Is IVF Treatment Covered Under Health Insurance? (2024)

Is IVF Treatment Covered Under Health Insurance? (1)

In-vitro Fertilization, also known as IVF, is the most commonly practiced assisted reproductive technique in India and globally. If statistics are to be believed, more than 8 million babies have been born through IVF treatment since the procedure’s inception. According to the Financial Express, 2-2.5 lakh IVF treatments are done every year in India alone. And, India has the potential of taking this number up to 5-6 lakh per year.

IVF treatment is a medical boon for couples who cannot conceive naturally for issues like a blockage in the fallopian tube, ovulation disorder, degraded sperm quality, or lower sperm quantity. IVF can be done using the eggs and sperm of the couple or by using donor eggs or donor sperm. In IVF, the eggs and sperm are combined in a petri-dish and fertilized. Once the fertilized egg develops into an embryo, it is implanted into the uterus of the female, where the pregnancy takes place for the next nine months.

There is no bigger joy than the joys of parenthood. But infertility treatments, including IVF, do not always come easy on the pocket. Not everyone can avail the treatment without a second thought due to the expenses that rob couples of this happiness more often than not. Nobody can guarantee a successful outcome from the procedure. If you are lucky, you can conceive for the very first time. If not, you may require a few more cycles, all the way from the very first step. IVF is expensive, and the higher the number of cycles, the higher the cost. Hence, many couples affected by infertility look for a health insurance plan that covers infertility treatment costs.

This piece of content is intended to help you understand IVF treatment costs in India and if IVF treatment in India is covered under insurance.

Table of Contents

Cost of IVF treatment in India

CityAverage cost of IVF treatment (in INR)
Delhi1,25,000 – 1,50,000
Bangalore1,40,000 – 1,80,000
Hyderabad1,40,000 – 1,80,000
Chennai1,40,000 – 1,80,000
Kolkata1,40,000 – 1,80,000
Pune1,40,000 – 1,80,000
Gurgaon1,40,000 – 1,80,000

Is IVF treatment in India covered under insurance by general health insurance policies?

No. The general health insurance policies in India usually do not cover IVF procedures. However, there are a few that do. As of March 2022, the only general health insurance covering IVF treatment expenses is the BMB Nirbhaya Scheme by Bharatiya Mahila Bank. But, the coverage is only limited to women of different financial statuses. Under this scheme, women can avail cashless facilities and maternity coverage for the first two children.

Most general health insurance providers cover only the hormonal assessment and medical testing costs, the expenses of the OT, and the charges of the anesthetic procedure. The rest of the treatment expenses as well as the medical costs are to be borne separately by the couple. As a result, the number of companies providing coverage for IVF treatment in India is very few. But as the number of couples undergoing IVF is increasing with every passing year, health insurance companies are pondering IVF coverage in their insurance policies. In a report published by Insurance Dekho, Chief Product Officer of Royal Sundaram General Insurance Nikhil Apte said, “We are looking to include IVF treatment in the health plans and to avoid frauds we will go for people who have been with us for six years, include sub-limit and link it to maternity cover.”

Types of IVF coverages

Before we learn about the health insurance plans with IVF covers, we should understand the four types of IVF coverages that a medical insurance policy might provide. These are:

  • Full infertility insurance coverage
  • Insurance for infertility diagnosis only
  • Insurance for infertility diagnosis and limited fertility treatment
  • Medication coverage which may include fertility drug prescriptions

You need to know what is exactly covered in your health insurance plan. To have a better understanding, you can speak to your insurance provider and gain more insight into the schemes. Let’s understand the four types in a bit more detail.

Infertility treatment

If the insurance policy covers the complete IVF treatment, it is essential to read and understand the covered procedures. Common infertility treatments include:

  • In-vitro fertilization (IVF)]
  • Intrauterine insemination (IUI)
  • Assisted hatching
  • Intracellular sperm injection (ICSI)
  • Preimplantation genetic diagnosis (PGD)
  • Ovarian hyperstimulation syndrome (OHSS)
  • Frozen embryo transfer (FET)
  • Gamete Intrafallopian Transfer (GIFT)

Diagnosis of infertility

Diagnosis of infertility include the following:

  • Hormonal profile testing
  • sem*n analysis
  • Genetic testing
  • Imaging tests for both male and female
  • Tests for DNA abnormalities
  • Ovarian reserve testing
  • Hysterosalpingography
  • Hysteroscopy
  • Laparoscopy

Insurance Policies in India that cover IVF and other infertility treatments

Here are a few health insurance policies that cover IVF and similar kinds of fertility treatments:

  1. Nirbhaya by Bharatiya Mahila Bank

Is IVF Treatment Covered Under Health Insurance? (2)

The IVF treatment coverage under Nirbhaya is available for women under limited financial statuses who have opened an account in Bharatiya Mahila Bank. The policy covers infertility treatment, hospitalization expenses, and maternity coverage without putting a financial burden on women. The insured sum is between INR 1 lakh to INR 5 lakh, and the premium for the insurance coverage of INR 1 lakh starts at INR 1,745 for women who are 22 years old and above. The Nirbhaya policy also includes coverage for the gyne health check ups from the fourth year and maternity coverage from the third year. Additionally, the policy also covers the expenses for miscarriages.

  1. Magma HDI OneHealth Insurance Policy

Is IVF Treatment Covered Under Health Insurance? (3)

The OneHealth Insurance Policy is the flagship health insurance plan from Magma HDI General Insurance Company.

The policy offers comprehensive coverage, including the hospitalization cost, daycare treatment, donor expenses, pre-post hospitalization for IVF treatment. OneHealth covers IVF treatment-related medical expenses taken at a clinic duly registered in accordance with applicable law* and on the written medical advice of an infertility specialist. The insured person is eligible for the coverage only up to 40 years of age.

The OneHealth Insurance Policy offers IVF Treatment cover of up to INR 50,000 even on an overall plan sum insured of INR 2,00,000. There is a waiting period of 3 years from the policy inception date before one can enjoy this benefit.

  1. Digit Health Care Plus Policy

Is IVF Treatment Covered Under Health Insurance? (4)

The Digi Health Care Plus Policy is a recently introduced health insurance policy from Go Digit General Insurance Limited, which packs in many features at competitive prices. Digit Health Care insurance for fertility treatment includes IVF, IUI, ZIFT, ICSI etc. In addition, the plan offers infertility treatment cover as an add-in cover that one can opt for. Under this policy, the insurance company shall pay medical expenses if you are hospitalized on the advice of a medical specialist for any infertility treatment.

The sum insured for IVF coverage by Digit Health is limited to either a percentage of the sum insured or to a particular amount.

What to look for in insurance policies for infertility treatments?

Infertility treatments are complex and hence require comprehensive health insurance coverages. When purchasing health insurance plans that cover IVF, look out for the following terms and conditions in the plans you examine:

  • Eligibility (this depends on your age, gender, lifestyle, occupation, and/or medical history)
  • Sum Insured (coverage offered by the health insurance plan for IVF procedures)
  • Waiting period (none of the insurance policies to date allows IVF treatment from day one)
  • Validity (number of times one can avail IVF expenses on their health insurance plan)
  • Sub-limits and Copayment (your sum insured might be restricted, and you might need to participate in part of the claimable amount)
  • Exclusions
  • Premium

Infertility treatment is not just a medical need but also a societal necessity. If you are planning IVF and looking for policies that can cover your treatment cost, we suggest you do thorough research first. Learn as much as possible about the treatment approaches, so when you choose an insurance provider, you pick the right one that meets your requirements.

if you are someone looking forward to experiencing the joy of parenthood, there are other financing options available that can cover the cost of the medicines, monitoring, diagnostic tests and even the child birth. At Pristyn Care, we arrange zero-cost EMI loan options to every couple considering to choose IVF.

Is IVF Treatment Covered Under Health Insurance? (2024)

FAQs

Are IVF medications covered by insurance? ›

California law currently requires insurance companies to offer fertility treatment, excluding in vitro, but it's up to the employer or group to decide whether that's included as a covered benefit.

Why is IVF not covered by insurance? ›

Because infertility has long been considered a women's health issue, insurance companies perceived it as a niche issue and denied coverage to those experiencing it. This is despite the fact that nearly half of all cases are due to “male factor infertility.”

How can I cover IVF costs? ›

If insurance doesn't cover your IVF treatments, here are other ways to finance the costs and who they're best suited for.
  1. Fertility specialist loan. Who it's best for: Those who want a lender that works directly with their fertility clinic. ...
  2. Credit union loan. ...
  3. Online personal loan. ...
  4. HELOC. ...
  5. IVF grant.
Nov 7, 2022

Which insurance cover IVF in India? ›

The general health insurance policies in India usually do not cover IVF procedures. However, there are a few that do. As of March 2022, the only general health insurance covering IVF treatment expenses is the BMB Nirbhaya Scheme by Bharatiya Mahila Bank.

Will IVF be covered by insurance in 2022? ›

As of June 2022, 20 states have passed fertility insurance coverage laws, 14 of those laws include IVF coverage, and 12 states have fertility preservation laws for iatrogenic (medically-induced) infertility.

Is IVF pregnancy expensive? ›

Depending on your needs, a single IVF cycle can cost $30,000 or more. More often, the total bill will fall somewhere between $15,000 and $20,000. Often, a clinic's base fee for IVF will cover monitoring appointments, bloodwork, egg retrieval and follow-up care.

What age is IVF free? ›

You must be between the ages of 23 and 40. You must have been trying to conceive for at least two years. You must have no living children from a current or previous relationship (for both partners). No treatment is available for women between the ages of 40 and 42.

How much is IVF without medication? ›

On average, the cost to have IVF treatment done in California across major cities ranges between $8,000 to $13,000 for one IVF cycle without the medication. California state requires insurance companies to have some form of coverage for intended parents looking to take part in infertility treatment.

Is hospitalization required for IVF? ›

As far as the OHSS is considered, the incidence of severe form is only 1-2%, which requires hospitalization. The mild and moderate cases can be handled on OPD basis.

How many cycles of IVF to get pregnant? ›

The Greatest Percentage of IVF Success Occurs in Six Cycles

From that comprehensive analysis, which included results from both fresh and frozen embryo transfers, researchers found that the average live birth rate for couples participating in six IVF cycles was 65.3%.

How many rounds of IVF is normal? ›

Most couples have to undergo that previously mentioned three IVF rounds or more. The process takes its toll on mental and emotional health, and infertility/fertility treatments also take their toll on relationships.

What is the success rate of IVF? ›

To put these figures into perspective, studies have shown that the rate of successful pregnancy in couples with proven fertility in the past is approximately 20% per cycle. Therefore, although a figure of 48.5% may sound low, it is much greater than the chance that a fertile couple will conceive in any given cycle.

What is the maximum age for IVF in India? ›

But according to the latest ART Bill 2020, the upper age limit for conception using assisted conception/IVF in India is 50 years for female and 55 years for male.

What is the minimum cost of IVF in India? ›

The minimum cost of getting an IVF treatment in India is about 70,000 Indian Rupees. the success rate for a single cycle of IVF treatment is about 50-72%,depending on specific patient characteristics.

What is the total cost of IVF in India? ›

Generally, the charges for IVF treatment in India is anywhere between Rs 60,000 and Rs 80,000, inclusive of medicines. However, in reality, most of the couples have to spend more than Rs 5 lakh on IVF treatment and procedures due to the need for several rounds of IVF cycles.

What percentage of IVF embryos survive? ›

Understanding embryo transfer success rates

Higher quality embryos are associated with a 79% live birth rate with good quality at 64%. Poor quality embryos, however, are associated with a low birth rate of 28%.

Which state has the best infertility coverage? ›

RESOLVE: The National Infertility Association's Fertility Scorecard shows Connecticut, Illinois, Maryland, Massachusetts, New Jersey and Rhode Island are the best states for those seeking fertility treatments. Alaska, Mississippi and Wyoming ranked the worst, receiving an F grade.

Is IVF painful? ›

This process is not painful. However, we may have patients take an oral sedative prior to the transfer to relax the cervix. For a day or two after treatment, patients may experience some abdominal cramping.

What are the disadvantages of IVF? ›

Risks of IVF include:
  • Multiple births. IVF increases the risk of multiple births if more than one embryo is transferred to your uterus. ...
  • Premature delivery and low birth weight. ...
  • Ovarian hyperstimulation syndrome. ...
  • Miscarriage. ...
  • Egg-retrieval procedure complications. ...
  • Ectopic pregnancy. ...
  • Birth defects. ...
  • Cancer.
Sep 10, 2021

Can you choose gender with IVF? ›

Intended Parents can determine gender through PGD/PGS/PGT-A during an IVF journey. Given a fertility doctor's ability to identify XX or XY chromosomes in the embryo with PGD tests, the gender selection process is almost 100% accurate.

What country is cheapest for IVF? ›

Cheapest IVF country
  • Czech Republic. IVF cost in the Chech Republic starts at €2,100 and egg donation IVF packages range from €4,600 to €5,500 – however you may find clinics where egg donation packages are cheaper – around €4,300.
  • North Cyprus. ...
  • Poland. ...
  • Ukraine.

Are IVF babies normal babies? ›

The simple answer is yes. Millions of babies have been born using In Vitro Fertilization (IVF) and they are perfectly healthy. The procedure does not pose any short term or long term risk to the health of the child. The primary difference between IVF babies and normal babies is the way in which they are conceived.

How many babies are born in IVF? ›

The world's first in-vitro fertilization baby was born in 1978 in the UK. Since then, 8 million babies have been born worldwide as a result of IVF and other advanced fertility treatments, an international committee estimates.

Do you need IVF after 35? ›

In general most people are still fertile and able to get pregnant naturally at age 35, but research shows that egg quantity and quality start to go down “more noticeably” around this age, Mary Ellen Pavone, M.D., associate professor in the division of reproductive endocrinology and infertility and director of in-vitro ...

How much is the first round of IVF? ›

The average cost for an IVF cycle with fresh eggs is around $15,130, while a cycle with frozen eggs is slightly less expensive at $13,180. The average cost of a new patient consultation is roughly $350, and additional fees for medications and fertility testing.

Can you pay for IVF to have twins? ›

Yes, a couple can ask for twins, but the clinic will counsel on the risks. The main risk with IVF is pre-term births. Pre-term births account for 60% of twin deliveries and bring a host of complications for the babies.

Can you have twins with IVF? ›

Multiple births can develop through in vitro fertilization when more than one embryo is put back into the mother's womb. Identical twins can develop even when only one embryo is put back into the womb.

Is bed rest required after IVF? ›

So, do you need bed rest after an embryo transfer? The simple answer is no. A study in 1997 demonstrated that even a 24-hour bed rest didn't produce any better outcomes than a 20-minute rest period.

How much sperm do you need for IVF? ›

At least 10 x 10(6) spermatozoa/ml, of which at least 30% are motile and 15% have progressive motility, are required for IVF or insemination therapy, despite the fact that pregnancies can be achieved with lower parameters. As a minimum, 20% of spermatozoa should be of normal morphology.

Can I be rejected for IVF? ›

There are many reasons that a woman might be refused IVF via the NHS. Often it comes down to the very tight rules within your area. NICE set the guidelines to decide who should be eligible for funded treatment. Then, the individual NHS integrated care boards (ICBs) have the final say in your local area.

How do I prepare my body for IVF? ›

How to Prepare for IVF
  1. Eat a healthy, well balanced diet.
  2. Start taking prenatal vitamins.
  3. Maintain a healthy weight.
  4. Stop smoking, drinking alcohol and recreational drugs.
Nov 10, 2020

What are the 3 types of IVF? ›

The three main approaches to IVF that involve no or fewer drugs are natural cycle IVF, mild stimulation IVF and in vitro maturation (IVM).

How many eggs are left after IVF? ›

In general, an average of 8 to 14 eggs are typically retrieved from a woman's ovaries with IVF; however, its ultimately not the number of eggs that matter but the quality.

Why do you have to wait 2 weeks after IVF? ›

Clinics recommend a two-week wait after your embryo transfer because taking a pregnancy test too soon after the frozen egg transfer often produces false results.

How many times a day do you inject with IVF? ›

The medicine is given either as a daily injection that you'll be taught to give yourself, or as a nasal spray. You continue this for about 2 weeks.

How many injections do you take a day for IVF? ›

This medication usually takes the form of injections. These injections can vary from one-two for the entire cycle, to one-two per day.

What are the 5 stages of IVF? ›

The process consists of five steps:
  • Step 1: Medication. The woman is given injection hormones to stimulate healthy egg development. ...
  • Step 2: Harvest the eggs. ...
  • Step 3: Fertilization. ...
  • Step 4: Embryo culture. ...
  • Step 5: Embryo transfer. ...
  • Delivering the good news.

How long does IVF process take? ›

IVF is not a single treatment but a series of procedures. An average IVF cycle takes about 6 to 8 weeks from consultation to transfer, but depending on the specific circ*mstances of each the path is similar for every patient. What varies is how your body responds at each stage.

Does IVF make better babies? ›

The truth lies in scientific studies and research. IVF babies seem to be just as healthy as naturally conceived babies though there is evidence of certain disparities that require further research.

Is 37 too old for IVF? ›

The Argument for Allowing IVF for Older Patients

Most fertility clinics set an age limit, often between 42 and 45 years old, for a woman to use her own eggs. However, the ASRM committee opinion concludes that "limited treatment may be provided after a process of explicit education and examination of values."

Can I get pregnant at 37 with IVF? ›

According to statistics collected by the Center for Disease Control, the percentage of live births from IVF procedures using the mother's eggs decreases with age. The live birth rates, after IVF treatment, are: 41.5% for women younger than 35. 31.9% for women age 35 to 37.

Can I freeze my eggs at 44? ›

Egg freezing typically works best for women in their 20s to 30s, and is not generally recommended for women older than 38 years. The biological clock cannot be reversed by oocyte cryopreservation in women older than 40.

Which month is best for IVF in India? ›

During the spring months, the neurons in the brain produce higher levels of gonadotropin-releasing hormones (GnRH). Research by Dr Braga et al3 shows that IVF cycles during months of March to September show higher success rates.

Which state is best for IVF in India? ›

Best IVF Centers In India
  • New Delhi(26)
  • Mumbai(17)
  • Chennai(13)
  • Gurgaon(12)
  • Hyderabad(12)
  • Bangalore(11)
  • Bangalore(11) Noida(7) Kolkata(6) Ahmedabad(4) Kochi(4) Pune(3) Chandigarh(2) Coimbatore(1) Trivandrum(1)

Why is IVF so expensive? ›

Number of IVF cycles required - More the number of IVF cycles, the higher would be the cost of treatment. Other factors include cost of ultrasound scans & tests, cost of donor eggs, cost of embryos freezing, uniqueness of medical and fertility condition and cost of ICSI treatment.

Is IVF 100 percent successful? ›

The most important fact to know about IVF is it's not 100 percent successful—the process can take time, money, and even an emotional toll on your life.

How many IVF babies are born in India? ›

The number of IVF cycles per couple is estimated to increase from 1.5 in 2015 to 3.5 lac in 2022. About 2 -2.5 lac IVF cycles are done every year in India. There is 20% of compound annual growth rate in fertility segment through the last 5 years in India.

Is IVF a test tube baby? ›

A test-tube baby is a baby who is conceived by IVF. IVF is in vitro fertilization where the word “vitro” means glass. In such cases, the fertilization is done outside the uterus in a glass vessel by combining a female egg with a sperm. IVF and test-tube babies are the same with no difference at all.

Do you have to pay for fertility medication? ›

If you need to have fertility treatment you have two options: you can either pay for it yourself or you can see if you're eligible for treatment on the NHS. Find out more about your options on this page.

How much do you spend on IVF prescription? ›

See our guide to fertility medications. We advise our patients that the average fertility medication costs for IVF, egg, and embryo freezing cycles is $2,000–5,000.

What is the average cost of an IVF cycle without medication? ›

On average, the cost to have IVF treatment done in California across major cities ranges between $8,000 to $13,000 for one IVF cycle without the medication. California state requires insurance companies to have some form of coverage for intended parents looking to take part in infertility treatment.

Does Starbucks pay for IVF? ›

Starbucks, which faces a national labor organizing campaign, has long been known among people struggling with infertility as one of the only major U.S. employers to offer coverage for procedures like IVF to part-time workers. Word about Starbucks' benefits has spread widely online in recent years.

What age is IVF most successful? ›

Studies show that women in their 20s and 30s have the most success when getting pregnant through IVF and other reproductive technologies. According to the CDC, the average percentages of assisted reproductive technology (ART) cycles that lead to a live birth are: 31% in women younger than 35 years of age.

How many rounds of IVF are free? ›

According to NICE, women aged under 40 should be offered 3 cycles of IVF treatment on the NHS if: they've been trying to get pregnant through regular unprotected sex for 2 years.

How can I make IVF more affordable? ›

But before you walk away from IVF, consider these seven tips for making the costs slightly more affordable.
  1. Read Your Insurance Plan Carefully.
  2. Use Your Health Savings Dollars.
  3. Price Shop and Negotiate.
  4. Medical Tourism for IVF.
  5. Saving Money on Fertility Drugs.
  6. Shared Risk or IVF Refund Programs.
Nov 20, 2020

Is Mini IVF cheaper than IVF? ›

When compared to typical IVF, mini-IVF costs less per cycle and lowers your risk of developing ovarian hyperstimulation syndrome. However, success rates are generally lower with mini-IVF. Compared to IUI, mini-IVF costs slightly more than IUI but has improved pregnancy success rates.

How many rounds of IVF is average? ›

Most couples have to undergo that previously mentioned three IVF rounds or more. The process takes its toll on mental and emotional health, and infertility/fertility treatments also take their toll on relationships.

How much does Amazon cover for IVF? ›

A learning trainer at Amazon, Sebastian, like all Amazon's employees, immediately qualified for comprehensive health benefits on Day 1, and that included the cost for IVF treatment. The benefits allow for $15,000 in IVF coverage.

Does Walmart insurance cover IVF? ›

27. Fertility services include assessments and education, fertility preservation, genetic testing, in vitro fertilization (IVF) and intrauterine insemination, a media release said. The benefits are available to full- and part-time employees and their dependents.

Can I get paid leave for IVF? ›

Your employer should treat your medical appointments for IVF treatment like any other medical appointment. If you are off sick due to the side effects of IVF, your employer should treat your absence the same as any other sick leave.

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