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Health Insurance Cover Infertility Treatment

  • Author :
  • TATA AIG Team
  • Last Updated On :
  • 05/09/2023

Parenthood is an incomparable experience for many. However, as many as 15% of reproductive-aged couples worldwide are unable to experience this joy as they are affected by infertility. Amongst young Indian couples, infertility is becoming a pertinent issue, and many couples may require medical advice and treatments. Since these medical treatments are expensive, couples are seeking health insurance that covers infertility treatments to help manage the costs. Before answering the question — is IVF covered by insurance? — let’s first understand infertility.

Understanding Infertility

Many couples across the globe struggle with conceiving. Infertility is a medical condition wherein a couple cannot get pregnant despite having frequent unprotected sex for at least a year.

Infertility can be caused due to a medical issue in either you or your partner, or it can be the result of a combination of factors. There are essentially two kinds of infertility – primary and secondary. Primary infertility refers to the condition wherein a couple cannot get pregnant despite having regular unprotected sex for a year. Secondary infertility, on the other hand, is when a couple has been able to conceive once but cannot get pregnant again.

Thankfully, as a result of advancements in medical sciences, several effective therapies can help enhance the chances of conceiving.

Causes of Infertility

As many as 15% of Indian couples are struggling with problems of infertility. The most common factors that contribute to infertility amongst Indian couples include overly stressful lifestyles, high intake of junk foods, alcoholism, etc. As infertility in India has reached double digits, the problem has become both a private and public concern within the country. Some of the most common causes of infertility amongst couples are as follows:

  • Obesity and leading a sedentary lifestyle
  • Diabetes
  • Smoking
  • Excessive consumption of alcohol
  • Ineffective stress management
  • Not having balanced and nutritious meals
  • Reproductive diseases in women such as uterine fibroid, PCOS, tubal block, endometriosis, pelvic inflammatory disease, etc.
  • Reproductive diseases in men such as issues concerning ejaculation, lower sperm count and quality, etc.
  • Advancing age of women
  • Various infections and tuberculosis
  • Frequently using emergency contraception
  • Getting surgical abortion
  • Pollution
  • Genetic concerns

Once the cause of infertility has been recognised, the doctor can prescribe the right treatment. However, since the costs of infertility treatments can be high, several individuals wonder if fertility treatment is covered by insurance to help with the treatment expenses.

Treatments for Infertility

How infertility is treated in your condition will depend on what is causing the issue in the first place. Only after efficiently diagnosing your condition will the doctor propose a treatment option. In a country like ours, many social stigmas and emotional stress are associated with infertility. However, meeting with a specialist can help manage most cases with simple treatments. Commonly, infertility treatments include:

Medicines: Medicines may be prescribed to women who are ovulating irregularly or are facing problems with ovulation. Whereas for men, medicines may be prescribed to enhance fertility. However, some of these medicines can lead to side effects such as nausea, hot flashes, headaches, vomiting, etc. It is, therefore, advised that the individual seeking the treatment ask their doctor about the possible side effects so they know what to expect.

Surgical Procedures: To further investigate fertility problems and help with fertility, the doctor might recommend surgical procedures based on your medical condition. In India, there are essentially two kinds of surgical fertility treatments:

  • Laparoscopy: This is a non-invasive surgical procedure that is undertaken to reconstruct the reproductive organs and thereby treat conditions such as endometriosis, ovarian cysts, blocked tubes, etc.

  • In Vitro Fertilisation: In Vitro Fertilisation or IVF is a fertility treatment where the eggs and sperm are fertilised outside the body in a laboratory dish. This is also commonly known as the “test tube baby technique.” In this method, the female partner is given hormonal injections to produce more eggs in both ovaries. The eggs are then retrieved and fertilised in an embryology lab, and on around days 2-

  • 5, are transferred to the uterine cavity.

Is the Treatment for Infertility Covered by Health Insurance?

Traditionally, no medical insurance plan covered the cost of infertility treatment. The expenses for IVF treatment can range anywhere between ₹1 lakh to ₹4 lakhs without guaranteeing success. Typically, most insurance companies do not offer IVF health insurance.

Now, however, insurance companies are becoming more inclusive by offering health insurance that covers infertility treatments. Newer insurance providers are either designing IVF insurance plans to include infertility treatment coverage or are providing IVF insurance coverage in India as an add-on to maternity insurance. IVF insurance plans are commonly placed under covers with a higher sum insured amount.

Insurance seekers must make a note, however, of the fact that not all IVF health insurance covers are the same. Before they buy health insurance online, policyholders need to carefully read the documents to know which treatments will be covered and what are the policy exclusions.

Which Infertility Treatments are Covered Under Health Insurance?

Here is a list of common fertility treatments covered by insurance:

  • In Vitro Fertilisation (IVF)
  • Intrauterine Insemination (IUI)
  • Gamete Intrafallopian Transfer (GIFT)
  • Intracytoplasmic Sperm Injection (ICSI)

Before investing in a medical insurance plan, it is advised to compare different policies and ask your insurance provider, “is IVF covered by insurance?” So that you are not unpleasantly surprised at the time of treatment.

Factors to Consider Before Buying IVF insurance coverage in India

A medical insurance plan covering infertility treatment will usually have certain terms and conditions that the policyholder will have to adhere to. Therefore, before you buy health insurance online for fertility treatment, check the policy for the following things:

  • The eligibility criteria for the fertility treatment coverage
  • If the insurance covers the cost of diagnosis
  • Procedures that will be covered under the health insurance
  • Policy limitations and the extent of coverage provided
  • Waiting period for claims (may range anywhere between 2-6 years)
  • If the insurance covers the cost of medication
  • Add-ons for any infertility treatment expenses

The Bottom Line

Infertility is a growing concern in India and more so in urban areas. With an increase in the number of individuals seeking treatment for infertility, the requirement for health insurance that covers fertility treatments also increased. However, the benefits of health insurance extend far beyond infertility treatments for young couples who are thinking of starting a family. The medical insurance plan by Tata AIG offers comprehensive coverage with plans for individuals as well as families. To find the best insurance, it is recommended to buy health insurance online so you can easily compare policies and find yourself a suitable cover.

Disclaimer / TnC

Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.

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