Health Insurance and Egg Donation

Because egg donation is considered an elective procedure, most insurance policies won't cover it. There are certainly exceptions, but they're not very common. So it's important to check with individual insurers to determine whether all, none, or a part of the procedure will be paid for.

For many people, the only available options may be to pay cash for the procedure or to purchase a special temporary insurance policy designed specifically to cover egg donation.

Insurance coverage for donors

Typically, the recipient or the program administering the procedure will pay for the donor’s medical costs and a fee for her time, expenses, and efforts. Sometimes, though, the donor will also be required to have her own health insurance to protect her in case complications or other unforeseen problems arise. In that case, if the donor is uninsured, she should ask who will pay the premiums and other costs for the insurance; a general comment that "the program or recipient will pay for all costs associated with the procedure" may not really cover everything, despite its wording. And if the donor is insured, she should read her insurance policy carefully to make sure it covers problems stemming from being an egg donor.

Insurance coverage for recipients

In many cases, the fertility center or egg-donation agency managing the procedure will require recipients to have health insurance prior to undergoing in vitro fertilization (IVF) with donor eggs. Egg-donation recipients need to check their insurance policies carefully to see what their plan covers.

Except in certain states where it's mandated, most insurance plans don't cover fertility treatments. But of the insurance plans that do cover fertility treatments, many don't include egg donation, even in those states that have a fertility-coverage mandate.

Even if the policy doesn't cover the actual fertility treatment itself, it's important to understand whether the plan covers subsequent problems that may arise as a result of fertility treatments.

Assisted reproduction insurance

Assisted reproduction insurance, sometimes called fertility insurance, is a one-time policy covering various fertility procedures which may not be covered by the patient's regular insurer. In addition to egg donation, the situations that can be covered include IVF, surrogates and gestational carriers, and even adoptions.

Despite what it sounds like, fertility insurance doesn't pay a woman who is ultimately unable to become pregnant. These policies can be difficult to obtain and quite expensive. They may cover multiple procedures, but only do so for one cycle, meaning that they may need to be purchased again for future cycles. They are available through some fertility centers and from a small number of specialized insurance agencies.

Other considerations for egg donors

There is no limit to the number of times a donor can donate eggs. However, the more donations, the higher the risk of complications in the donation process and to the donor's own health and fertility. The long-term risks to egg donors' health, if there are any, have not been clearly established.

In the past, there was a risk that having been an egg donor could impact the donor’s ability to obtain health insurance in the future, because insurance companies might have viewed an applicant with a history of having been an egg donor as a pre-existing condition, and therefore charge high premiums or deny coverage. However, the advent of the Affordable Care Act ("Obamacare") has meant that when applying for an insurance policy in the United States, pre-existing conditions are no longer taken into account. Insurers can no longer ask about them.

Nevertheless, if a donor’s current insurance plan notices a pattern of very high gynecological costs, they may begin to investigate and possibly refuse payments if being an egg donor violates the plan's guidelines. So it's important for egg donors to understand their insurance policy's rules.

Updated August 2014

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