurance provider, as many companies don’t want to provide coverage for medications that are prescribed as a result of infertility. Different types of drugs are involved in an IVF process, including oral ovulation drugs or injectable medications. So, you must know what is covered by your insurance policy. 

Points To Consider While Purchasing Health Insurance for Infertility Treatment

• Should verify your policy coverage, including the cost of infertility treatment
• Take a look at whether the procedures for infertility treatment are included in the policy or not
• The waiting period for the infertility treatment coverage could be between 2 and 6 years
• Check the coverage and sub-limits on various procedures for infertility that are included in the policy
• Check whether the policy covers the costs of medications used during infertility treatment or not
• Thoroughly check the claim settlement ratio of the insurer before making any commitment

The Conclusion

Though IVF procedure is common these days, it is not offered by many health insurance companies. There are no concrete health plans that cover the entire procedure. Thus, you need to check several plans to find out the most suitable one for you. You also need to keep in mind how many attempts are covered by your health insurance policy because not everyone gets success on the first attempt. So, read your policy documents thoroughly to ensure that they are in line with your requirements.