Government Schemes and Insurance for IVF in India
Infertility is an issue with which millions of couples in India are grappling, and In-Vitro Fertilisation (IVF) has been the aspiration for many. Yet, the exorbitant cost of IVF treatment is generally a limitation for the majority of those in need of fertility treatment. Thankfully, numerous schemes adopted by the government and provided insurance plans have become increasingly popular in India so that IVF becomes affordable and accessible.
In this article, we’ll explore the most notable government schemes offering IVF coverage in India, fertility treatment insurance, eligibility, application process, and where to get trusted treatment. This guide will equip you with the knowledge you need to make decisions about your fertility.
Understanding IVF and Its Costs in India
IVF, or In-Vitro Fertilization, is a sophisticated set of procedures used to cure infertility or avoid genetic diseases. As much as its increasing success rate and popularity are on the rise, cost continues to be a huge issue.
Average IVF Cost in India
● A single cycle of IVF ranges from INR 1.2 lakh to INR 2.5 lakh.
● Premium methods such as ICSI (Intracytoplasmic Sperm Injection), freezing embryos, or donating eggs/sperm will increase costs.
● Several cycles could be required, incurring more cost.
● Tests and medications can cost an additional INR 50,000 to INR 1 lakh.
With these, the overall cost of a full IVF cycle could easily exceed INR 4-5 lakhs for those who are trying repeatedly.
Government Schemes Promoting IVF in India
Though India does not yet enjoy a national IVF scheme for everyone, there exist various central and state schemes providing assistance one way or another.
- Pradhan Mantri Jan Arogya Yojana (PM-JAY) – Ayushman Bharat
● Coverage: INR 5 lakh per year per family for secondary and tertiary care.
● Eligibility: Socio-Economic Caste Census (SECC) data.
● IVF coverage: IVF is not available everywhere, but some of the procedures that come under the treatment for infertility could be covered by some of the empaneled hospitals.
● Availability: These facilities are accessible in empaneled private as well as government hospitals.
- Employee State Insurance Scheme (ESIS)
● Beneficiaries: Employees with a maximum salary of INR 21,000 per month.
● Coverage: IVF treatments can be covered subject to medical requirements and hospital empanelment.
● Application Process: IVF to be recommended by ESIS panel doctors.
- Central Government Health Scheme (CGHS)
● Provides coverage to central government staff and pensioners.
● Although IVF is not covered, consultations and standard tests for infertility might be covered.
Health Insurance Cover for IVF in India
Infertility treatment has not been covered under Indian health insurance plans traditionally but is being covered more and more these days.
Best Insurance Companies That Cover IVF (Partially or Fully)
● Niva Bupa (earlier Max Bupa): Maternity and infertility are covered in some plans.
● Star Health Insurance: Maternity insurance with the option to add infertility cover as an add-on.
● Aditya Birla Health Insurance: Some plans cover IVF treatment after a waiting period.
● Care Health Insurance: Fertility treatment is a part of higher-end plans.
● ManipalCigna Health Insurance: Infertility cover as part of higher-end plans in wellness and maternity riders.
Points to Consider
● Waiting Period: Most insurance companies ask for a waiting period (2-4 years) before covering infertility procedures.
● Sub-Limits: There can be a sub-limit on reimbursement amount, which is between INR 50,000 and INR 1.5 lakh.
● Network Hospitals: Avail of the treatment at network hospitals or approved centers.
● Documentation: Doctor prescriptions, pre-approval, and medical necessity may be necessary for claims.
How to Apply for IVF through Government Schemes
The process to apply for IVF benefits differs with the scheme and the state.
Common Procedure to Apply:
● Check Eligibility: Confirm income status, dwelling, and other eligibility parameters.
● Collect Documents: Proof of age, income statement, Aadhaar card, ration card, health reports, and treatment quotes.
● Select an Empanelled Hospital: Go to a government-listed or scheme-related IVF hospital.
● Application Filing: Fill outthe hospital or scheme web portal forms.
● Approval & Treatment: After due verification, scheduling of treatment becomes possible.
Support Services
● Help Desks: Present in most government hospitals.
● Online Portals: Some states provide application tracking and online submission.
● Health Workers: ASHA workers and PHC staff can provide information about local schemes.
Where to Get IVF Treatment in India
India has some of the world’s best-known fertility clinics, private as well as government-owned, providing world-class IVF treatments.
Why Ayuh Fertility Centre?
Ayuh Fertility Centre is India’s most-preferred fertility clinic with a reputation for customized services at affordable costs. Here’s what makes them different:
● Latest IVF technologies and laboratory standards.
● Very experienced fertility experts and very high success rates.
● Transparency in pricing and no hidden or extra fees.
● Ease in funding, EMI, and insurance claims.
● Emotional support and fertility counseling to accompany the couple through each procedure.
You can know more about their IVF Services and consult them regarding treatment alternatives best for you.
Other Services to Explore:
● IUI (Intrauterine Insemination)
● Fertility Counseling
● Egg Freezing and High-Tech Reproductive Techniques
Myths About IVF Coverage in India
Myth 1: IVF is never insured in India.
Reality: The majority of insurance firms now have partial or full insurance coverage plans for infertility treatment.
Myth 2: Private clinics only do IVF.
Reality: Subsidized IVF is provided by government hospitals and empaneled private hospitals.
Myth 3: The scheme is for married couples only.
Reality: Although the majority of schemes are for married couples, some states and private schemes are now including single women and LGBTQ+ couples as well.
Myth 4: IVF always works.
Reality: IVF works in 30-60% of cases based on age, health, and the skill of the clinic. It can take numerous cycles.
Maximizing Your IVF Coverage Benefits
● Take Advice from an Insurance Advisor: Ensure your plan covers IVF benefits.
● Keep Records: Have a clear record of all the medical bills and documents.
● Approach Government Hospitals: The cost is mostly very low.
● Ask for Financing: Most hospitals provide EMI or low-interest loans.
● Read the Scheme Guidelines Carefully: Various schemes have different rules of eligibility and applications.
Conclusion: Making IVF Accessible for Every Indian Family
The IVF path to parenthood may prove to be cost and anxiety-provoking. Yet greater governmental intervention and improved insurance coverage are movements in the correct direction. Proper information, planning, and counselling make fertility interventions more affordable and accessible to Indian families.
If IVF is in your thoughts, research your options carefully. Look for government programs that apply, talk to your insurance company, and select a reputable clinic such as Ayuh Fertility Centre for advice.
Ready to take the next step in your fertility journey?
