Does Surest cover IVF?
What Surest (UnitedHealthcare's employer copay plan) publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 22 h ago
Only if your employer's plan includes it. Surest is a UnitedHealthcare plan that employers offer, self-funded, fully insured or level funded, and its policy list says your plan document decides what is covered and overrides the policies. The UnitedHealthcare infertility policy Surest lists (effective June 1, 2026) says certain plans do not cover infertility services, and that IVF and other assisted reproduction are excluded unless the member has an infertility benefit. A fully insured Surest plan also follows any IVF law of the state it is issued in.
What Surest's policies say
Read on Oct 25, 2026. The words in quotation marks are the source's own.
Only if your employer's plan includes it
“Surest is an ACA-compliant employer-sponsored health plan available to employers with 2+ employees* - offered on a self-funded, fully insured, and level funded basis.”
“Assisted reproductive technologies, ovulation induction, and insemination procedures are excluded from coverage unless the member has a benefit for Infertility and the criteria listed in the Coverage Rationale section have been met”
Your plan document decides
Surest's policy list says coverage is set by the member's own plan document (a certificate of coverage, schedule of benefits or summary plan description) and applicable laws, and that the plan document wins where it and a policy disagree. The infertility policy itself says legislative mandates and the plan document must be reviewed, and that certain plans do not cover infertility at all.
“Benefit coverage for health services is determined by the member specific benefit plan document, such as a certificate of coverage, schedule of benefits, or summary plan description, and applicable laws that may require coverage for a specific service.”
“In the event of a conflict, the member specific benefit plan document supersedes these policies and guidelines.”
“Certain plans do not cover Infertility services. Legislative mandates and the member specific benefit plan document must be reviewed when determining benefit coverage for Infertility services.”
Copays shown in advance
Surest plans have no deductible or coinsurance: members look up what a service will cost in the app or on the website before they go, within UnitedHealthcare's national network.
“There is no deductible, no coinsurance, and no cost-shifting. Instead, members search on the app or website, see what they'll owe in advance, compare options within the national UnitedHealthcare provider network, then decide.”
How the policy defines infertility
Not getting pregnant after 12 months of regular unprotected intercourse under 35, or 6 months at 35 or older, or being unable to get pregnant because of medical, sexual or reproductive history.
“Failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse when the female partner is less than 35 years of age.”
“The inability to achieve a successful pregnancy due to an individual’s medical, sexual, or reproductive history.”
Fertility drugs
Fertility drugs given in a hospital, an office or at home fall under the infertility benefit when the plan has one; self-injected fertility drugs follow the plan document and the pharmacy benefit.
“Pharmaceutical products for the treatment of Infertility that are administered on an outpatient basis in a hospital, alternate facility, physician's office, or the home”
“Self-injectable drugs for Infertility (Refer to the exclusion for self-injectable drugs in the member specific benefit plan document; refer to the pharmacy benefit administrator for self-injectable medication benefit information.)”
Fertility preservation and egg freezing
Fertility preservation is a benefit when a medical treatment such as chemotherapy or radiation will cause infertility. Elective egg freezing and embryo banking are excluded, as is storage longer than a year.
“Benefits are available for fertility preservation for medical reasons that cause irreversible Infertility such as chemotherapy, radiation treatment, and bilateral oophorectomy due to cancer; refer to the member specific benefit plan document.”
“In vitro fertilization that is not an assisted reproductive technology for the treatment of Infertility; this would include but is not limited to elective fertility preservation or embryo accumulation/banking”
“Long-term storage (greater than 1 year) of reproductive materials such as sperm, eggs, embryos, ovarian tissue, and testicular tissue”
Embryo genetic testing (PGT)
Surest's PGT policy (effective May 1, 2026) covers testing for a single-gene condition or an inherited chromosome rearrangement as medically necessary, treats other uses, PGT-A included, as unproven, and leaves whether a plan covers it to the plan document.
“Preimplantation Genetic Testing (PGT) is proven and medically necessary only for monogenic/single-gene defects (PGT-M) or inherited structural chromosome rearrangements (PGT-SR)”
“PGT is unproven and not medically necessary for all other populations and conditions due to insufficient evidence of efficacy.”
“Refer to the member specific benefit plan document to determine if the coverage applies.”
Not covered
Donor eggs, sperm or embryos; a gestational carrier who is not a member; and infertility treatment after a sterilization such as a vasectomy or tubal ligation.
“Donor services for donor sperm, ovum or oocytes (eggs), or embryos”
“Surrogate parenting: Services and treatments for a gestational carrier of a pregnancy who is not our member and all related services”
“Infertility treatment when the cause of the Infertility was a procedure that produces sterilization, e.g., vasectomy or tubal ligation”
How to see what your Surest plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Search for fertility services in the Surest app or website: it shows coverage and your copay before you book.
- 2Read your plan's certificate of coverage or summary plan description for an infertility benefit and any dollar or procedure maximum.
- 3Ask HR whether the plan is fully insured (then your state's IVF law can apply) or self-funded, and whether it has a separate fertility program.
- 4Call Surest Member Services at 866-683-6440 and ask for a clinical advocate, who can guide you on family-planning providers and options.
Surest and IVF: common questions
Does Surest cover IVF?
Only if your employer's Surest plan includes an infertility benefit. The UnitedHealthcare infertility policy Surest lists (effective June 1, 2026) excludes IVF and other assisted reproduction unless the member has an infertility benefit, and Surest says the plan document decides.
How much does IVF cost with Surest?
Surest plans use copays with no deductible or coinsurance, and members see what they will owe in the app before a visit. Whether IVF is covered at all, and at what copay, depends on your employer's plan.
Does Surest cover egg freezing?
For medical reasons, such as before chemotherapy or radiation, when your plan has the benefit. Elective egg freezing and embryo banking are excluded.
- Surest Health Plan (surest.com home page) (Surest, Page current Oct 2026)
- Infertility Diagnosis, Treatment, and Fertility Preservation (UnitedHealthcare Commercial and Individual Exchange Medical Policy 2026T0270NN, listed on Surest medical & drug policies) (UnitedHealthcare, Effective Date: June 1, 2026)
- Surest medical & drug policies (UHCprovider.com) (Surest, Policy list current to October 2026)
- Surest members page (FAQ: How does the Surest health plan work?) (Surest, Page current Oct 2026)
- Preimplantation Genetic Testing and Related Services (UnitedHealthcare Commercial and Individual Exchange Medical Policy 2026T0597Q, Surest copy) (UnitedHealthcare, Effective Date: May 1, 2026)