What Fertility Insurance Covers: Meds, Tests, PGT and Abroad

A fertility benefit is rarely one simple yes or no. Medicines may sit under a different part of the plan from the procedures, testing may be covered while embryo testing is not, and a dollar cap can run out faster than people expect. This guide goes through the parts of an IVF cycle that insurance treats differently, what tax rules allow, and what happens to coverage if you have treatment abroad. If your plan has denied IVF outright, start with our guide to IVF denials and prior authorization.

Do fertility medications count toward the lifetime maximum?

Often they do, and that is why medicines deserve their own line in your budget. Many plans set a lifetime maximum in dollars or in cycles. When it is in dollars, the medicines billed for a stimulation cycle can use a large share of it before the retrieval is even billed.

Injectable fertility drugs are usually dispensed by a specialty pharmacy under the pharmacy benefit, which may have its own prior authorization, copay or exclusion even when the procedures are covered under the medical benefit. Some patients compare the cash price at several pharmacies with the price billed to insurance, so the maximum is kept for the procedures. Whether that helps depends on your plan, so ask how medicines are counted before you fill the first prescription.

Public schemes have similar gaps. Ontario funds one IVF cycle per lifetime but not the fertility drugs, which the province says cost about CAD 5,000 per cycle.

Are testing, monitoring ultrasounds and bloodwork covered?

Diagnostic testing is the part most likely to be covered, sometimes even when IVF itself is excluded, because it is billed as investigation of a medical problem. Monitoring during a cycle is different: the ultrasounds and blood tests in the days before retrieval are usually billed as part of the fertility benefit and follow its rules, including copays for each visit.

Ask your plan for the billing codes it treats as diagnostic and those it treats as fertility treatment, and ask the clinic which codes it will use. Two people on the same plan can get different bills for the same scan depending on how it is coded.

Does insurance cover PGT-A testing and embryo banking?

Embryo testing and banking are two of the most common gaps. Many plans exclude PGT-A or cover genetic testing only when there is a known genetic condition, and some plans decline another retrieval while frozen embryos remain.

If a test or a further retrieval is denied, the same appeal route applies as for any other denial: ask for the policy the plan used and have your doctor explain why it does not fit your case. For what testing involves and costs, see our guide to PGT-A embryo testing. In China, embryo testing is allowed only for medical reasons, not as a general screening add-on.

Can you deduct IVF costs on your taxes?

In the US, yes in principle. IRS Publication 502 (for 2025 returns) lists procedures such as in vitro fertilization, including temporary storage, as medical expenses, but you can deduct only the part of your total medical expenses above 7.5% of adjusted gross income, and only if you itemize. The same publication allows transportation that is primarily for medical care and lodging of up to USD 50 a night per person, subject to conditions. Money from an HSA or FSA used for qualifying expenses cannot also be deducted.

In Canada, the Canada Revenue Agency's medical expense tax credit lists IVF costs such as the fertilization procedure, ultrasound and blood tests and cycle monitoring. The CRA says eligible medical expenses are generally not limited to those paid in Canada, but fees paid to a fertility clinic or donor bank to obtain sperm, eggs or embryos must be paid in Canada. Rules have conditions and change, so check with a tax adviser before you rely on a deduction or credit.

Does insurance cover IVF abroad?

Usually not. US employer plans that cover IVF generally require network clinics, and a clinic abroad is rarely in network, so check your plan wording and ask for any answer in writing. Medicare says it usually does not cover health care outside the US. Travel insurance is not a substitute: the NHS and Australia's Smartraveller both say most travel policies do not cover planned treatment abroad. In Ontario, planned treatment outside Canada needs written approval from the Ministry of Health before treatment, or you pay all costs. Chinese medical insurance covers only insured residents, so foreign patients in China pay in full.

That is why a self-paid cycle abroad has to stand on its own price. For a legally married couple of a man and a woman, patients in China report a median of about CNY 33,000 (≈ USD 4,950) for one cycle with one transfer, before insurance (Chinese patient reports, 2025–26). Embryo testing changes that picture: patients report a median of about CNY 110,000 (≈ USD 16,400) for a full course with PGT, with many paying CNY 50,000–60,000 (≈ USD 7,450–8,950), and that is not cheaper than some other destinations. Foreign patients pay the full listed price, and international departments charge more. Each hospital confirms eligibility case by case before you travel, and no hospital can promise a result.