All About Blue Cross Blue Shield IVF Coverage

Blue Cross Blue Shield IVF Coverage – Overview

Questions about In Vitro Fertilization (IVF) insurance are common. Many insurance policies offer coverage for certain infertility treatments, including initial consultations and testing.

Coverage of the first visit to an IVF specialist depends on specific policy terms.

Let’s take a closer look at how Blue Cross Blue Shield offers IVF coverage.

How does Blue Shield define Infertility

Infertility is defined as the inability to conceive after 12 months of unprotected sex for women under 35.

For individuals over 35, infertility is defined as the inability to conceive after 6 months of unprotected sex.

How helpful is Blue Shield with Infertility Treatment

Initially, the insurance covers the diagnostic process. The tests help determine if either partner has inhibited fertility.

Infertility may be caused by female-centric factors, such as ovarian dysfunction, pelvic adhesions, prior tubal ligation or endometriosis.

Similarly, infertility in men may be caused by problems in the male reproductive system, including abnormal sperm production, transport or function and even a prior vasectomy. A combination of male and female-centric factors may also cause infertility.

Does Blue Shield Insurance Offer Coverage for IVF Diagnosis and Treatment

Blue Cross Blue Shield offers varying levels of coverage for infertility diagnosis and treatments depending on the plan.

Once the main cause of infertility is diagnosed, Blue Shield also covers the expense of treatment. Initially, Blue Shield offered coverage for undergoing basic infertility treatment.

If this fails, then the insurance also covers the expense of advanced infertility treatments, which are included in Assisted Reproductive Technologies (ART).

Assisted Reproductive Technology (ART) refers to procedures in which both eggs and sperm are handled to facilitate fertilization.

Usually, ART procedures require removing eggs surgically from the ovaries, mixing them with the sperm in a laboratory and finally implanting them in the uterus.

It is important to remember that coverage details for procedures involving only sperm or only medications for egg production vary by plan and should be verified with your policy.

Blue Shield IVF coverage typically includes specific diagnoses and treatments for infertility.

What types of Infertility Diagnostic Tests are Covered Under the Blue Shield Insurance Policy

Here’s a detailed list of everything relating to infertility that is covered by the Blue Shield insurance policy:

The policy initially requires an accurate diagnosis of the condition to provide effective treatment. Some of the diagnostic tests that help determine the need for infertility treatment under Blue Shield include:

(For Females)

1. General medical evaluation, including CBC (complete blood count), LFT (liver function test), RPR (rapid plasma regain test), HIV (human immunodeficiency virus) and chlamydia and gonorrhea culture tests.

2. Tests to rule out endocrine causes of infertility, such as thyroid-stimulating hormone (TSH), DHEA, blood sugar, total and fractionated testosterone, etc.

3. Pelvic ultrasonography

4. Hysteroscopy

5. Laparoscopy

6. Hormonal anti-sperm antibodies

7. Fasting insulin

8. Serum chlamydia IgG

(For Males)

1. Semen analysis tests with two samples at least 1 month apart

2. Endocrine evaluation is detected

3. Anti-sperm antibodies

4. Post-ejaculatory urinalysis

5. Vasography

6. Urine and semen culture

7. Scrotal ultrasonography

8. Testicular biopsy

What are the Types of Infertility Treatments Covered by the Blue Shield Insurance Policy

Coverage for infertility treatments after diagnosis depends on the specific insurance plan and conditions met.

You can find additional information regarding infertility treatment in the member’s benefit booklet.

The Blue Shield IVF Coverage Bears Expenses of Basic Infertility Treatments, Including:

Infertility drugsThe specific infertility drugs covered under the Blue Shield IVF policy are listed in the member’s benefit booklet.

Dopamine agonists Including cabergoline and bromocriptine

Clomiphene citrate

GonadotropinsIncludes human chorionic gonadotropin (hCG), choriogonadotropin alfa (a bio-synthetic chorionic gonadotropin derived from recombinant DNA), human menopausal gonadotropins (hMG), recombinant FHS, etc.

Therapeutic operative procedures For females, such as therapeutic operative laparoscopy, open surgical treatments, salpingo-ovariolysis, terminal salpingostomy, fimbrioplasty, uterotubal implantation, balloon tuboplasty, ovarian wedge resection, etc.

Therapeutic operative procedures For males, such as varicocelectomy, transurethral resection of the ejaculatory duct, orchiopexy, surgical correction of epididymal blockage for individuals with obstructive azoospermia (epididymectomy, epididymovasostomy, excision of epididymal cysts and tumors, etc.).

The Blue Shield IVF coverage also bears the expense of advanced infertility treatments for individuals, including:

Artificial insemination for female infertility – Artificial insemination (AI) is considered medically necessary for female infertility under certain conditions, such as tubal abnormalities or ovulatory disorders, which should be confirmed with the insurer.

Artificial insemination for male infertility AI for male infertility is considered medically necessary in case the individual needs comprehensive urological evaluation, semen analysis, low sperm count, anti-sperm antibodies, retrograde ejaculation, seminal fluid liquefaction defect, aspermia, etc.

IVF (in vitro fertilization) IVF is considered for individuals who require monitoring of ovulation stimulation, stimulation of ovulation, oocyte removal, embryo assessment and thawing of cryopreserved embryos.

Additionally, this policy also covers the cost of medicines & drugs, lab tests, pathology procedures and radiology costs for treatment techniques, including TESE, TESA, PESA, MESA, ICSI, etc.

To learn the complete benefits of Blue Cross Blue Shield for IVF coverage, you are strongly advised to check the member’s benefit booklet you received along with your insurance policy documents.


Blue Cross Blue Shield offers comprehensive coverage that includes the most basic and advanced diagnostic tests and infertility treatment procedures for men and women alike.

IVF Grants in the U.S.

See Also

Reintegration Grants

Loans for IVF

FET Due Date Calculator

How Much Does IVF Cost?

How to Read Blue Cross Blue Shield Insurance Card?

Current Version
September 13, 2023
Updated By
Andrea Morales G.
January 24, 2021
Written By
Shubham Grover
April 20, 2024
Updated By
Andrea Morales G.

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