Medicare does not typically cover fertility treatments, unless they are deemed medically necessary by a doctor. Learn more about the circumstances in which Medicare might cover your fertility treatment.
Medicare Part B may help cover some fertility treatments if they are deemed medically necessary by a doctor, but specific coverage rules and costs will vary from situation to situation.
In order for Medicare to cover any infertility treatments, they would need to be deemed reasonable and necessary tests or treatments for infertility in a person when fertility would be expected.
Medicare Advantage (Part C) plans also help cover fertility treatments if the treatments would be covered by Medicare Part B.
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What should I know about Medicare and fertility treatments?
We recommend speaking with your doctor or health care provider directly about your fertility treatment coverage options and to determine what kind of coverage Medicare will provide (if any) for the specific treatment you are considering.
Some questions to ask include:
Will Medicare cover infertility treatments? If so, which ones?
Do I need to undergo specific fertility tests before my plan covers my treatment?
Are there any restrictions related to this coverage, for example does Medicare restrict fertility treatment or testing coverage based on age?
Will Medicare cover fertility medications?
Medicare Part A and Part B do not cover most prescription drugs. Most Medicare Part D Prescription Drug Plans do not cover medications used to treat infertility, such as Clomid (clomiphene citrate).
Do I have to try certain fertility treatments before moving on to others?
Medicare Advantage plans may offer benefits Original Medicare does not cover
Medicare Advantage plans provide the same hospital and medical benefits as Original Medicare (Medicare Part A and Part B).
Since fertility treatments aren’t generally covered by Original Medicare, Medicare Advantage plans are not required to cover them.
However, many Medicare Advantage plans provide benefits beyond the standard Part A and Part B benefits.
Check your Medicare Advantage Prescription Drug Plan’s formulary (list of covered drugs) to find out if it covers certain fertility medications.
Plan availability can vary by location.
Find Medicare Advantage plans in your area
A licensed insurance agent can help you find Medicare Advantage plans in your area so that you can enroll in a plan that works for you.
Or call 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.
About the author
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
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Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
Original Medicare (Parts A and B) doesn’t cover routine dental or vision care. 2024 Medicare Advantage (Part C) plans can cover benefits Original Medicare doesn’t cover, but dental and/or hearing benefits may not be available where you live. Learn more and find out how to compare the plans and benefits available in your area.
Medicare Part B may cover emergency ambulance services, and some Medicare Advantage plans may offer non-emergency transportation to plan-approved locations. Learn more about Medicare transportation coverage.
Medicare Advantage plans can offer gym memberships and fitness benefits that Original Medicare doesn’t cover, such as SilverSneakers. Learn how to compare your local plan options and how to find a Medicare Advantage plan that covers fitness benefits.
While Original Medicare (Parts A and B) doesn’t cover hearing aids, Medicare Advantage (Part C) plans can cover hearing benefits Original Medicare doesn’t cover. Hearing benefits may be available where you live, so learn how to find out if Medicare Advantage plans that help pay for hearing aids are available in your area.
Medicare Part B covers annual wellness visits. Medicare Advantage plans also cover annual wellness visits, and many Medicare Advantage plans also offer other wellness benefits not found in Original Medicare.
Medicare Part A does not cover outpatient surgery, but Part B covers medically necessary outpatient surgery. Medicare Advantage plans may also cover outpatient surgery and include an annual out-of-pocket spending limit, which Original Medicare doesn’t offer.
Original Medicare and Medicare Advantage plans can cover chiropractic care, but some plans may cover services more than others. Learn about what’s covered, what’s excluded and how much your Medicare costs could be.
Medicare covers many telehealth services, and those benefits expanded during the coronavirus pandemic. Beneficiaries can use telehealth to access their doctor while also staying safe during COVID-19.
Original Medicare (Medicare Parts A and B) doesn’t cover bathroom grab bars or other bathroom safety devices. Medicare Advantage plans can cover bathroom safety devices, but only in limited situations and only for beneficiaries who qualify.
Original Medicare covers some limited home health services. Medicare Advantage plans cover the same home health care services and may include some additional benefits.
Join our email series to receive your Medicare guide and the latest information about Medicare.
By clicking "Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
Thanks for signing up for our emails!
Your Medicare guide will arrive in your email inbox shortly. You can also look forward to informative email updates about Medicare and Medicare Advantage.
If you'd like to speak with an agent right away, we're standing by for that as well. Give us a call!