According to the National Family Health Survey-5 (NFHS-5), infertility affects nearly 17.5 - 18.1% of couples in India and abroad, with rising IVF cases prevalent in urban and semi-urban areas. The demand for IVF coverage in health insurance plans is also increasing.

For many couples, the emotional strain of infertility is already overwhelming. What increases the stress is discovering the cost of advanced treatments like IVF and IUI, which can cost lakhs of rupees, often without any clarity on insurance coverage. The assumption that a health insurance policy will step in during such times can turn into a harsh reality check.

Does Health Insurance Cover Infertility Treatment in India?

Traditional health insurance policies in India do not cover infertility treatments. Procedures such as IVF, IUI, and ART are typically listed under exclusions in individual health plans. Insurers usually categorise infertility treatments as elective or lifestyle-related, rather than essential medical treatments.

But nowadays, the scenario is changing; more insurance providers are realizing the growing demand for reproductive health support. They are designing health insurance that includes infertility coverage or providing IVF insurance as an add-on to maternity insurance. These plans usually provide partial or full benefits for fertility-related consultations, diagnostic tests, and advanced treatments such as IUI, IVF, and ICSI. IVF medical insurance plans are often placed under a higher sum insured.

Also Read: Everything you need to know about Medical Malpractice Insurance

What is IVF in Medical Insurance?

IVF Medical insurance is a kind of health insurance plan that bears the high costs of fertility treatments like IVF. These policies may cover a range of consultation fees, medications, diagnostic tests, and all procedures related to IVF.

Types of Infertility Treatments in India

Intrauterine Insemination (IUI):  One of the simple, non-invasive procedures in which doctors place the processed sperm directly into the uterus to aid fertilization.

In Vitro Fertilization (IVF):  In this case, eggs of women are fertilized with sperm in a lab. The embryo is then transferred into the uterus.
Intracytoplasmic Sperm Injection (ICSI): Doctors inject one healthy sperm directly into an egg, usually when male infertility is the main concern.

Donor Program:  In this scenario, the eggs of a donor, sperm, or embryos are used when either partner’s reproductive cells are unsuitable.

Surrogacy: A gestational surrogate carries the embryo for couples who are unable to carry a pregnancy.

​Inclusions of IVF Treatment in Health Insurance

  • Ovarian Stimulation:  Bears the cost of medicines that are being taken for the ovaries to produce more eggs.
  • Egg Retrieval and Fertilization: It also covers the cost the doctor charges for retrieving eggs from the ovaries and fertilising them in a lab.
  • Embryo Transfer:  Cover the procedure cost of placing the fertilised embryo into the uterus.
  • Embryo Harvesting: Covers the cost of collecting, storing, and handling embryos.
  • Pre-Implantation Tests: Genetic or chromosome tests performed on embryos before implantation.
  • OPD Doctor Visits: Reimbursement of the cost of visits to fertility doctors.
  • Hospitalization Expenses: Pays for room charges, nursing care, and other hospital costs during treatment.
  • Day-Care Procedures: Covers treatments that are completed in a single day without staying overnight in the hospital.
  • Medicines: Covers the cost of fertility medicines and doctor-administered hormone injections.

Exclusions

  • Donor Material Costs: Expenses for donor eggs or sperm are usually not covered in health insurance plans.
  • Surrogacy Payments:  All payments given to a surrogate or gestational carrier are excluded.
  • Unauthorised Procedures:  If IVF treatment is done without a certified doctor’s recommendation, it is not claimable.
  • Pre and Post Treatment Costs: Expenses incurred before or after the IVF cycle.
  • Reversal Surgeries: Reversal of voluntary sterilisation procedures like vasectomy or tubectomy is excluded.
  • Cryopreservation Charges: Costs incurred for freezing and storing eggs, sperm, or embryos are not included.
  • Subsequent IVF Attempts: IVF for a second or later child is usually not covered.
  • Fertility Enhancement Surgeries: Procedures like bariatric surgery or ovarian drilling are not covered.

Eligibility for IVF Coverage in Women’s Health Insurance

  • Waiting Period: A claim for IVF treatment is made only after the completion of the waiting period, usually 2 to 6 years.
  • Approved Clinic: The IVF treatment must be done at a recognized and approved fertility clinic.
  • Age Requirement: Most insurance plans cover IVF for women ages 21 to 42.
  • Doctor’s Recommendation: IVF should be advised by a doctor and supported with medical reports.
  • Infertility Confirmation: A qualified doctor always confirms infertility before treatment starts.
  • Policy Continuity: The insurance policy must be renewed on time without any break.
  • Marital Status: Many insurers cover IVF only for married couples, though some plans may also include single women.
  • Past Treatment History: Some insurers require previous fertility treatment reports before approving the claim.

    Some of the Popular Health Insurance Plans Offering IVF Treatment

  • Bajaj Allianz HERizon Care Plan
  • Care Ultimate Care Plan
  • Digit Health Insurance Plan
  • Cholamandalam Flexi Health Supreme Plan
  • Future Generali Health PowHER Plan
  • HDFC ERGO my: Optima Secure Plan with Parenthood Cover
  • Liberty HealthPrime Connect Plan

Online, there are many more options available; you can explore more as per your health needs.

Bottom Line

Choosing the right IVF insurance plan can be confusing, but you don’t have to do it alone. PBPartners insurance advisors guide you at every step, from policy comparison to claim support—so you can focus on your IVF journey, not insurance complexities.