The journey to parenthood can be complex, particularly when it involves in-vitro fertilization (IVF) using donor eggs. One question that often arises as part of this process is, "Does health insurance cover donor eggs?" The answer to this question is nuanced, and will depend largely on your specific health insurance policy, your place of residence, and several other factors. This article will explore the ins and outs of insurance coverage for procedures involving donor eggs, providing a roadmap for prospective parents navigating this intricate terrain.
Understanding health insurance and ART
Before delving into specifics, let’s discuss the fundamental relationship between health insurance and assisted reproductive technology (ART). Health insurance policies vary significantly in their coverage of fertility treatments. Some plans offer comprehensive coverage, including multiple cycles of IVF, while others might only cover diagnostic procedures, or nothing at all. What’s more, some plans limit coverage to people facing infertility, leaving out same-sex couples and those pursuing IVF for genetic reasons. So an important first step is understanding the specifics of your individual insurance plan’s coverage of fertility treatment. From there, you can investigate potential coverage of procedures involving donor eggs.
Insurance coverage for donor eggs
The insurance landscape for donor egg IVF is even more complex. For starters, if your insurance plan does cover IVF, it doesn't necessarily guarantee that it also covers procedures involving donor eggs. Those plans that do offer coverage for IVF using donor eggs can also vary - some may cover the medical procedures related to egg retrieval and embryo transfer but might not cover the costs associated with the donor herself. These costs can include compensation for the donor, legal fees, agency fees, and the donor's medical and psychological screenings, among others.
Your location can also significantly impact the extent of coverage you might have for fertility treatments involving donor eggs. Across the country, 17 states (and counting!) have laws requiring insurance companies to cover or offer coverage for infertility diagnosis and treatment.
However, the specifics of these laws vary from state to state, and not all necessarily mandate coverage for procedures involving donor eggs. While most laws are vague without any mention of donor eggs, a few specifically require coverage of donor eggs. Let’s look at those:
The DE law states that “in vitro fertilization, including IVF using donor eggs, sperm, or embryos and IVF where the embryo is transferred to a gestational carrier or surrogate must be covered.”
The ME law states that health plans must cover fertility diagnostics and treatment, without “any limitations on coverage for any fertility services based on an enrollee's use of donor gametes.” However, any nonmedical costs for using donor eggs can be excluded from coverage.
The MA law requires insurance plans to cover treatment of infertility including donor egg procurement.
The NH law states that health plans must provide coverage for medically necessary fertility treatment, including “treatments associated with the procurement of donor eggs.”
NJ law requires health plans to provide coverage for four egg retrievals per lifetime, and IVF using donor eggs.
An important note: Even if your state has infertility coverage laws in place, your specific health plan might not be required to comply. Self-insured or self-funded insurance plans are exempt from state law and employers do not have to follow the state insurance laws. Some states also exempt employers under a certain size from having to provide coverage. The best way to find out is to talk to your health plan directly.
Other ways to pay for donor eggs
If your insurance plan does not cover procedures involving donor eggs, there are still options you can explore to help manage the costs. These can include employer-sponsored reimbursement options (like Carrot Fertility), fertility financing companies, grants and scholarships from non-profit organizations, and discounted treatment packages or refund programs from fertility clinics. It's worthwhile to explore these avenues and to discuss potential options with a financial counselor at your fertility clinic.
Read more in Eggonomics: Seven Options for Paying for Donor Egg IVF
Find an amazing egg donor at Cofertility
At Cofertility, our program is unique. After meeting with hundreds of intended parents, egg donors, and donor-conceived people, we decided on an egg donation model that we think best serves everyone involved: egg sharing.
Here’s how it works: our unique model empowers women to take control of their own reproductive health while giving you the gift of a lifetime. Our donors aren’t doing it for cash – they keep half the eggs retrieved for their own future use, and donate half to your family.
We aim to be the best egg sharing program, providing an experience that honors, respects, and uplifts everyone involved. Here’s what sets us apart:
- Human-centered. We didn’t like the status quo in egg donation. So we’re doing things differently, starting with our human-centered matching platform.
- Donor empowerment. Our model empowers donors to preserve their own fertility, while lifting you up on your own journey. It’s a win-win.
- Diversity: We’re proud about the fact that the donors on our platform are as diverse as the intended parents seeking to match with them. We work with intended parents to understand their own cultural values — including regional nuances — in hopes of finding them the perfect match.
- Baby guarantee. We truly want to help you bring your baby home, and we will re-match you at no additional Cofertility Coordination Fee until that happens.
- Lifetime support: Historically, other egg donation options have treated egg donor matching as a one-and-done experience. Beyond matching, beyond a pregnancy, beyond a birth…we believe in supporting the donor-conceived family for life. Our resources and education provide intended parents with the guidance they need to raise happy, healthy kids and celebrate their origin stories.
We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account to get started today!
Summing it up
Navigating health insurance coverage for procedures involving donor eggs can be complex and sometimes overwhelming. Unfortunately most plans do not cover any IVF, let alone donor egg IVF.
Start by understanding your individual insurance plan, and don't hesitate to seek clarification from your insurance provider about the specifics of your coverage. Exploring other financing options can also help manage costs if insurance coverage is limited or non-existent.
Importantly, remember that our team is here for you every step of the way, before and after matching. If you have questions about how an egg donor journey with Cofertility would be covered by your insurance, don’t hesitate to reach out. We wish you all the best!
Jessie heads up partnership efforts at Cofertility, forging relationships with clinics and other strategic partners that support Cofertility members across their journeys. She joined Cofertility while in business school and came on full-time after graduation. Prior to business school, she worked in healthcare research and consulting, leading best practice research studies and advising medical device, pharmaceutical, and healthcare technology companies. Her passion for improving access to health care services stemmed from her experience as a health clinic volunteer, where she connected lower income patients with social services that could improve health outcomes. Jessie has a Bachelor of Arts (BA) in Economic History from the University of Pennsylvania and a Masters in Business Administration (MBA) from Columbia Business School with a focus in Healthcare and Pharmaceutical Management.
View all articles