Insurance and Surrogacy: What to Check on Your Policy Before You Apply

Many health plans quietly exclude pregnancies that result from a surrogacy arrangement. Here's how to find out what your policy says — and what happens if you have an exclusion.

Published May 20, 2026 · Updated October 7, 2026

Check whether your health insurance policy excludes pregnancies that result from a surrogacy arrangement, by reading the full Certificate of Insurance for terms like "surrogate" or "gestational carrier" and then calling your insurer to ask directly. An exclusion does not disqualify you and does not cost you anything, because the intended parents cover all your medical costs either way, including buying a separate surrogacy medical policy if your plan will not pay.

One of the most common surprises in the surrogacy process happens before the pregnancy even begins. A surrogate gets matched with intended parents, gets cleared by the fertility clinic, signs the contract — and then someone reads the fine print on her health insurance and finds a clause that says the plan won't pay for prenatal care or delivery if the pregnancy is for someone else.

This doesn't disqualify you from surrogacy. It just changes how the medical costs of your pregnancy are paid. But it's something you want to know before you're matched, because it can affect timing, your compensation conversation, and which agencies are the easiest fit for your situation.

Why your insurance matters in surrogacy

In a surrogacy arrangement, the intended parents are financially responsible for all medical costs related to the pregnancy and delivery. They cover everything either directly or through a dedicated surrogacy medical insurance policy they purchase for the journey.

But if your own health insurance is willing to pay for the prenatal care and delivery as a normal pregnancy, that's a simpler and less expensive setup for everyone. The intended parents still cover deductibles, copays, and anything your insurance doesn't pay. If your policy excludes surrogacy, they have to buy a separate policy — and those policies are expensive, which has downstream effects on the journey.

How to check your policy

You're looking for a specific clause. Most plans don't make it easy to find on a member portal — you usually have to read the Summary of Benefits and Coverage (SBC) or the full Certificate of Insurance.

Step 1 — Find your full policy document

The SBC is the short version; the full Certificate of Insurance (sometimes called the Evidence of Coverage) is what actually controls. You can usually request a copy from your insurer by calling member services or downloading it from your portal. If you have employer-based coverage, your HR department may have it.

Step 2 — Search for these terms

Open the document in a PDF reader and search (Ctrl+F or Cmd+F) for any of these words:

• "Surrogate" or "surrogacy"
• "Gestational carrier"
• "Compensated" in the context of pregnancy
• "Third-party reproduction"
• "Pregnancy not for member's own family" or similar phrasing

If none of these terms appear in the exclusions section, that's a good sign — but it isn't a guarantee. Some policies have surrogacy exclusions hidden inside broader categories like "experimental treatment" or "non-medically necessary services."

Step 3 — Call and ask directly

This is the step most people skip and shouldn't. Call your insurer's member services line and ask, in plain words: "Does my plan cover prenatal care and delivery if I'm pregnant as a gestational surrogate for another family?" Then ask them to point you to the exact section of the policy that confirms their answer, and write down their name and the date of the call.

Some agents will say yes when the answer is actually no. The written policy is what controls, not what the rep tells you on the phone — which is why you also want them to cite the document. Your agency will likely need this in writing at some point.

What surrogacy exclusions look like

Exclusions vary a lot. Here are the patterns you'll see:

Which plans most commonly exclude surrogacy

You can't predict it perfectly, but a few patterns hold up across the country.

• Marketplace (ACA) plans — Mixed. Some cover, some don't. Worth reading carefully.
• Medicaid — Doesn't cover surrogacy pregnancies. Being on Medicaid is still workable at many programs, as long as you discontinue it once you're matched and the intended parents buy a separate policy.
• TRICARE (military) — Does not cover surrogacy. Intended parents always buy a separate policy.
• Large-employer self-funded plans — More and more of these added surrogacy exclusions over the past few years. Read it carefully.
• Spouse's employer plan — If you're on a partner's policy, the exclusion is determined by their employer's plan, not yours.

What happens if your policy excludes surrogacy

Not much, from your point of view. The intended parents purchase a dedicated surrogacy medical policy, usually through a specialty insurance broker, that covers your prenatal care, delivery, and recovery. Their attorney and the agency typically handle the paperwork. You'll see an OB that you and the intended parents are both comfortable with - often your regular OB - and you remain the one who consents to your own care.

The cost of that separate policy typically runs from roughly $15,000 to $35,000, paid by the intended parents — plus a claims-fund deductible deposit on top. It does not come out of your compensation. It just means a bit more administrative work for the intended parents and, in some cases, a different set of in-network providers.

What we do with this on the Borne side

When you fill out the questionnaire, we ask about your insurance carrier and plan type. That isn't to disqualify anyone — it's so we can flag whether the agencies we'd introduce you to need to plan for a separate medical policy. We don't ask you to read your full Certificate of Insurance before applying. That comes later, with the agency. We just want a rough picture.