Insurance Coverage for LGBTQ Patients
Insurance plans do not cover assisted reproduction expenses for gay males, however, lesbians using IUI with donor sperm may have coverage for office visits and testing.
Female Couples Using IUI with Donor Sperm
Female couples using intrauterine insemination with donor sperm may have insurance coverage for office visits and testing. If you are the woman who is getting pregnant (considered the patient), check with your insurance provider for your specific infertility benefits.
Infertility must be proven before a health insurance provider will approve coverage for IUI or IVF. If you are 35 years old or younger, this usually means paying out-of-pocket for 12 cycles of IUI or IVF without conceiving (regardless of the result of the pregnancy). If over 35 it usually means paying out-of-pocket for 6 cycles of IUI or IVF without conceiving (regardless of the result of the pregnancy).
If you conceive and miscarry, some insurance plans may require that you complete another 12 treatment cycles without conceiving before your infertility treatment benefits will kick in. Please Note: Insurance providers typically require IUI to be "doctor supervised" and do not acknowledge "at-home" inseminations.
* All references to health insurance coverage apply to persons with Massachusetts-based coverage.
Insurance plans do not cover assisted reproductive expenses for gay males, however lesbians using IUI with donor sperm may have coverage for office visits and testing.
Female Couples Using Reciprocal IVF or IVF with Donor Egg and/or Gestational Surrogacy
If you need eggs provided due to ovarian failure, the egg recipient may have insurance coverage for office visits, testing, and treatment. However, this depends on your insurance plan. If you have insurance coverage for donor egg/IVF treatment, you will need to meet your insurance provider's criteria for an infertility diagnosis and coverage approval. Usually to meet the insurance company's criteria for approval, the lesbian partner who is considered to be the patient (carries the pregnancy) must have premature ovarian failure that was diagnosed prior to the age of 40.
Insurance Coverage for Gay Men
Insurance plans do not cover assisted reproductive expenses for gay males because the fact that medical help is needed is not based on infertility, but rather attempting pregnancy with a male partner.