Insurance May Not Cover Surrogacy — Here Are 15 Ways to Afford it
Key takeaways:
In the U.S., surrogacy typically costs $150,000 to $200,000. Intended parents usually pay for most of this cost out of pocket due to limited insurance coverage.
As an intended parent, you may be able to lower the cost of surrogacy by starting an online fundraiser, applying for grants, and asking family and friends to consider becoming a surrogate.
If surrogacy remains financially out of reach, you can consider alternative options such as adoption or foster care.
Surrogacy provides an alternative path to parenthood, but it comes with a significant financial burden. The process involves many steps and expenses that can quickly add up, making it challenging for intended parents to afford.
The high cost may be discouraging. But, there are ways to make surrogacy more affordable and make your dream of becoming a parent a reality.
How much does surrogacy cost?
Surrogacy in the U.S. can cost between $150,000 and $200,000. This hefty price tag is due to the involvement of many professionals and the various expenses throughout the surrogacy process.
Search and compare options
Some factors that contribute to the high cost of surrogacy include:
Agency fees
Type of surrogacy, such as traditional or gestational
Surrogate compensation
Additional surrogate expenses
Health insurance
Medical expenses, such as in vitro fertilization (IVF) and fertility medications
Legal fees
Geographic location
For example, where the surrogate lives, whether they have health insurance, the need for an egg donor, and the agency used can all impact the total cost.
Does insurance cover surrogacy?
Many insurance companies see surrogacy as a choice rather than a medical necessity. Because of this, they often won't cover costs related to surrogacy.
For example, some parts of the surrogacy process may be covered by the intended parent’s health insurance, while others may not. If the surrogate has health insurance, their plan may cover some of the expenses related to the pregnancy. However, in many cases, neither the intended parent’s nor the surrogate's health insurance will cover surrogacy-related medical care.
Does the intended parent’s insurance cover surrogacy?
The intended parent's health insurance generally does not cover the surrogate's pregnancy care and childbirth expenses. But, with new services from companies such as Progyny and Carrot becoming more available, it is possible that some intended parents may receive reimbursement for surrogacy-related costs, Jessie Jaskulsky, the owner of Surrogacy Simplified, told GoodRx Health. Progyny and Carrot are companies that provide fertility benefits and services for employers to offer their employees.
An intended parent’s health plan may cover IVF, which is necessary to create embryos for the surrogacy process. However, the extent of coverage can vary depending on the state and the insurer.
For example, in the U.S., 21 states and the District of Columbia mandate that health insurance plans cover fertility treatments, with 15 of those states specifically requiring coverage for IVF. But even in states with mandated fertility coverage, there may be exclusions. According to Jaskulsky, some health plans might cover IVF if the intended mother is carrying the pregnancy but not if the embryos are being created for a surrogacy journey.
The process of transferring the embryo to the surrogate's uterus is generally not covered by insurance, either. Additionally, if the intended parent uses donated eggs to create the embryo, their insurance company likely won't cover the costs associated with obtaining and using those donated eggs.
Does the surrogate’s insurance cover surrogacy?
If the surrogate's health insurance is considered "surrogate-friendly," it may cover the medical expenses associated with the pregnancy. A surrogate-friendly health plan means the policy does not exclude surrogacy pregnancies.
However, for health plans that don’t cover surrogacy pregnancies, the intended parent may need to purchase a separate policy. This could be a short-term health insurance policy or one that covers maternity care.
If a health plan doesn't specifically exclude surrogacy in its benefits handbook, it’s important to double-check with the insurance company. Jeff Hu, director of SurrogateFirst, told GoodRx Health that it uses a third party to verify the surrogate’s insurance coverage. According to Hu, the third-party company will contact the insurance provider and get written confirmation about whether the plan covers surrogacy pregnancies.
Are there ways to lower the cost of surrogacy?
The high price tag of having a baby through surrogacy can feel impossible for most people. Here are ways to lower and manage the costs.
1. Verify your health insurance coverage
Contact your health plan to check what fertility and surrogacy-related medical care is covered. Ask questions about out-of-pocket expenses, limitations, and coverage requirements. If you have coverage for IVF or other fertility treatments, you could save thousands in medical expenses.
2. Check your employer benefits
Ask your employer's human resources department if your workplace offers coverage for fertility treatments and surrogacy in addition to your health insurance. Some employers are expanding their corporate benefits to include fertility treatment and coverage for surrogacy expenses, Hu said. Even if your employer does not offer fertility or surrogacy coverage, it’s worth asking about plans to do so in the future.
3. Start an online fundraiser
Share your decision to have a baby via surrogacy. Websites such as GoFundMe allow you to share your surrogacy story and gather donations easily. You can ask friends, family, co-workers, and online communities to chip in whatever amount they can. They may donate directly or fundraise to assist you with the costs.
4. Ask people you know to volunteer
Consider approaching close friends or family members to ask if they might volunteer as an altruistic surrogate (someone willing to carry the pregnancy without pay). If qualifications are met, having an unpaid surrogate eliminates the compensation fees.
5. Apply for grants
Many nonprofit organizations offer grants to help cover surrogacy costs. Some help you pay for the IVF portion of the surrogacy, while others may cover 100% of the costs. Read the qualification requirements and pay attention to application deadlines.
6. Start saving money early
Determine how much you need to save and set a budget. Consider opening a high-yield dedicated savings account and scheduling automatic transfers to it. Small, regular contributions plus the interest earned add up over time.
7. Use a matching platform
An online matching platform such as Nodal lets intended parents connect directly with prescreened surrogates. “It’s different because they’re not an agency, and you’re saving the agency fee,” Jaskulsky said. Unlike traditional agencies, Nodal uses a membership fee structure, which generally costs less than agency fees.
8. Compare agency fees
Look at the fees from a few surrogacy agencies before deciding. Pricing and program structures can vary widely, so understand what’s included upfront versus what’s charged separately. This helps you determine what makes the most financial sense for your situation.
9. Research clinics
Since surrogacy agency fees usually exclude medical expenses, shop around for fertility clinics. Get quotes from several to find the most reasonable pricing. However, pregnancy success rates are important considerations when selecting your clinic.
10. Explore financing options
Loans allow you to pay the high surrogacy costs over time. Some options are borrowing against your home equity, taking funds from a 401(k) account, or getting personal bank loans. But carefully consider if you can realistically budget monthly repayments in addition to regular costs of living, especially with the potential added expense of raising a child. If you're not sure, it might be a good idea to talk to a financial adviser.
11. Go the independent route
Rather than paying an agency, you may choose to go through the process independently. This do-it-yourself approach requires an incredible amount of work and research. If you choose this route, carefully consider the pros and cons.
12. Consider a hybrid service
If you’ve found a surrogate match but managing the independent journey sounds complicated and time-consuming, you can still save money by hiring a surrogacy consultant or concierge service. These services can provide case management, coordination, and on-demand support throughout the entire journey, Jaskulsky said, but you save on the agency fee.
13. Save on health insurance
The cost of surrogate health insurance can be quite high. Jaskulsky suggested that you may be able to save money by buying health insurance during the marketplace open enrollment.
Additionally, consider a surrogate who has surrogate-friendly health insurance, as you can save on insurance premiums.
14. Deduct qualified expenses on your tax return
Some surrogacy expenses, such as surrogate compensation and the surrogate's medical bills, are not tax deductible. However, certain medical fees directly involving the intended parents, such as egg retrieval and sperm donation, may be tax deductible. But you can only deduct expenses that exceed 7.5% of your adjusted gross income. Save your receipts and talk to a tax expert about your deduction options.
15. Use an HSA or FSA to pay for qualified expenses
If you have a health savings account (HSA) or flexible spending account (FSA), you can use the pretax dollars in your account to cover IVF expenses that are not reimbursed by your insurance plan or anyone else.
Every surrogacy journey is unique. So consider ways to lower your costs with your specific situation in mind. An approach that worked well for one person may not be the best option based on your priorities. When budgeting, Jaskulsky advised to hope for the best, but plan for unexpected costs.
What are the alternatives to surrogacy?
While surrogacy allows an intended parent to raise a biological child when faced with infertility or health barriers, the price tag often makes this option unaffordable. But there are alternatives that hopeful parents can consider on their journey to building a family. Each option comes with its own benefits, challenges, and costs.
Some alternatives include:
Fertility treatments: Assisted reproductive therapy such as in vitro fertilization (IVF) or intrauterine insemination (IUI) may help you conceive without using a surrogate. IVF involves fertilizing an egg with sperm in a lab and transferring the embryo to your uterus. With IUI, sperm is placed directly into your uterus to make fertilization easier.
Egg, sperm, or embryo donation: Using donated eggs, sperm, or embryos is another path to pregnancy if fertility treatments like IVF or IUI haven’t worked for you. This option allows you to carry and give birth to a child.
Adoption: Adoption may have lower costs than surrogacy, although with complex paperwork and waiting periods. But it can expand a family when surrogacy or biological children aren’t possible, all while giving a child in need a loving home.
Fostering: Foster care provides temporary care for children unable to live with their birth parents safely. While the main goal is to reunite the child with family, adoption by foster parents is possible.
Which option is cheaper: IVF or surrogacy?
IVF (in vitro fertilization) is usually more affordable than surrogacy. IVF is a fertility treatment where an egg is fertilized by sperm in a lab, and then the resulting embryo is transferred to the uterus. The cost of IVF can range from $20,000 to nearly $30,000 per cycle. Some intended parents may face multiple rounds of IVF in order to potentially become pregnant.
Surrogacy, on the other hand, costs anywhere from $150,000 to $200,000 or more. This is because surrogacy includes not only the cost of IVF but also the surrogate's compensation, legal and medical fees, and other related expenses.
The bottom line
Having a child through surrogacy is expensive, usually costing between $150,000 and $200,000. While it may seem impossible to afford, there are some ways to get help paying for surrogacy.
Qualifying for grants, getting creative with fundraising, using a hybrid service or matching platform, or asking someone you know to become an altruistic surrogate can make the cost more manageable. Alternatives such as adoption allow you to grow your family if surrogacy remains out of reach. Building your family comes down to researching all options and deciding what feels right for you.
Why trust our experts?
References
American Surrogacy. (n.d). Traditional vs. gestational surrogacy: Which type of surrogacy might be the best fit for you.
ART Risk Solutions. (n.d.). Surrogacy maternity insurance coverage options.
Child Welfare Information Gateway. (n.d.). Adoption.
Child Welfare Information Gateway. (n.d.). Foster care.
Gift of Surrogacy Foundation. (n.d). About Gift of Surrogacy Foundation.
Resolve: The National Infertility Association. (2023). Insurance coverage by state.
Resolve: The National Infertility Association. (n.d.). Fertility treatment scholarships and grants.
