Oocyte cryopreservation, commonly known as egg freezing, is a medical procedure that allows individuals to preserve their fertility for future use. The process involves stimulating the ovaries, retrieving the eggs, and cryopreserving them in liquid nitrogen for long-term storage. Because of the significant financial investment, the question of insurance coverage is immediate. Coverage is highly dependent on the specifics of an individual’s health plan, the reason for the procedure, and where they live.
The Determining Factor of Coverage
The primary factor determining coverage is the distinction between a medically necessary procedure and an elective, or social, one. Traditional health insurance policies cover treatments for illnesses or diagnosed conditions, often excluding procedures done solely for age-related fertility decline. Therefore, if the procedure is classified as elective—done to delay childbearing for personal or professional reasons—it is rarely covered by a standard health plan.
Coverage is far more likely for medically necessary preservation, which refers to freezing eggs before a treatment that is known to cause infertility, a condition called iatrogenic infertility. The most common scenario is fertility preservation for individuals facing cancer treatment, such as chemotherapy or radiation, which can permanently damage ovarian function. Certain surgical procedures, like those for severe endometriosis, or treatments for specific autoimmune disorders may also qualify a patient for coverage. In these situations, the procedure is covered under the standard medical benefits portion of a policy, not a specialized fertility rider.
The lack of a medical diagnosis of infertility is the main reason traditional health insurance denies coverage for social freezing. Insurers often categorize age-related fertility preservation as non-essential, a lifestyle choice, or an experimental procedure, despite its established success. A person freezing eggs due to career planning or a lack of a partner will almost certainly be responsible for the full cost out-of-pocket, unless their plan has specific, non-standard benefits.
Policy Structures That Include Elective Freezing
While standard policies exclude elective egg freezing, specialized policy structures can provide coverage, largely through state mandates or employer-sponsored riders. Several states have passed laws requiring insurers to cover fertility preservation, though the extent of this coverage varies significantly. For example, some state statutes mandate coverage only for medically induced infertility, which helps those facing cancer or other specific medical treatments.
A few states, however, have broader mandates that define infertility more inclusively, sometimes extending coverage to fertility services that may include aspects of elective freezing. These laws are complex, often applying only to fully insured plans and large group employers, while self-funded plans remain exempt from state regulations. Therefore, living in a state with a mandate does not guarantee coverage, and the specific wording of the law must be carefully reviewed.
The most common way for elective egg freezing to be covered is through employer-provided benefits, often referred to as fertility riders or specialized programs. Large employers, particularly in competitive industries, frequently offer these benefits to attract and retain talent. These riders are specialized benefit packages that specifically include coverage for elective procedures, often with a lifetime maximum financial allowance. Since this is an employer choice, employees must contact their Human Resources department or insurance provider directly. They must confirm whether a fertility benefit is included in their specific plan and what services, such as the retrieval procedure, medications, or storage, are covered.
The Full Cost of Oocyte Cryopreservation
Even when insurance coverage is secured for the egg retrieval procedure, the overall financial commitment for oocyte cryopreservation involves multiple separate components. The cost of a single egg freezing cycle, including retrieval and laboratory processing, typically ranges from $10,000 to $16,000 if paid for entirely out-of-pocket. A significant component often billed separately is the cost of the necessary hormone medications used for ovarian stimulation.
These stimulation drugs, which are administered for about 10 to 14 days before retrieval, can cost an additional $3,000 to $6,000 per cycle. Even if the retrieval procedure is covered by an insurance plan or rider, the prescription drug benefit may not cover these specific fertility medications, leaving this substantial expense to the patient. The first year of cryostorage is sometimes included in the initial cycle cost, but long-term storage is an almost universally separate, annual fee.
These storage fees, which range from approximately $500 to $1,000 per year, are rarely covered by standard health insurance or many fertility riders beyond a limited initial period. This creates an ongoing financial commitment for as long as the eggs remain frozen. The costs associated with using the eggs in the future—including thawing, fertilization, and subsequent In Vitro Fertilization (IVF) transfer—are entirely separate procedures that incur new costs when the individual is ready to attempt pregnancy.