Quick answer
Rarely in full. Health insurance doesn’t pay for surrogacy itself, and many plans exclude pregnancy care for someone carrying a baby as a surrogate. Some pieces can be covered, like IVF under the intended parents’ fertility benefits, or the surrogate’s prenatal care and delivery if her plan has no surrogacy exclusion. Intended parents usually pay whatever insurance doesn’t, which often includes a surrogacy-specific policy.
Key takeaways
- Insurance doesn’t cover agency fees, legal fees or the surrogate’s compensation.
- Many health plans exclude maternity care for a surrogate pregnancy, and some pay claims and then try to recover the money from her compensation.
- A professional review of the surrogate’s health plan is a standard step before signing a contract.
- If her plan won’t work, intended parents often buy her a Marketplace plan or a surrogacy-specific policy.
- According to a 2025 IRS letter ruling, intended parents can’t deduct the surrogate’s medical costs on their taxes.
On this page
Who usually pays for what
| Cost | Who usually pays |
|---|---|
| IVF and embryo creation | The intended parents’ plan, if it covers fertility treatment; otherwise the intended parents |
| Surrogate’s prenatal care and delivery | Her health plan if it doesn’t exclude surrogacy, or a separate policy |
| Surrogate’s premiums, deductible and copays | Usually the intended parents, under the contract |
| Agency, legal and compensation costs | The intended parents; insurance doesn’t pay these |
| Baby’s care after birth | The intended parents’ plan, once the baby is added |
Checking the surrogate’s health plan
Before a match, a specialist usually reviews the surrogate’s policy for two things:
- Surrogacy exclusions. Some plans won’t pay for pregnancy care when the woman is a surrogate.
- Reimbursement clauses (liens). Some insurers pay the bills, then ask to be paid back from the surrogate’s compensation.
If her plan has neither, it can cover the pregnancy like any other. Every ACA plan covers maternity care; see maternity coverage explained. Under most contracts, the intended parents pay the surrogate’s costs under that plan, including her deductible and copays. The plan’s metal level and whether it’s a high or low deductible plan affect those costs, and the out-of-pocket maximum caps them for the year.
If her plan won’t work, the options are usually a new Marketplace plan with no surrogacy exclusion or a surrogacy-specific policy. In most states, pregnancy doesn’t open a special enrollment period, so a new Marketplace plan may need to start during open enrollment.
Fertility coverage for intended parents
Your own plan may cover some fertility care, like testing, medications or IVF. Coverage depends on your plan and state; see will health insurance cover infertility treatment. Some large employers offer family-building benefits that can help with surrogacy costs, so ask HR.
Your baby’s coverage
A birth lets you add your baby to your plan: you get 60 days on a Marketplace plan and at least 30 days on a job-based plan. Before the due date, ask your insurer what it needs to add the baby, such as a birth certificate listing you as parents or a court parentage order. See qualifying events, health insurance for children and family health insurance.
Taxes
In a 2025 letter ruling, the IRS said a couple’s own fertility treatments could count as deductible medical expenses, but costs for the gestational carrier couldn’t: her medical care, insurance premiums, legal fees and compensation. A letter ruling applies only to the taxpayer who asked for it, but it shows how the IRS views these costs. Talk to a tax professional; see is health insurance tax deductible.
Surrogacy is expensive, and most of it is paid out of pocket. For planning, see what if you can afford your medical bills out of pocket.
Compare plans in your area: see quotes by ZIP code.
Frequently asked questions
Can I add my surrogate to my health insurance?
No. Health plans cover you, your spouse and your dependents, and a surrogate isn’t your dependent.
What is surrogacy insurance?
It’s a policy designed to cover a surrogate’s pregnancy when her own plan won’t. Intended parents usually pay for it.
Can a surrogate buy an ACA plan?
Yes, during open enrollment or a special enrollment period. ACA plans cover maternity care, but the policy still needs a review for surrogacy exclusions or reimbursement clauses.
Does insurance pay for IVF for surrogacy?
Sometimes. It depends on the intended parents’ fertility benefits and state law.
Sources
This article is general information, not legal, tax or medical advice. Last reviewed September 2026.