India is climbing the infertility chart, with 27.5 million infertile people in the nation. According to the Indian Society of Assisted Reproduction, 1 in every 15 Indian couples struggles with infertility. Late marriages, smoking, alcohol consumption, drug addiction, obesity, and demanding and sedentary lifestyles are major contributing factors. These factors prompt couples to seek assisted reproductive treatments, thereby increasing demand. The adoption of these advanced technologies is rapidly increasing. In 2021, the Indian fertility industry was valued at $746 million and is expected to reach $1,453 million by 2027, with a potential of doing 5-6 lakh IVF cycles.
High Cost of IVF and Other Fertility Treatments
The most common fertility treatments are IVF, IUI, ICSI, and ART. Additionally, certain fertility drugs assist couples in conceiving. Considering the cost of these treatments, you may have to spend around Rs 90,000 to Rs 1.5 lakh per cycle of fertility treatments. While this cost might seem reasonable for the prospect of parenthood, there is an important consideration. But there is a catch.
Gold Rate
Thursday 13 March 2025
Success is not guaranteed with the first attempt. The success rate depends on factors like egg and sperm quality, age, embryo development, and implantation.
| Age | Success Rate |
| 35 | 54% |
| 35-37 | 40% |
| 38-40 | 26% |
| 40+ | 8% |
Therefore, it’s difficult to guarantee the success of IVF on the initial attempt. Consequently, repeated attempts incur further expenses, highlighting the necessity of health insurance coverage for IVF and other fertility treatments.
Are you considering IVF but worried about the costs? Maternity insurance plan can help you cover some of these expenses.
IVF and Fertility Treatment Coverage in India
Most health insurance companies exclude IVF and other fertility treatments as they don’t consider them necessary medical procedures. Furthermore, the uncertainty of pregnancy with these treatments poses a risk for insurers. However, considering the growth of IVF cycles in India, many insurance providers have introduced these to their plans. Many health insurance plans now include coverage for medical expenses for infertility treatment, such as doctor consultations, hospitalisation, medication, and fertilisation procedures. It is essential to carefully review the coverage and policy terms and conditions. Most insurance policies cover fertility treatments under the name of Assisted Reproductive Treatments.Therefore, consulting with your insurance agent about this clause is crucial for making an informed decision.
What to Expect From IVF Insurance Policies
Health insurance coverage aspects have evolved in India. Ensure you look for a comprehensive option before buying a maternity insurance plan covering fertility treatments. Below are key features to consider before choosing your insurer.
IVF Procedure: Coverage includes expenses for IVF cycles, such as sperm extraction, egg retrieval, and embryo implantation. It’s important to confirm any limitations on the number of cycles covered.
Waiting Period: The waiting period for coverage of assisted reproductive treatment is around 36 months for many maternity insurance plans. Therefore, purchasing a suitable insurance plan when planning a family is advisable to ensure coverage. Additionally, treatment must be received from a licensed medical practitioner; otherwise, the insurance company may deny coverage.
Age Restrictions: Most insurance companies have age limitations for IVF coverage.Typically, only women aged 40-45 are eligible for this benefit. Beyond this age, infertility treatments are not covered.
Add-ons: Some insurance policies provide additional coverage for infertility procedures. Since IVF may not be covered in a standard maternity insurance plan, a specific add-on is often required.
Exclusions
Certain treatment limitations may apply, such as the exclusion of egg or sperm donation, surrogacy, and ICSI. Therefore, carefully reading the terms and conditions of your health insurance policy is crucial before purchasing a plan for you and your partner. Some other exclusions are mentioned below-
- Reversal of sterilisation
- Gestational Surrogacy
- Any type of sterilisation or contraception
- Expenses related to miscarriages, unless caused by an accident.
7 Essential Tips for Choosing Health Insurance for Fertility Treatment
Not all health or maternity insurance plans cover infertility or ART treatments. Review the plan’s terms and conditions in depth to ensure coverage. Consider these key points before purchasing health insurance for fertility treatment coverage:
- Verify if fertility diagnosis costs are covered under the plan.
- Review eligibility criteria to determine who qualifies.
- Confirm the treatment procedures included in the coverage.
- Check sub-limits and coverage extent.
- Understand the waiting period for infertility treatment, as it varies by insurer.
- Ensure prescribed medications are covered.
- Check if add-ons cover additional infertility treatment procedures.
A New Beginning!
Navigating the complexities of fertility treatment can be overwhelming for couples aspiring to have a child. The cost of advanced treatment services is high and may not be under everyone’s budget. The financial burden can be lightened with health insurance coverage. A comprehensive and affordable fertility treatment option will cater to your needs, covering your financial and emotional aspects. You can expand your family with joy and happiness.
