Surrogate pregnancy is one of those gray areas that gives insurers a great deal of leeway to deny claims for maternity and postnatal coverage. Laws have not kept pace with the need for and the increasing popularity of surrogacy as an infertility option, so there are few black-and-white rules. Who pays for what is often decided on a case-by-case basis.
Surrogate Pregnancy Insurance Coverage
A handful of insurance companies offer specialized policies to cover a wide range of infertility issues. They're pricey, but when intended parents can afford such a luxury, all costs of surrogate pregnancy are typically covered, from fertilization through gestation, delivery, and postnatal care. This coverage is ideal because intended parents and surrogate mothers – also called gestational carriers – can be assured from the start that all their medical costs will be covered.
When intended parents don't have special policies covering infertility issues, many gestational carriers rely on their own health insurance instead. This can be dicey if the insurer isn't aware that the pregnancy is a surrogacy. Insurers can – and some have – sued gestational carriers to recapture maternity claims they've paid. The surrogate's medical records often provide substantiation of the nature of the pregnancy, so it may be difficult – and unwise – to try to conceal the truth. Insurers have also denied postnatal care claims on the basis that the baby is not the surrogate mother's dependent; she has no intention of claiming the child, raising him, or supporting him. If a contract exists between the intended parents and the gestational carrier – and it usually does – the surrogate mother can enforce it to collect the medical bills from the intended parents if her insurance claims are denied.
Intended Parents' Coverage
Intended parents' health coverage sometimes addresses the preliminary steps of surrogate pregnancy, those involving the initial infertility procedures. This usually depends on whether they have an extensive policy that covers a few such extras. These policies don't usually cover the pregnancy itself, or delivery and postnatal care.
The situation is further complicated by the fact that coverage varies not only from insurer to insurer, but from policy to policy with the same insurer. If you're considering a surrogate pregnancy, read your policy over carefully to find out where you stand. Some policies specifically and precisely exclude surrogate pregnancy coverage. Others may couch the exclusion in murky language that tries to make a distinction between dependents and biological children, or that prohibits coverage for conditions where money or remuneration has changed hands. Legislation is gradually catching up with the issue of surrogacy, however, and some states have begun to implement rules. For example, the Wisconsin Supreme Court ruled in 2010 that an insurer could not deny maternity coverage to a surrogate mother even though the policy stated that it would not pay for such care.
- State Bar of Wisconsin: Insurers Cannot Exclude Surrogate Mothers From Maternity Coverage Under Statute
- American Fertility Association: Healthcare Reform and the Extension of Hospital Visitation Rights
- Brown & Brown Insurance: Fertility Insurance Program
- The AFA Blog: Medical Insurance Issues as They Affect the Selection of a Potential Surrogate
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