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Infertility is defined as the inability to conceive children and can cause severe distress to couples. While determining the exact cause for this may be difficult, it could be attributed to several factors.

 

This can be a difficult experience to undergo, both physically and emotionally, but there are various treatment options available. These include medication, surgery, and assisted reproductive technology (ART) such as In Vitro Fertilisation (IVF) to help couples conceive.

 

Read on to learn more about this and the ways to seek medical and financial aid.

What are the Causes of infertility?

There may be many different causes for infertility issues in men and women. Some of the most common reasons behind infertility, as identified by modern medicine, include the following.

Ovulation Disorders: 

These can include conditions such as polycystic ovary syndrome (PCOS) and thyroid disorders that can prevent ovulation from occurring.

Fallopian Tube Damage or Blockage: 

This can be caused by pelvic inflammatory disease, endometriosis, or prior surgery in the pelvic area.

Immunological Problems: 

Some people have antibodies that attack the sperm or the egg, making it difficult for them to conceive.

Age: 

As people get older, their fertility decreases, and the chances of not conceiving a child or having a miscarriage increase.

Lifestyle Factors: 

These include, smoking, alcohol consumption, drug use, being overweight or underweight, and extreme stress.

Environmental Factors: 

Exposure to certain chemicals or toxins can harm the reproductive system and lead to infertility.

Genetic Factors: 

Some genetic conditions can cause infertility, such as Turner syndrome, which affects the development of ovaries in females.

 

It's important to note that infertility can be a complex issue. A diagnosis may require multiple tests, and treatments may involve a combination of different methods.

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Is IVF Covered Under Health Insurance?

IVF is a type of assisted reproductive technology (ART) that is used to help couples who are struggling with infertility to conceive a child. The process typically involves the collection of eggs from the woman's ovaries, fertilization of the eggs with sperm in a lab, and then transfer of the resulting embryos back into the woman's uterus. It is a complex and expensive procedure, but it can be an effective solution for many couples struggling to conceive a child. That said, infertility treatment procedures like IVF can be a significant financial burden, both in India and abroad. The cost of IVF treatment, for example, can range from ₹1,00,000 to ₹4,00,000 or more per cycle, with no guarantee of success. 

 

It would be incredibly beneficial to have health insurance that covers IVF and other Unfortunately, a vast majority of health insurance plans do not provide coverage for such infertility treatment. However, there is a silver lining. In recent years, some health insurance companies have begun to include infertility treatment coverage in their health insurance plans. Many others even plan to offer it as standard coverage or as an add-on. 

 

In case you are considering getting medical help to treat infertility, it may be a good idea to look for IVF coverage in insurance as an option in advance. This will help you meet the costs of the medical procedures without taking on a loan or using your savings. Health insurance that covers IVF works much like regular health insurance. The key difference is that it offers IVF coverage insurance benefits, which a basic or standard health insurance plan may not provide. 

 

Keep in mind that the level of coverage for different infertility and IVF insurance policies can vary widely. Some plans may offer comprehensive health coverage, while others may only cover certain types of infertility treatment. This is why you need to compare different infertility and IVF health insurance plans, review what is covered by each of them, and then make a decision. 

 

Other important aspects of IVF health insurance to be mindful of include the waiting period, any sub-limits in the coverage, and capping of coverage, if any.

What are the Types of IVF Coverages?

While many health insurance plans typically do not offer reimbursement or coverage for expenses related to infertility treatments, there are some policies that may offer IVF coverage insurance benefits.  Based on the extent and scope of the benefits offered, IVF coverage in insurance can be classified into different categories.

 If you are planning to buy health insurance that covers IVF, it helps to be aware of the different types of health insurance coverage you can find in the insurance market. If you are looking for IVF insurance policies, you can typically find that offer the following four types of coverage options. 

Insurance for Infertility Diagnosis Only

As the name indicates, these insurance policies only cover the cost of diagnosing infertility. They will not offer IVF insurance coverage, since in vitro fertilization (IVF) is a reproductive assistance technique and not a diagnostic procedure. 

 

That said, while these plans do not cover IVF, they will offer coverage for the diagnostic processes you may have to undergo to determine if you or your spouse is infertile. This includes any surgical procedures that may be necessary for diagnosis. However, if you intend to undergo IVF following the diagnosis, it may be prudent to choose health insurance that covers IVF and infertility treatments too.

Insurance for Infertility Diagnosis and Limited Fertility Treatment

These insurance plans cover the costs of the procedures necessary to diagnose infertility. In addition to that, these policies also offer coverage for limited fertility treatment options, such as oral medications or injected medications. 

 

However, these plans also typically do not provide any IVF insurance coverage, because the IVF procedure is fairly extensive and is generally not classified under the category of limited fertility treatments. 

Medication Coverage (With a Possible Inclusion for Fertility Drug Prescriptions)

These health insurance plans generally offer coverage only for the medications that your physician prescribes. Some policies in this category may include coverage for prescription drugs that help with infertility. So, as indicated by the name of the policies, they do not offer IVF insurance coverage benefits. 

 

To ensure that the costs of IVF do not add up and burden you financially, you can consider complementing a medication coverage policy with health insurance that covers IVF and other infertility treatments as well. 

Full Infertility Insurance Coverage

As the name makes it evident, this type of health insurance policy offers full and complete coverage for infertility treatments like in vitro fertilization. Some health insurance service providers may also offer IVF health insurance benefits on their regular policies. 

 

However, it is important to read the fine print in such policies before making a purchase, because insurers may put a cap on the number of IVF treatment cycles that may be covered, or on the number of children for which the coverage will be applicable.

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Infertility Treatment Procedures Under Health Plans

Before you go ahead and purchase IVF insurance coverage, it is essential to have a deeper understanding of the different kinds of infertility treatment procedures you can opt for. This way, you can get more clarity on the scope of the health insurance plan that you wish to purchase. Additionally, you can also better understand the different types of infertility treatment procedures covered in or excluded from your preferred IVF insurance policy. So, check out the various medical solutions available to treat infertility in today’s medical system.

In Vitro Fertilisation (IVF)

This is the process of creating an embryo in a laboratory dish by fertilizing eggs retrieved from your ovaries using your partner’s sperm. The embryo is then implanted in your uterus to mimic regular conception. Typically, you should look for policies that offer comprehensive infertility treatment coverage if you want health insurance that covers IVF too. 

Intrauterine Insemination (IUI)

Intrauterine Insemination (IUI) is the procedure of placing your partner’s sperm directly into your uterus. This is generally during the ovulation phase to improve the chances of creating a viable embryo. Since Intrauterine Insemination (IUI) is also nearly as extensive as IVF, health insurance that covers IVF may also include coverage for IUI. 

Gamete Intrafallopian Transfer (GIFT)

GIFT is the method of combining your eggs and your partner’s sperm in a laboratory dish, just like in the case of IVF. However, the key difference is that the mixture is transferred and planted in your fallopian tubes. IVF insurance coverage may or may not cover Gamete Intrafallopian Transfer, so read the fine print of your policy for more clarity.

Intracytoplasmic Sperm Injection (ICSI)

In the ICSI technique, a single sperm is injected into a single egg in a laboratory dish. This creates an embryo, which can then be implanted in your uterus. Again, as with Gamete Intrafallopian Transfer, it is advisable to check the terms and conditions of an IVF insurance policy to verify if the ICSI process is also covered.

Points to Consider While Buying Health Insurance for Infertility Treatment

There are many aspects you need to consider if you are planning to purchase an IVF insurance policy. IVF coverage in insurance may not be available at all in the policies you have shortlisted, or the coverage could be partial (limited only to diagnosis or to oral medication and treatments). Before purchasing health insurance that covers IVF and other infertility treatments, here are some things to check or consider. 

  • Find out if you are eligible for infertility treatment or IVF coverage in insurance by reviewing the criteria set by the insurer.

  • Understand what specific infertility treatment procedures are covered by the policy.

  • Know the maximum limit on the number of claims you can make under your policy for IVF or infertility treatment cycles.

  • Be aware of any waiting period in health insurance that may be required before infertility treatment and IVF coverage in insurance begins, as it varies from one insurer to the next.

  • Find out if the infertility and IVF insurance plan covers the expenses pertaining to the cost of medication used for the treatment for infertility.

  • Learn about the scope of the inclusions and the limitations for different infertility procedures within the policy, so you know the sub-limits well, if any.

  • Review the inclusions and verify if the cost of diagnosing infertility is covered by your preferred IVF insurance policy.

  • Check if there are any add-on riders with your IVF health insurance plan that offer additional coverage for infertility treatment expenses.

     

Getting an IVF insurance plan can be highly useful for you due to the immense cost-saving benefits it provides. While not all providers ensure coverage against such expenses, it becomes crucial to conduct appropriate research and select the best plan for you.

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FAQs

Yes. According to medical research,  infertility does affect men and women equally. Statistics tell us that in couples with infertility issues, around 35% are due to male-related factors and 35% are due to female-related factors. So, if you are experiencing infertility and may need medical assistance to have a child, IVF insurance can be helpful.

Typically, most IVF insurance plans in India do not automatically cover infertility treatments that are available outside the country. That said, it is recommended to check the terms and conditions of your specific IVF health insurance policy to verify what is covered and what is not.

This depends on the exact terms and conditions in your IVF insurance policy. There are some IVF coverage insurance plans that only include the treatment undergone to conceive the first child. Then, there are others that may offer coverage for IVF costs for more than one child. It is best to read the fine print in your IVF health insurance policy to avoid any ambiguity later on. 

No. The Aarogya Sanjeevani Policy does not offer IVF coverage insurance benefits. Maternity expenses and costs related to sterility and infertility are specifically excluded from the policy’s coverage. 

The ideal IVF coverage insurance plan for you depends on your requirements and your budget. So, it is recommended that you compare different IVF insurance plans, go through the terms of each shortlisted policy, check the premiums for the same, and then choose a cover that gives you the best cost-benefit advantage. 

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