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Navigating insurance as a gay couple

The journey to become parents, particularly for LGBTQ+ families, can be an arduous one. The law is not by default always inclusive and navigating health insurance and coverage for both a surrogate and baby can be tricky. 

Covering the surrogate

If you’re adopting or having a baby with the help of a surrogate, there are a few considerations to help provide adequate coverage for all parties.

Taking out a health insurance policy to cover the surrogate while she’s carrying your baby can be a form of protection both for your finances and legally for everyone. Supplemental insurance plans can cover the surrogate’s prenatal care. This generally ends up costing less than paying out of pocket for medical expenses. Plus, it also takes the guesswork out of the process, including potentially unanticipated expenses if there are complications during the pregnancy or birth.

What’s an insurance review?

If your surrogate already has health insurance, an insurance review can determine is there are any surrogacy exclusions in her plan. 

There are companies (like one called ArtRisk) that offer an insurance review service. Usually the agency coordinates this, but you as the intended parent can do it as well. For a fee the insurance review company will fine-tooth-comb the surrogate’s insurance policy to determine whether there are any surrogacy exclusions. If there are no exclusions, her plan can be used to cover the medical expenses of the pregnancy even though it’s not for her own child.

It is certainly a bit of a confusing landscape when it comes to identifying the right path to make sure your surrogate has health coverage. A few things to know:

  • It’s not possible to add your surrogate to your insurance plan. 
  • If your surrogate is currently employed and receiving health insurance through the employer, she’s legally prohibited from obtaining separate insurance coverage. 
  • Her current provider may or may not cover expenses related to surrogacy, including through her pregnancy. 
  • There are also limitations with buying a health insurance exchange policy, including the limited enrollment window and the same double coverage risk. 

For most people, the best option is to purchase what’s known as surrogacy insurance, a plan that will cover the surrogate, most often from the point of conception (which means any fertility treatments prior to getting pregnant won’t be covered). These plans could cost somewhere between $15,000 to $25,000 or more. They do generally cover everything, though, removing the concern about potentially high hospital fees related to the birth and if there are any complications that might require more specialized services or surgery, or a longer hospital stay.

Some surrogacy policies also cover parental leave and recovery time post-birth. That can be a considerate addition to any medical coverage you’re weighing for your surrogate. Be sure to do your homework in advance, as not all insurance carriers offer surrogacy insurance. 

Baby’s coverage

If you are legally married to your spouse and on the same health insurance, it may be easier to add the baby to your health insurance when they’re born. Identify the primary insurance holder if you are married, and whose insurance the baby will go on, if not the primary insurance holder’s. If you are the insurance holder but you are not married to your spouse and the baby is genetically related to you and not your spouse, you should make sure the baby is on your insurance. If you don’t have legal spousal benefits, but do have domestic partnership status, that can provide similar cover for you. If you are married and you and your spouse are both on the same insurance, then the baby can just get added to that plan. Regardless, ensuring your baby is covered from birth is a more straightforward process than securing health insurance for a surrogate during her pregnancy. 

In all, not securing insurance poses the largest risk. It’s worth the investment upfront to ensure there are no surprise expenses or medical emergencies that risk the health of the surrogate or your baby, down the line. You can rest more soundly knowing that all parties are protected and focus on the most important part of the journey — the excitement of welcoming a new life into the world and your family!

Reviewed by the Ovia Health Clinical Team

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