I wrote my original post about surrogate health insurance years ago, and it's still one of the most-read on this site – but the American insurance market doesn't stand still, and what was true then needs some important updates. So here's the 2026 version: what changed, and which questions to ask today.
A quick reminder for newcomers: the U.S. has no national health coverage like Israel's, and the basic rule in surrogacy is that all pregnancy and birth costs are on you. The big question is how: through the surrogate's existing insurance, or through a dedicated policy you purchase.
So what changed in recent years? Three main things. First: more and more regular policies now include a surrogacy exclusion – a clause stating the policy won't cover a pregnancy the woman carries for others. Such exclusions, once rare, have become common – which is why a professional insurance review of the surrogate's policy has moved from "recommended" to mandatory, before signing the contract. Second: prices of dedicated surrogacy-friendly policies have risen significantly, and must be budgeted accordingly – many thousands of dollars a year that weren't in the old calculations. Third: enrollment windows. Many policies can only be purchased during a short annual open-enrollment period at year's end – and missing the window can delay the entire transfer timeline. It's a timing consideration a good agency manages, but you need to make sure it's on the table.
And the baby? This is the point I most want to sharpen, because it surprises parents anew every year: the surrogate's insurance covers her – not the baby after birth. From the moment your baby is born, they need coverage of their own, and newborn hospital days – especially NICU – are the single largest potential expense of the entire journey. Make sure there's an insurance solution for the baby from minute one, plus appropriate travel insurance for yourselves for the stay (I wrote separately about claims on Israeli insurance).
My tip: don't settle for "she has good insurance" – ask to see the written insurance review report, with three clear answers: is there a surrogacy exclusion, what are your actual cap and out-of-pocket costs, and what's the backup plan if the policy changes mid-pregnancy (it happens – policies renew every January, even mid-pregnancy). Three answers, one paper, peace of mind for a whole year.
