Does insurance cover surrogacy?

Insurance rarely pays for the whole of a surrogacy journey, and when the surrogate lives in another country it pays for even less. Your home health plan may help with your own IVF. The surrogate's pregnancy and birth abroad are usually funded by a separate maternity policy or a line in the programme budget. Travel insurance often excludes them altogether. This post explains each layer so you can budget for the gaps, alongside our international surrogacy cost comparison.

The short answer

For intended parents going abroad, insurance usually covers only pieces of the journey: sometimes your own fertility treatment, sometimes your baby after birth, and sometimes your life or travel. The surrogate's pregnancy, delivery and compensation are almost never paid by your home plan, so programmes arrange local maternity cover or budget for it directly.

It helps to think of the costs in five layers, each insured (or not) differently.

US employer plans and state IVF mandates

US coverage depends on whether your employer plan includes fertility benefits and which state's rules apply. Even generous plans normally cover the intended parents' IVF and, at most, limited services for the carrier. The carrier's pregnancy, compensation, legal and agency fees are generally excluded, wherever the birth takes place.

California is the clearest recent example. Senate Bill 729 (opens in new tab) requires large-group health plans to cover infertility diagnosis and treatment, including up to three completed egg retrievals with unlimited embryo transfers, and bars plans from denying coverage because treatment involves a gestational carrier or surrogate. The bill text originally applied from July 1, 2025. A 2025 budget bill moved the start to plans issued or renewed on or after January 1, 2026, so many employees only gain the benefit at their plan's renewal date. Small-group plans must only offer the coverage; religious employers are exempt. Self-funded employer plans, which are regulated federally, are not bound by state mandates.

The regulator's guidance matters for surrogacy. California's Department of Managed Health Care says in its revised All Plan Letter 25-021 (February 2026) that the carrier's lab tests, imaging and embryo transfers are covered, but her compensation, legal and agency fees, and the costs of her pregnancy are not paid by the intended parent's plan. Whether a California plan will pay for IVF performed at an overseas clinic is a separate question: out-of-network and out-of-country rules apply, and we could not find guidance addressing it.

ACA plans and surrogate exclusions

US Affordable Care Act marketplace plans must cover pregnancy, maternity and newborn care as an essential health benefit. That matters mainly when the surrogate lives in the US and has her own plan. Some plans still contain surrogacy exclusions or reimbursement clauses, so a written policy review is essential before transfer.

HealthCare.gov lists (opens in new tab) pregnancy, maternity and newborn care among the ten essential benefits. If your journey is in the US, see our page on surrogacy in the USA for international parents, which explains why the USA is now uncertain for families where neither parent is a US citizen (Executive Order 14418, August 2026). For surrogates living in Mexico, Colombia, Georgia (the country) and similar destinations, US marketplace rules do not apply; the local maternity arrangement does.

UK: the NHS and surrogacy

The NHS generally does not fund surrogacy, and nothing in NHS funding extends to arrangements overseas. One NHS trust states plainly that surrogacy is never NHS funded. In Scotland, NHS Lothian may fund the IVF element for eligible patients treated locally, but not surrogacy arrangements or expenses.

So UK intended parents going abroad should budget for all treatment, the surrogate's care and the birth privately. A surrogate living in the UK receives NHS maternity care like any other pregnant resident, but that does not help when she lives elsewhere. After the birth, you will also need a parental order; our guide to bringing your baby home explains the steps.

Australia: Medicare

Medicare does not pay for IVF linked to surrogacy. The Department of Health's patient information sheet, updated in August 2025, states that MBS benefits cannot be claimed for IVF treatment involving a surrogacy arrangement, even though access was broadened in 2024–2025 to single people and same-sex couples.

Australians should also check their state's law before any arrangement abroad, because some states criminalise commercial surrogacy overseas. See our surrogacy laws by country guide.

The surrogate's maternity insurance abroad

In most destinations, the surrogate's pregnancy and birth are paid for through a private maternity policy bought for her, a fixed hospital package, or a contingency fund held by the programme. What matters is the limit, the exclusions and who pays if complications push costs beyond them.

Questions worth asking any programme:

1. What exactly is the policy? Insurer, policy holder, start date and the annual or per-pregnancy limit.
2. What is excluded? Pre-existing conditions, multiple pregnancy, preterm birth, intensive care and medical evacuation are common pressure points.
3. Who pays overruns? The surrogacy agreement should say whether you, the programme or a complications product covers costs above the limit. Our post on surrogacy contracts abroad covers this clause.
4. Is the surrogate protected after birth? Postnatal care and treatment of any complications should be funded, regardless of the outcome of the pregnancy.

Some programmes sell "complications" or "guarantee" add-ons that pay for extra medical costs or repeat attempts. Read these as contracts, not promises: check the cap, what triggers payment and whether the provider is a regulated insurer or simply the programme itself.

Newborn and NICU cover

Your baby's care after birth is often the largest uninsured risk. A US employer plan must let you enrol a newborn dependant within at least 30 days, with cover from the date of birth, but whether a plan pays for care in a foreign hospital, and before parentage is legally settled, varies.

Under federal special-enrollment rules (45 CFR 146.117 (opens in new tab)), group plans must offer enrolment for a new child by birth, with cover starting on the date of birth. Ask your insurer three things in writing: does the plan treat a baby born through surrogacy abroad as your dependant from birth; does it pay for out-of-country hospital care; and what documents (birth certificate, court order) it needs. Premature birth and neonatal intensive care can be expensive, and twins raise the risk, so make sure the programme's maternity policy, your plan or a dedicated newborn product covers the gap.

Travel insurance exclusions

Standard travel insurance is designed for sudden, unexpected events. Policies commonly exclude planned medical treatment and claims connected with pregnancy and childbirth, and many say nothing explicit about surrogacy. Do not assume it covers the newborn, the surrogate or delays while you wait for exit documents.

The UK government's travel insurance guidance (opens in new tab) advises reading the exclusion clauses and declaring existing conditions or pending treatment so that related complications are covered. For a surrogacy trip, tell the insurer the purpose of travel, ask whether a baby born during the trip is covered, and check how long the policy can be extended if passports or court orders take longer than planned.

Life insurance for intended parents

Many surrogacy agreements ask intended parents to hold life insurance, and often to appoint a guardian, so the child is provided for if something happens to them during the pregnancy. Some programmes also require life or disability cover for the surrogate, paid for by the intended parents.

If your agreement requires a policy, check the minimum amount, the named beneficiary or trust and the deadline. Update your will at the same time.

What insurance does not cover: tax and financing

Uninsured surrogacy costs usually come out of savings, loans or employer benefits. In the US, the IRS position is that payments for a surrogate's compensation and medical care, including her insurance, are not deductible medical expenses, although the intended parents' own IVF costs can be.

That rule appears in IRS Publication 502 (opens in new tab). For loans, grants, employer benefits and currency risk, see our companion post on surrogacy loans and financing options.