Does Insurance Cover Egg Freezing?
Though the majority of health insurance providers do not yet cover egg freezing, some states have begun mandating fertility coverage on a case-by-case basis. Even so, these benefits tend to vary from policy to policy and typically only apply to women undergoing chemotherapy, radiation, or other medical treatments that could permanently alter their ability to conceive.
If your insurance company offers fertility benefits, they will likely still charge you a deductible and coinsurance for every egg freezing and eventual embryo transfer. Alternatively, women in states without mandated fertility coverage often must pay for these services entirely out of pocket.
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Understanding the Egg Freezing Process
Because female fertility generally declines around age 35, some women choose to have their eggs extracted, frozen, and stored in a controlled facility. This process allows individuals ample time to prepare for and rear a child during a more advantageous period in life.
However, the success of egg freezing also diminishes with age. Eggs from women in their early 20s and 30s each have an estimated 8% chance of successful fertilization, whereas eggs from women over 40 only have a 3% fulfillment rate. Therefore, older women must freeze significantly more eggs to ensure a higher likelihood of pregnancy, which can quickly inflate costs.
How Does Health Insurance Cover Egg Freezing?
Even if you live in a state with mandated fertility benefits, access and limitations will vary depending on your plan. Some employer-sponsored health plans will pay for egg freezing without a medically necessary precedent. Meanwhile, other forms of group coverage and most private health insurance policies will only cover women expected to undergo procedures – such as chemotherapy or radiation – that could permanently inhibit their ability to conceive.
As of 2023, 21 states have laws requiring insurance companies to offer baseline fertility benefits. These include:
- New Hampshire
- New Jersey
- New York
- Rhode Island
- Washington D.C.
- West Virginia
However, only 12 of these cover both the egg preservation and the in vitro fertilization services required for embryo development:
Fertility Preservation Coverage
All large group health plans must cover three completed oocyte removals and unlimited embryo transfers if recommended and medically appropriate.
All policies must offer at least two cycles of IVF for people unable to conceive through more affordable means.
All individual, group, and blanket health insurance policies must cover IVF and fertility preservation services for individuals undergoing medically necessary treatment capable of causing iatrogenic infertility.
All group insurers and HMOs providing pregnancy-related coverage must include 4-6 lifetime egg retrievals and IVF.
All health plans must cover fertility services for patients undergoing medically necessary procedures that could cause iatrogenic infertility.
All health plans must cover non-experimental fertility preservation services.
Individual and group plans with pregnancy benefits must cover three IVFs per live birth up to a $100,000 lifetime maximum.
All health insurers issuing group plans must cover preservation services for individuals expected to undergo medical procedures that could impair their fertility.
Group insurers, HMOs, and State and School Employee Health Benefits Programs providing pregnancy-related coverage must cover IVF, egg freezing, and retrievals for women under 46.
Group health plans must offer 3 IVF cycles and medically necessary fertility preservation services to women facing iatrogenic infertility.
Insurers and HMOs with pregnancy benefits must provide standard fertility preservation services for women who could become infertile due to another medically necessary procedure.
Medicaid must cover standard fertility preservation services for patients with approved waivers.
By 2025, all individual and group health insurance plans must cover standard fertility preservation services and three rounds of IVF.
How Much Does Egg Freezing Cost?
Even with insurance coverage, egg freezing can become very expensive. Approximate fees include:
- Cryopreservation of embryos: ~$1,200, including egg retrieval, anesthesia, and monitoring.
- Embryo storage: ~$5,000, assuming 5 years of storage.
- Transfer of frozen embryo: ~$4,000 per transfer.
- Frozen embryo transfer medications: ~$5,000, depending on how aggressively doctors must stimulate a patient.
Notably, these costs only pertain to one round of treatment. Most women must undergo 2-3 IVF cycles to initiate a successful pregnancy. Furthermore, even those in states with mandated fertility benefits typically must pay their policy’s annual deductible and a sizeable coinsurance for every egg retrieval and transfer.
Medicaid Coverage for Egg Freezing
While Utah’s Medicaid program covers egg freezing for patients who clear specific cancer waivers, no other state will pay for fertility preservation treatments. However, some Medicaid providers still cover medically necessary IVF procedures, which occasionally include monitoring services, bloodwork, and other costs associated with egg freezing.
Medicaid finances nearly 42% of births in the United States but still offers very little assistance in helping members achieve pregnancy. As fertility technology continues to gain popularity, so should public access to related care. Periodically ask your Medicaid provider about egg freezing, IVF, and other annual coverage updates to maximize your potential benefits.
Alternative Financing for Egg Freezing
Depending on the number of cycles you require before a successful pregnancy, out-of-pocket costs for egg freezing and fertilization can range from $15,000 to $40,000. Considering the many restrictions potentially limiting your access to insurance benefits, explore the following financing options to reduce immediate costs:
- Loans or payment plans: Some fertility clinics offer payment plans that help patients incrementally pay for medical treatment via monthly allotments.
- Health Savings Accounts: HSAs allow members to contribute pretax dollars and build tax-free interest applicable toward eligible medical expenses. Depending on your income bracket, switching to an HSA-backed health insurance policy can help you save 20-25% on fertility costs.
- Friends and family: Borrowing or pooling money from your parents, siblings, or spouse can help significantly absorb the cost of egg freezing. Sometimes, a fertility clinic will even allow family members to purchase a treatment loan on your behalf.
When Should You Freeze Your Eggs?
Generally speaking, younger women have a higher quality and quantity of eggs, significantly boosting the likelihood of fertilization. According to the American Society of Reproductive Medicine, the best time to freeze eggs is in your 20s and early 30s.
However, many young women lack the resources to independently finance fertility treatment nor the medically necessary justification required to trigger state-mandated insurance coverage. While some people in their late 30s can still have eggs frozen and transferred for use in their early 40s, women over 45 typically have very little chance of facilitating a successful in vitro pregnancy.
All in All
Today, more and more people have to choose between career and family. By freezing their eggs, younger women can buy themselves time to accumulate the necessary resources to support children later in life. However, considering the high out-of-pocket costs, this luxury remains out of reach for most potential candidates.
As fertility treatment gains popularity, state-mandated insurance coverage should continue expanding to include egg freezing and IVF for a broader population of women. Ask your employer or private insurer about potential fertility services included in your policy. If you lack coverage, explore financial alternatives such as medical loans, HSAs, or support from friends and family members.