Does Medicaid Cover Surrogacy Costs?
Unpack Medicaid's nuanced coverage for surrogacy. Learn what's covered for the surrogate and how state policies impact overall costs.
Medicaid is a joint federal and state program providing healthcare coverage to eligible low-income individuals and families. Surrogacy offers a path to parenthood for many, involving a gestational carrier. Understanding the financial aspects of surrogacy, particularly insurance coverage, is important.
Medicaid’s Stance on Surrogacy Coverage
Medicaid generally does not cover the comprehensive costs associated with a surrogacy arrangement for intended parents. This includes expenses for fertility treatments, agency fees, or direct compensation for the gestational carrier.
Medicaid’s primary role is to provide medically necessary care. It may cover the pregnancy-related medical care for a gestational carrier if she meets the program’s eligibility criteria. While broader costs of surrogacy are typically excluded, the medical care for the pregnant surrogate herself might be covered if she is Medicaid-eligible.
How State Policies Affect Coverage
Medicaid operates under a general federal framework, but each state administers its own program with variations in eligibility and covered services. States have flexibility in setting income thresholds and determining the scope of reproductive health and pregnancy care benefits. This means that Medicaid policies regarding services related to surrogacy can differ significantly.
Some states have specific policies that might impact a Medicaid-eligible surrogate’s coverage. Receiving compensation as a surrogate can impact Medicaid eligibility due to increased income, potentially leading to a loss of coverage. Many surrogacy agencies require that potential surrogates are not receiving government assistance like Medicaid. If a surrogate maintains Medicaid coverage while receiving compensation, it could be considered insurance fraud, with possible legal consequences.
Specific Expenses and Medicaid Coverage
The costs involved in a surrogacy journey are substantial, often ranging from $100,000 to $200,000 or more in the United States. These expenses encompass various medical and non-medical components. Medicaid’s coverage is typically limited to specific, medically necessary pregnancy-related care for the gestational carrier.
Medicaid may cover the gestational carrier’s prenatal care, delivery, and postpartum care, assuming she meets the program’s income and residency requirements. This coverage includes routine doctor visits, laboratory tests, ultrasounds, and hospital charges for childbirth. Federal law ensures pregnant individuals can qualify for Medicaid at higher income levels than other adults, and coverage typically extends for up to 12 months postpartum in most states.
Conversely, many expenses associated with surrogacy are generally not covered by Medicaid or most private insurance plans. These include fertility treatments such as in vitro fertilization (IVF), embryo creation, and embryo transfer costs for the intended parents. Medicaid does not cover surrogate compensation, which can range from $30,000 to over $110,000, depending on factors like location and experience. Other uncovered costs typically include agency fees, which average $20,000 to $40,000, and legal fees for drafting contracts and establishing parental rights, which can be between $3,000 and $20,000. Additional expenses such as psychological evaluations, travel costs for the surrogate, maternity clothing allowances, or lost wages are also generally not covered by Medicaid.