Do you need your own health insurance to be a surrogate?
No. You do not need to buy a policy to become a surrogate with Private Label Surrogacy, and you never pay a medical bill for the pregnancy. All pregnancy-related medical costs are paid or reimbursed by the intended parents.
What happens depends on the coverage you already have. PLS checks it during screening, before you are matched, so everyone knows which case applies before anyone commits.
| Scenario | Who pays | Policy type | Cost to intended parents | Your out-of-pocket |
|---|---|---|---|---|
| Your own plan covers a surrogate pregnancy | Your plan, with the intended parents reimbursing your share | Your existing plan | Your premiums, deductible and copays during the journey | None; costs are reimbursed |
| Your own plan excludes surrogacy | A new policy bought by the intended parents | Surrogacy-friendly policy | $5,000 to $40,000 | None |
| You have no health insurance | A new policy bought by the intended parents | Surrogacy-friendly policy | $5,000 to $40,000 | None |
| You are covered by Medicaid | Not eligible to apply while receiving government assistance | Not applicable | Not applicable | Not applicable |
Health insurance is one part of the package. A first-time PLS surrogate carrying one baby receives a typical total package of roughly $68,000 to $78,000, built on $60,000 base compensation (proposed). Insurance costs are paid by the intended parents on top of that, never out of it.
What is the PLS insurance review?
The insurance review is a check of your health plan before match. An independent insurance reviewer reads your policy and looks for one thing above all: whether it excludes surrogacy, or excludes a pregnancy carried for someone else. It is one of the seven screening steps, alongside the application, an interview with a case manager, the records review by Mark Silverberg, DDS, MD, a background check, the psychological evaluation by an independent licensed professional, and medical screening at the intended parents' clinic.
The review matters to you and to the intended parents. For you, it means you will not discover halfway through a pregnancy that your plan refuses a claim. For the intended parents, it turns the most common surprise cost in surrogacy into a known number before they commit. The cost of the review is a third-party cost paid by the intended parents. See the insurance review step.
What to have ready: your insurance card, the plan documents or certificate of coverage, and the name of the employer or marketplace the plan comes through. If you are not sure where your plan documents are, your case manager will tell you what to request.
What if your plan excludes surrogacy?
Many employer plans now exclude surrogacy. If yours does, the intended parents buy a surrogacy-friendly policy that covers your pregnancy and delivery. The cost to them is $5,000 to $40,000, depending on the policy and where you live.
You keep your own plan for everything else in your life. The new policy covers the surrogate pregnancy. Your attorney and the intended parents' attorney write into your agreement which policy pays for what, so there is no question at delivery.
If you have no health insurance at all, the same solution applies: the intended parents buy a surrogacy-friendly policy for you.
PLS requires that surrogates not receive government assistance. Medicaid counts as government assistance for this requirement, so a surrogate covered by Medicaid is not eligible to apply while she is on it. See the government assistance requirement.
Why does this matter so much? Because the insurance question decides who carries the financial risk of the pregnancy. When it is answered before match, in writing, the risk sits with the intended parents, who planned and budgeted for it. When it is left open, the risk can land on you at the worst moment, with a denied claim after a hospital stay. The review, the agreement and the funded escrow account together keep that risk where it belongs.
Who pays deductibles, copays and out-of-network costs?
The intended parents. If your own plan covers the pregnancy, they reimburse your premiums, deductible and copays for the journey. You submit the bills or statements, and the independent escrow agent pays you from the account the intended parents funded before medications began.
Out-of-network costs for care your agreement requires, such as monitoring at a fertility clinic outside your network, are paid by the intended parents. IVF and fertility clinic fees are paid by the intended parents directly to their clinic and never go through your insurance.
In practice, a reimbursement works like this:
- You receive care. A prenatal visit, an ultrasound, a monitoring appointment or the delivery itself.
- Your plan processes the claim. You receive an explanation of benefits showing what you owe.
- You submit it. Send the statement or bill, with proof of payment if you paid it, to the escrow agent with your case manager's help.
- Escrow repays you. The escrow agent checks it against your agreement and pays you from the funded account.
Keep every explanation of benefits and every bill. Your case manager will help you match each one to a reimbursement claim. If a bill reaches you by mistake, do not pay it; send it to your case manager.
What life insurance does a surrogate get?
The intended parents fund a term life insurance policy on you of up to $750,000, with the beneficiary you choose. You choose the beneficiary, usually your partner or a trust for your children. If your children are minors, ask your own attorney how to name the beneficiary so the money reaches them the way you intend.
The policy is in place from before medications begin through several weeks after delivery. The exact policy term and amount are being confirmed with Nancy Block, RN.
Life insurance is not a benefit you are likely to use. It exists because pregnancy carries medical risk, and your family should be protected while you take it on. It is one of the clearest ways to tell whether an agency treats surrogates as partners. See the full list of benefits and allowances.
How long does coverage last after delivery?
Health coverage continues through at least eight weeks postpartum. Illinois law requires this, and PLS contracts follow that minimum. Postpartum care, including a C-section recovery and any complication related to the pregnancy, is part of the journey and is covered on the same terms as the pregnancy itself.
Before you sign, ask your attorney three questions about postpartum coverage:
- Which policy covers postpartum care, and until what date?
- If a pregnancy-related complication appears after that date, who pays?
- How long does the life insurance policy run after delivery?
What does Illinois law require?
The Illinois Gestational Surrogacy Act (2005) makes compensated gestational surrogacy agreements enforceable and sets conditions for them, including that the surrogate has her own attorney and health insurance that extends through eight weeks postpartum. The Equality for Every Family Act, signed in December 2025, removes the genetic-link requirement and requires independent counsel for both sides.
If you live outside Illinois, your own state's law governs your agreement. Your attorney, who is paid by the intended parents and answers only to you, will confirm what your state requires.
Statute details on this page are pending review by counsel.
Sources
- Illinois Gestational Surrogacy Act (2005), Illinois General Assembly. Pending review by counsel.
- Illinois Equality for Every Family Act (2025). Pending review by counsel.
- Private Label Surrogacy compensation and insurance practice, pending confirmation by Nancy Block, RN.