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Is IVF treatment covered after a waiting period?

Planning for a family is a life-changing decision for a couple, but infertility may come in the way of one’s cherished dream. In this scenario, it becomes vital to seek medical help. Around 10-15% of couples face fertility-related health issues. Nearly 27.5 million couples in India are struggling with infertility in the hope of conceiving a child. IVF treatment brings some relief to such couples as it offers a window of opportunity by diagnosing problems in the partners’ respective reproductive systems. However, IVF treatment is expensive and can cost between Rs. 1-2.5 lakhs for the procedure.

Most health insurance policies do not cover IVF at all. Only a few plans do and that too as part of the Maternity coverage option. Maternity coverage itself involves a waiting period.

IVF treatment is high-priced because of the treatments associated with the overall process.  There are diagnostic assessments such as blood tests, genetic testing and other expenses which cannot be avoided. Fertility treatments are complex and hence require comprehensive health insurance for IVF expenses to be covered. For the few plans that do offer IVF specific health insurance, there are usually details specified for coverage. For example, plans may have sub-limits and stipulate the number of embryo-transfer attempts.

When purchasing health insurance plans that cover IVF, you should examine the following terms and conditions:

  • Eligibility: Based on your age, medical history and other health complications.
  • Waiting period: The waiting period to avail IVF cover can range from 2 to 4 years. (maternity insurance has a waiting period of 3-6 years depending on the policy)
  • Validity: This insurance may be availed one or two times.
  • Add-ons: Add-ons are additional benefits or coverage which do not come within the existing features of a health insurance policy but have to be added separately. Any add-ons to this policy such as specialized fertility treatments will come at extra premium.
  • Treatments under such insurance: All procedures mentioned for assisted conceptions may not be covered under the health insurance plan. After doctors identify the fertility issue, one can decide which assisted procedures to opt for and see if it is covered by the health policy.
  • Sub Limits: Some plans might include a sub-limit or upper cap on IVF treatment expenses, and specify the number of embryo-transfer attempts

Presently, a few insurance companies offer IVF cover, linked to maternity cover, as part of high-sum-insured premium policies to pre-existing clients. For example, New India Assurance and Magma HDI Insurance companies offer plans to cover limited expenses for IVF treatment.

SANA Insure is here to help couples navigate this extremely stressful process and the associated health expenses. We provide information and advice tailored to your needs, covering maternity and family insurance plans to coverage for fertility treatments, on our health insurance portal.

We invite you to visit SANA.insure to receive customized suggestions factoring in the diseases and conditions you want coverage for. You can also get in touch with us over WhatsApp chat on 8278271818 or call us on 1800 202 8118.

Wish you a healthy and happy life!

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