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In vitro fertilization, or IVF, is a series of procedures that is used to help with fertility and assist in making a child. It is also used to help prevent genetic problems.
If this is a procedure you are considering and you have Medicare, you may have the question “does Medicare cover in vitro fertilization?” In this article, we answer that question in clear, plain English. You will also find the average costs of in vitro fertilization if you have to pay for it out of pocket.
Does Medicare Cover In Vitro Fertilization?
The short answer is no. In most cases, Medicare will not cover the cost of in vitro fertilization. That said, there may be some situations where you can get some related costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for this type of treatment.
Original Medicare (Medicare Part A and Part B) does not provide coverage for In Vitro Fertilization. So that means you will have to pay 100 percent for your IVF. Original Medicare does not provide coverage for many types of treatments and services regarding infertility such as IVF.
Original Medicare also does not provide coverage for medications to treat Infertility. However, Original Medicare may provide coverage for certain treatments and diagnostic tests for infertility in some cases.
Original Medicare provides coverage for treatment and diagnostic tests for infertility as long as it is considered medically necessary. Original Medicare may also provide coverage for treatment and diagnostic tests for infertility if your healthcare provider orders it.
Coverage for certain doctor’s services, outpatient treatment, medical supplies, and medically necessary treatments are provided by Medicare Part B. Medicare Part B provides coverage for diagnostic tests and treatments for infertility such as the following:
- Testicular biopsies
- Genetic testing
- CAT scans
- MRI scans
- Semen analysis
- Testosterone levels tests
- Thyroid tests
- Hormone tests
Medicare Part B provides coverage for the diagnosis of male infertility by way of sperm analysis. A sperm analysis plays a vital role in diagnosing male infertility. Medicare Part B provides coverage for a sperm analysis if your healthcare provider orders it. A sperm analysis is a procedure that is difficult to determine if it is medically necessary or not.
Part C and Part D Coverage for In Vitro Fertilization
Like with Original Medicare, Medicare Advantage plans (Medicare Part C) also do not cover In Vitro Fertilization. Medicare Advantage plans cover the exact same things that Original Medicare covers but will offer some additional benefits as well.
Medicare Part C plans that include prescription drug plans will not provide coverage for medications that your healthcare provider will prescribe to you with regards to infertility. Part C plans do not provide coverage for IVF medications
Medicare Part D plans also do not provide coverage for infertility and IVF medications. Medicare Part D is a prescription drug plan. Like Medicare Part C, Medicare Part D plans are provided by private insurance companies.
How Much Does In Vitro Fertilization Cost?
In Vitro Fertilization may cost from $12,000 to $17,000 if you have to pay for it yourself. This does not include the cost of related medications.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover chemo treatments?