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/Assisted Reproductive Treatment
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What is Assisted Reproductive Treatment in health insurance?
Covers fertility treatments like IVF or IUI for couples having difficulty conceiving naturally. Each treatment cycle can cost Rs 1-2 lakh and often needs multiple attempts. This cover is rare in standard plans and is usually an optional add-on.
Star Health
Family Health Optima
Standard
IUI, IVF, ICSI and TESA/TESE are covered inside the base plan after a 36-month wait, and you do not need to be admitted to hospital to claim. The most the policy pays is Rs.1 lakh at a Rs.5 lakh Sum Insured and Rs.2 lakh from Rs.10 lakh upwards - and that amount covers a whole 36-month block, not each year.
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Watch out
Both partners must stay insured under this policy without a break for the whole block, or the benefit is not payable. Pre- and post-treatment expenses, cryopreservation, surrogacy and fertility-improving surgery are all excluded, and neither Automatic Restoration of Sum Insured nor the Recharge Benefit adds to this limit.
Star Health
Star Health Assure
Standard
Fertility treatment is built into the base plan rather than sold as an add-on. IUI, IVF, ICSI and TESA/TESE are reimbursed up to ₹1,00,000 to ₹4,00,000 a policy year depending on your sum insured, after a 24-month wait. One cycle is paid per policy year, and you do not need to be admitted as an in-patient to claim.
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The catch
Cryopreservation and storage of sperm, eggs and embryos, surrogacy, and fertility-enhancing surgery such as diagnostic laparoscopy with ovarian drilling are all excluded. Real parts of an IVF plan are paid by you.
Star Health
Super Star
Standard
Assisted reproduction is bought as Option C of the Maternity Expenses cover. It reimburses IUI, IVF, ICSI and TESA or TESE for sub-fertility, one cycle a Policy Year, up to a yearly limit that rises with your Sum Insured from Rs.1,00,000 to Rs.4,00,000. You wait 24 months, and both you and your spouse must have been covered for all 24. No in-patient admission is needed.
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Watch out
Only one treatment cycle is paid in a Policy Year, so a second attempt in the same year is paid from your own pocket. The benefit is a reimbursement, which means you settle with the fertility centre first and claim it back. The limit is a rupee amount, not a share of your Sum Insured, so at the lower Sum Insured levels it pays part of a cycle rather than all of it.
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