Assisted Reproduction Costs and Insurance Coverage for Lesbian Couples
Assisted reproduction costs and insurance coverage for lesbian couples varies; reciprocal IVF is more costly than IUI for example.
Female Couples Using Reciprocal IVF
Insurance providers do not cover IVF services when one partner carries a pregnancy and the other provides eggs unless medical necessity is documented. Doctor visits and diagnostic testing for the woman carrying the pregnancy might be covered, but this varies among health insurance providers.* Verifying your coverage with your provider is encouraged.
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.
Some of the costs you will incur if paying out-of-pocket for donor egg/IVF treatment:
• Administrative fee: $4,300 (never covered by insurance)
• Donor egg IVF cycle estimated cost: $10,890.
• Diagnostic testing and office visits for the couple, medications for the egg donor and recipient, day 5 embryo culture, ICSI, assisted hatching, and embryo cryopreservation would be at an additional cost.
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. This usually means paying out-of-pocket for 12 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.
You may qualify for financing available through RSC New England or the IntegraMed Attain IVF Refund and Multi-Cycle Discount programs. RSC New England also offers a 10% discount for active members of the US Armed Services and their spouses.