Why is the baby not covered by the surrogate's insurance?
Status as of [date], reviewed by counsel.
Because the surrogate's health insurance covers her, not the baby. Her policy pays for her own prenatal care, delivery and recovery. From the moment of birth, the baby is a separate patient with separate bills, and those bills belong to the intended parents.
Families who live in the US usually add the baby to an employer plan. International parents have no US employer plan to add the child to, and a home-country policy may not pay a US hospital. So international parents buy a dedicated newborn medical policy before the birth.
This is one of the costs most often missed in an international budget, because it does not appear on the agency fee schedule, the clinic quote or the escrow statement. It is a separate policy, bought by you, for your child. When you build your budget, list the newborn policy as its own line, next to the PLS program fee, the surrogate's compensation package, third-party costs and your clinic's quote. Intended parents typically budget $150,000 to $200,000 for the whole journey; check that your own figure includes this line.
What does a newborn policy for surrogacy cover?
A newborn policy is a medical policy for the baby, written for the period the baby is in the US. The terms vary by policy, so read the policy document itself, not only the summary. Check for each of these before you buy:
- Hospital care from birth, including the newborn stay after delivery.
- NICU admission, with the daily limit and the total limit written out.
- Pediatric visits after discharge, before you fly home.
- Transfers between hospitals, if the baby needs a higher level of care.
- The start date. Coverage must begin at birth, not after a waiting period.
- Exclusions, especially for preterm birth, multiples, or conditions present at birth.
- How claims are paid: billed directly by the hospital to the insurer, or paid by you and reimbursed.
If you are expecting twins, confirm that each baby is covered and that the limits apply per baby.
What does the NICU cost without insurance?
The NICU is billed per day. A preterm baby may need days or weeks of intensive care, and without coverage, every one of those days is billed to you. [NICU cost per day and typical total for a preterm stay: cite a source before publishing a figure.]
You cannot predict whether your baby will need the NICU. You can decide in advance who pays if it does. That is the reason for buying coverage before the birth rather than hoping it is not needed.
When must coverage be in place?
PLS requires international parents to show proof of newborn coverage by 28 weeks of pregnancy.
Some policies can be bought after the birth, at much higher cost and with exclusions. Buying before the birth avoids that. A deadline in the second half of the pregnancy also gives you time to compare quotes, read the policy, and fix a gap before the due date.
| Coverage | Who it covers | Typical cost | Deadline |
|---|---|---|---|
| Surrogate maternity coverage | The surrogate | Her existing plan, or a dedicated policy at $5,000 to $40,000 if her plan excludes surrogacy | Reviewed at screening, before match |
| Newborn policy | The baby, from birth | Quote from a broker [typical range to confirm] | Proof of coverage by 28 weeks |
| NICU | The baby | Check the daily and total limits in the newborn policy | Same as the newborn policy |
| Well-baby visits before departure | The baby | Check outpatient pediatric cover in the newborn policy | Same as the newborn policy |
| Travel medical for the parents | You | Quote from your insurer [typical range to confirm] | Before you travel |
Plan the newborn policy around your travel dates. The travel and birth timing page explains how to plan your dates, and leaving the US with your baby covers the final weeks.
Which brokers write these policies, and what do they cost?
PLS refers international parents to insurance brokers who write surrogacy newborn policies. PLS does not name them here, and it does not take a share of their fees, consistent with its policy on every independent professional in a journey. Ask Jan Telman Berman, PLS's Global Surrogacy Coordinator, for current referrals.
[Typical premium range for a surrogacy newborn policy: confirm with brokers before publishing.]
When you compare quotes, ask each broker the same questions:
- What is the total limit, and is there a separate NICU limit?
- Does coverage start at birth, with no waiting period?
- Are preterm birth and multiples covered?
- Does the hospital bill the insurer directly?
- When does coverage end, and can it be extended if your stay runs longer?
- Can the policy be bought now and start at birth?
What about the surrogate's own insurance review?
The surrogate's own maternity coverage is a separate question, settled much earlier. PLS reviews her health insurance policy at screening, before match, to check whether it excludes surrogacy. If it does, you fund a new policy for her pregnancy at $5,000 to $40,000. That figure appears in the full cost of surrogacy, and the review itself is part of the third-party costs of $15,300 to $29,000.
Because the review happens before match, the surrogate's coverage is a known number before you commit. The surrogate health insurance page explains how that review works.
The two policies do different jobs. Hers covers her care through delivery and recovery. Yours covers the baby from birth. Neither covers the other.
What does PLS check before the birth?
In the third trimester, PLS works through a short list with you so the hospital stay is settled before labor:
- Proof of newborn coverage. On file with PLS by 28 weeks.
- The parentage filing. With a pre-birth order and your newborn policy on file, the hospital bills the baby's care to your policy or to you, not to the surrogate.
- The hospital birth plan, naming you as the intended parents.
- Your travel plan, with arrival before the due date.
Jan coordinates this list with your attorney and the delivering hospital. A case manager, Natalie Gaudio-Fricano or Jenni Symons, carries the pregnancy and is your contact for the surrogate's appointments. Both are former surrogates, and Natalie delivered for an international couple in 2016.
Sources
- Private Label Surrogacy program terms: third-party cost range, surrogate insurance review and surrogate health policy range.
- NICU cost data: source to be added before publishing a figure.