Don't let IVF drain your savings— Know your insurance options first

Mint

2 days ago

Many health insurance and maternity plans in India now offer IVF coverage as an add-on or under specific conditions, usually requiring a minimum sum insured, a waiting period, sub-limits on IVF expenses and restrictions on the number of treatment cycles
There's been an increase in in-vitro fertilization (IVF) treatment in India due to factors such as rising infertility rates, growing disposable incomes, wider awareness about IVF and progress in IVF technology. Assisted reproductive technology refers to the medical procedures used to treat infertility.
IVF is one of the most common forms of fertility treatment. The process starts with getting eggs from a woman's ovaries, fertilizing them with sperms in a lab and then implanting the resulting embryo in the uterus.
Do health insurance policies cover IVF?
The cost of a single IVF cycle in India can range from ₹90,000 to ₹300,000. Couples often wonder if health insurance covers IVF treatment. Generally, it does not but some insurers have started offering it in select plans.
"As awareness around assisted reproductive health grows, we're seeing a shift in how insurance products are evolving to support this journey. Treatments like IVF, once considered outside the ambit of health coverage, are gradually being included in select health insurance plans, with a standard waiting period of two years or more," said Siddharth Singhal, head of health insurance at Policybazaar.
'Many health insurance and maternity plans in India now offer IVF coverage as an add-on or under specific conditions, usually requiring a minimum sum insured, a waiting period of two to three years, sub-limits on IVF expenses, and restrictions on the number of treatment cycles," said Bhabhtosh Mishra, director and chief operating officer at Niva Bupa Health Insurance.
Review and check
However, one should not assume that IVF is automatically a part of maternity plans. To identify these plans, policyholders should review policy documents for fertility benefits, check for optional riders, confirm waiting periods and limits, and consult insurance advisors or comparison platforms.
While coverage for IVF treatment is gaining ground, it remains uneven across policy types.
'Corporate group policies (more common for mid-to-large employers) are much more likely to include fertility benefits, sometimes even without waiting periods," said Kunal Varma, CEO and founder of Freo, a digital finance app.
However, a survey by Plum, an employee health insurance platform, found that less than 1% of the companies in India offer infertility treatment under group health insurance. Google and Flipkart have IVF cover in their corporate health policies.
If you do not have corporate IVF coverage, getting an individual policy is the only option.
People often overlook the key aspects of IVF coverage in insurance policies that can significantly affect their benefits. Most plans impose a waiting period of one to three years (commonly three years) before IVF-related claims can be made.
Niva Bupa offers waiting periods of nine months up to four years, depending on the plan variant, and provides sub-limits aligned with the sum insured.
'Additionally, insurers usually set sub-limits and caps on IVF expenses—often a specific amount like ₹2 lakh separate from the base sum insured (typically ₹5 lakh or more)—and restrict the number of IVF cycles covered, generally allowing one cycle every few years," said Mishra.
Many policies provide only partial coverage, covering diagnostics and medication but excluding advanced treatments like ICSI (intracytoplasmic sperm injection), embryo freezing or donor-related costs. Coverage typically applies only to treatments deemed medically necessary and performed at insurer-approved centres.
One should also look at the actual words 'infertility treatment" or 'assisted reproductive technology" and consider if there are any exclusions, sub-limits or co-payment clauses. IVF is typically covered when deemed medically necessary. If it is not medically required, coverage may be denied.
'The policy seeker is advised to go through the policy document, terms and conditions and exclusions before opting for any riders or maternity cover," said Sarita Joshi, head of health and life insurance at Probus, an insurance broker. The fine print is thus critical.
What are the exclusions?
Most policies that offer IVF benefits typically cover only one cycle.
'If that attempt is unsuccessful, the cost of any additional cycles is usually borne by the insured. Non-medical expenses like travel, accommodation or psychological counselling are not included," said Ajay Shah, head – distribution at Care Health Insurance.
Policies such as the Care Classic Plan by Care Health Insurance pay the benefit once in a block of three years, subject to policy renewal, and come with a waiting period of 36 months from the date of starting the policy.
If the policy limits the number of cycles, policyholders will have to bear subsequent IVF expenses on their own. Also, policies covering IVF exclude costs such as egg/sperm donation, surrogacy fees, advanced procedures (ICSI, genetic testing), embryo freezing/storage and certain medication.
IVF is often just one part of a longer journey—diagnostics, hormonal injections, follow-ups, and repeated attempts may all add to the bill. Take control of your IVF journey by getting financially prepared today. Health insurance can cover it only partially.
(The author is a freelance journalist)