Infertility has become a prevalent problem in recent times and affects many couples. Infertility is medically defined as not being able to conceive even after one year of regular unprotected sexual intercourse. When this happens, couples often turn to infertility treatments, which help women get pregnant using a medical procedure. However, the costs for these procedures are quite high. That’s when health insurance comes into play. The most obvious question arises, ‘Will my health insurance cover this?’ Fortunately, many new insurers have developed or are starting to develop plans that cover fertility treatment, mainly as an add-on, which we will discuss in detail. From health insurance that covers IVF to things you can do to ensure you make the right decision, we cover it all in this article.
What are the Causes of Infertility?
In men and women, infertility is caused by health issues, bad lifestyle choices, and environmental factors.
The reasons for infertility in women can be:
- PCOS or polycystic ovarian syndrome, PCOD or polycystic ovarian disorder, and hormonal issues
- Blocked fallopian tubes or endometriosis
- Reduced fertility caused by advanced age
- Fibroids or issues with uterine walls
The reason for infertility in men can be:
- Reduction in sperm quality or quantity due to hormonal issues, environmental factors, or lifestyle choices.
- Erectile dysfunction
Lifestyle choices like regularly drinking alcoholic drinks and smoking can also be the reasons affecting fertility.
Are Infertility Treatments Covered Under Health Insurance?
Infertility treatment can be quite expensive, with costs ranging from 100,000 to 400,000 INR per cycle. Most insurance companies do not offer any coverage for this treatment. However, a few companies may offer partial coverage based on the severity of the issue, in their basic or additional health policies. For those with maternity insurance coverage, IVF insurance may be added at an extra cost.
Additionally, various health insurance providers offer coverage for specific aspects of infertility treatment rather than providing coverage for the whole procedure. It is thus important for people to compare the many available options from different health insurance companies and then plan accordingly based on their future needs. Usually, health insurance companies cover around 50-70% of the cost of infertility treatment, which excludes the cost of in vitro fertilisation (IVF). However, more expensive procedures, like laparoscopic surgeries are typically included in health insurance policies for infertility treatment.
Procedures for Infertility Treatment Covered Under Health Insurance
While infertility treatments include a considerable range of different procedures, there are some procedures that are included by many health insurance policies while some are not. We’ve mentioned them below:
- IUI (Intra-uterine insemination): This is one of the most affordable treatment options for infertility. Many health insurance policies fully cover this procedure as part of infertility treatment. With proper research, you’ll find an insurance that covers IVF suited to your needs.
- IVF (In vitro fertilisation): IVF is an infertility treatment that comes with higher costs and involves multiple procedures, all of which are not always covered by health insurance policies. However, some companies offer add-ons for IVF coverage, so it is important to properly check and compare different policies.
- GIFT (Gamete intrafallopian transfer): This procedure is nearly similar to IVF, just a little less technical, as it does not require embryo implantation. In many cases, a health insurance company provides full/partial coverage of this procedure.
- ICSI (Intracytoplasmic sperm injection): This procedure is also subjected to partial or full coverage, depending upon the company or particular insurance policy.
Things to Check Before Buying Health Insurance for Infertility Treatment
As different infertility treatment procedures have different rates and not all health insurance policies cover all of them, it is important to keep certain factors in mind before buying health insurance.
- Check the eligibility criteria. You may need to opt for a sum insured above a specific amount, such as 5 lakhs, to avail of this benefit.
- Verify whether the cost of diagnosing infertility is covered or not.
- Check what procedures of IVF or other techniques are covered by the health insurance policy.
- Check the limitations of the policy for those covered procedures. For example, they may or may not provide full coverage or may cover only a limited number of cycles.
- Determine the waiting period before you can make a claim through the policy (that might range up to 6 years).
- Check if the cost of medicines is covered under that policy. Infertility treatments require a lot of medications, which come with hefty charges.
- Determine what add-ons are provided by that particular insurance policy that might be useful when you need to opt for several treatment procedures.
FAQs
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Is infertility treatment expensive?
Yes, infertility treatments like IVF are expensive and can cost anywhere between one lakh to five lakh or more.
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Can health insurance cover the entire cost of infertility treatment?
Most policies do not cover 100% of the cost. Partial coverages and limitations are applied to infertility treatment.
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Does maternity insurance cover infertility treatments?
No, maternity insurance covers delivery and postnatal costs and does not include infertility treatments.
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Are infertility medications covered under insurance?
It differs from policy to policy. While some plans include medications and hormonal therapies, others do not offer any coverage.
Conclusion
There are so many resources out there that can help you get the necessary treatments when working with financial constraints. Discussing these treatments and potential issues with friends, family, or other members of the community can provide support and guidance as you navigate this complex process. At the end of the day, it’s important to remember there is always hope in beginning or continuing your parenthood journey, despite any obstacles that come along with it.
Disclaimer: The information provided in this blog is for educational purposes only. Please consult a medical or nutrition professional before making any significant changes in your daily diet. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any impact or consequences resulting from the use of the information shared.