Even if you have insurance that includes fertility treatment, it’s important to understand that you’ll still be responsible for a number of costs. Let’s look at a common example: a patient undergoing two IVF cycles in one year with a typical policy — $500 monthly premiums, a $5,000 deductible, and 20% co-insurance on a plan that covers $20,000 in fertility care.
For the first half of the year, the patient pays $3,000 in premiums (6 months × $500). Because the $5,000 deductible hasn’t yet been met, the $5,000 fertility drug cost is paid entirely by the patient.
The IVF procedure itself costs $10,000, of which the insurer covers 80% ($8,000), leaving the patient responsible for $2,000.
So far, the total paid by the patient for this cycle is $10,000:
$3,000 in premiums
$5,000 for drugs
$2,000 to the clinic
Since the success rate of a first IVF cycle is typically only 10–50%, many patients proceed with a second cycle later in the year.
During this time, the patient pays another $3,000 in premiums (6 months × $500). Because their deductible has already been met and their coverage maximum hasn’t yet been reached, the patient pays $1,000 (20%) of the next drug bill and $2,000 (20%) of the clinic fee.
At the end of the year, total patient expenses amount to $16,000, while insurance covers $20,000 — nearly a 1:1 cost split, even with solid coverage.
In the previous scenario, both IVF cycles occurred in the same year. Now, let’s see what happens if the second cycle is postponed six months, crossing into a new calendar year.
Because deductibles reset annually, the patient now faces new out-of-pocket drug expenses for the second cycle — even though their fertility maximum remains unspent. As a result, total patient costs rise to $20,000, while insurance still covers only $16,000.
Whenever possible, it’s often more cost-effective to complete multiple treatments within the same plan year to avoid paying multiple deductibles.
It’s natural to assume that if your insurance will pay, you should use it. But surprisingly, there are situations where relying on insurance can cost more than paying cash directly.
That’s because clinics and pharmacies often maintain two pricing systems:
A “cash pay” price (for direct payments)
A “contracted insurance price” (for claims billed through insurers)
In many cases, the cash pay rate is significantly lower because providers avoid the delays and administrative costs associated with insurance billing.
This pricing gap can be especially large for fertility medications, which are a major part of total treatment costs.
Let’s say your fertility medications cost $10,000 through insurance but only $3,000 at the cash pay rate.
If you bill insurance:
You pay less immediately, but your $20,000 fertility maximum gets depleted quickly.
Later, when it’s time for the clinic bill, you’ve hit your cap and must pay the remaining costs yourself.
Total personal expense = $10,000
If you pay the pharmacy directly:
You spend $3,000 upfront, but preserve most of your fertility maximum.
When clinic bills come in, insurance still covers a large portion.
Total personal expense = $7,000, and you still have $4,000 left in coverage.
In this case, paying cash actually saves money and preserves benefits for future use.
While not always applicable, it’s often worth considering paying directly when:
You require expensive injectable medications, and your fertility drug costs are part of your treatment cap
Your fertility coverage is limited by a dollar maximum (not by the number of cycles)
There’s a large price gap between the clinic’s cash rate and the insurer’s contracted rate
You have an HSA with pre-tax savings, and prefer to let those funds grow
Most fertility treatment expenses come from your clinic — either as physician fees (consultations, monitoring) or lab fees (egg retrieval, embryo culture, transfers). Sometimes these are billed by separate entities, each with different insurance arrangements.
That’s why it’s essential to speak directly with your clinic’s billing coordinator and request a detailed explanation of all potential costs.
Ask for a breakdown of all expected fees, including:
Physician visits
Anesthesia (if billed separately)
Lab work (ICSI, assisted hatching, PGT testing)
Embryo freezing and annual storage fees
Doctors may hesitate to discuss costs, but understanding what’s optional versus necessary is key to avoiding unexpected expenses.
Your clinic may outsource services like anesthesia or embryo testing (PGT) to external providers. These third-party vendors issue their own bills, which can be much cheaper if they’re in-network with your insurance.
Request that your clinic use in-network vendors whenever possible — it can dramatically reduce your costs.
Many insurance plans that cover fertility treatments require patients to try lower-cost options (like medication or IUI) before approving IVF.
However, a specific diagnosis may allow you to skip these preliminary steps and qualify for coverage sooner.
For example, if a physician diagnoses a condition that prevents natural conception — such as blocked fallopian tubes, diminished ovarian reserve, or severe male factor infertility — insurers may authorize more advanced treatments directly.
Insurance companies often base coverage decisions on the diagnosis “code” submitted by your doctor.
If you or your partner have a medical condition that impacts fertility, make sure it’s properly documented and coded as an infertility-related diagnosis.
For example:
A gay male couple may be more likely to qualify if one partner is diagnosed with “male factor infertility” based on semen analysis.
A woman with endometriosis or irregular cycles should ensure those conditions are recorded, as treatment may be partially covered if the procedures address related symptoms (like pelvic pain) rather than infertility alone.
Correct medical coding can be the difference between full denial and partial approval of insurance benefits.
Our job is to listen, to connect the dots between your needs, and to determine how we can best help you have your baby. If you’re asking how much does it cost for a surrogate, we’ll walk you through every step of the process to ensure there are no surprises.
To make an appointment with one of our counselors or physicians, please call (212) 661-7673 or email info@surrogacy4all.com. We look forward to hearing from you.
Surrogacy4All is a unique international surrogacy service targeted at providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex or color, at the lowest possible cost in the world.
Secret Guide to Minimizing Surrogacy Costs
All Rights Reserved to Surrogacy4all