fertility insurance

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Fertility Insurance: Financial Security on the Journey to Your Desired Child

7 May 2025

7

Minutes

Katrin Straub

Managing Director at nextsure

The desire for a child of their own is a central life dream for many couples, but the cost of fertility treatment can pose a significant hurdle. Comprehensive fertility insurance, as part of proactive financial planning, can provide reassurance in this area. This article outlines ways in which you can manage the financial burden.

The topic in brief and concise terms

A special 'fertility insurance' scarcely exists in Germany; financial security requires a combination of statutory/private health insurance benefits, government subsidies, and personal provision.

The statutory health insurance covers 50% of the costs for up to three IVF/ICSI cycles for married couples within certain age limits; private health insurance often covers 100% based on the causation principle, even for unmarried individuals.

Government subsidies from the federal and state levels can halve the personal contribution after statutory health insurance benefits; the Embryo Protection Act imposes strict legal restrictions on treatments.

Realistically assessing the financial burden of wanting children

Unfulfilled desire for children often represents an emotional roller coaster for couples, frequently accompanied by significant financial strain. The costs of fertility treatments are an important factor that should be included in planning at an early stage. For example, a single IVF cycle (in vitro fertilisation) can average between 2,400 and 3,800 euros, plus medication costing around 500 to 1,500 euros. The costs for an ICSI treatment (intracytoplasmic sperm injection) per cycle are often between 4,000 and 5,500 euros, again plus medication. An insemination attempt is comparatively cheaper, at around 800 to 900 euros per attempt. Similarly, 'social egg freezing', a kind of personal fertility insurance through the freezing of eggs, incurs initial costs of 5,000 to 10,000 euros, not including later costs for implantation. Many couples require several treatment cycles, which can quickly raise the total costs to over 10,000 euros. These figures illustrate why careful financial preparation and the examination of insurance options that resemble fertility insurance are so important. Knowing the various cost factors is the first step towards an informed decision.

Check statutory health insurance (GKV) benefits for family planning

The statutory health insurance (Gesetzliche Krankenversicherung or GKV) provides basic coverage for couples wishing to have children, but under clearly defined conditions. According to § 27a SGB V, the GKV generally covers fifty percent of the costs for a maximum of three cycles of IVF or ICSI treatment. One of the requirements is that the couple must be married, with the woman aged between 25 and 40 and the man between 25 and 50 years old. For inseminations in the spontaneous cycle, up to eight attempts can be subsidized, and with hormonal stimulation, up to three attempts. The remaining self-pay portion of fifty percent can still mean a four-figure sum per cycle. Some health insurance funds offer so-called statutes benefits that go beyond their regular services, which may allow for higher cost coverage; making an inquiry with your own insurance provider is worthwhile here. A comprehensive health insurance is the foundation, but when it comes to the desire to have children, the details are crucial. It is important to clarify the exact conditions and the extent of cost coverage with your own health insurance at an early stage to avoid being surprised by unexpected costs.

Utilise the potential of private health insurance (PKV) for fertility treatments

For privately insured individuals, more advantageous conditions may arise for fertility treatments than in the statutory health insurance (GKV). Many policies of the Private Health Insurance (PKV) cover the costs of medically necessary fertility treatments at one hundred percent. What is often crucial here is the so-called causation principle: the insurance of the partner for whom the medical cause of childlessness lies is obligated to perform. Another common condition is a treatment success expectation of at least fifteen percent. Unlike the GKV, marital status or rigid age limits play a less significant role in the PKV, although there may be differences in policy terms. The exact policy terms are crucial for the scope of benefits. It is therefore essential to examine your own PKV contract in detail or to have a tariff analysis carried out. Some policies may, for example, limit the number of attempts or specific treatment methods. Early clarification with the insurer provides clarity here regarding possible cost coverage.

Special fertility insurance and additional options: What is available?

An explicit, comprehensive 'fertility insurance' as a standalone product is currently not widely available in Germany, unlike in Switzerland, where some insurers offer such policies. However, there are approaches aiming in a similar direction. The previously mentioned social egg freezing can be seen as a form of individual provision to secure one's own fertility for a later date, but it is associated with costs of several thousand euros. There are occasional supplementary health insurances that provide grants for fertility treatments. An example is a policy that contributes up to 1,500 euros for IVF/ICSI treatments without requiring a health check, even for unmarried couples, provided their own egg and sperm cells are used. Such supplementary insurances usually cover only part of the considerable overall costs. It is important to carefully examine the price-performance ratio of such offers and consider whether they are a worthwhile addition to existing coverage. Finding the right financial support often requires a combination of different elements.

Legal Frameworks: Understanding the Embryo Protection Act

All medical procedures involved in fertility treatments in Germany are subject to strict legal regulations primarily outlined in the Embryo Protection Act (ESchG) of 1990. The purpose of this law is to protect the embryo from the beginning of its development and to prevent the misuse of reproductive techniques. The ESchG defines an embryo as a fertilised, viable egg cell from the moment of nuclear fusion. Practices prohibited in Germany include egg donation and surrogacy. It is also prohibited to create or use embryos purely for research purposes. An important regulation pertains to the number of embryos: a maximum of three embryos may be transferred to the woman per treatment cycle. These legal provisions directly influence the treatment options and strategies available in German fertility centres. Couples should be aware of these legal frameworks, as they can limit the available options compared to other countries. Comprehensive health and care planning should also take these aspects into account. Knowing these laws helps in developing realistic expectations for treatment in Germany.

Expert Advice: Setting the Right Financial Course for Your Desire to Have Children

Securing financing for fertility treatment demands careful planning and information, to ensure that the dream of having a child does not falter due to costs. Start financial planning as early as possible. Thoroughly check the benefits of your statutory or private health insurance, specifically for fertility treatments; often this requires more than three calls. Actively ask your public health insurance about possible statutory benefits that go beyond the standard. Inform yourself about federal and state support programs that can reduce your personal contribution by up to fifty percent. Seek independent advice for complex cases or uncertainties regarding cost coverage, for example from specialized advisory services. Our expert tip: Create a detailed cost plan for at least three treatment cycles and compare the offers from various fertility centers. At nextsure, we understand the complexity of your situation and discreetly support you in analyzing potential gaps in your health insurance coverage. A solid financial foundation is an important step on the path to having the child you wish for.

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FAQ

Was versteht man unter einer Fertilitätsversicherung?

Eine explizite „Fertilitätsversicherung“ als einzelnes Produkt ist in Deutschland selten. Der Begriff umschreibt eher eine umfassende finanzielle Absicherung für Kinderwunschbehandlungen durch Nutzung bestehender Systeme (GKV, PKV), staatlicher Hilfen und ggf. privater Zusatzversicherungen.

Wie funktioniert die Kostenübernahme bei der PKV nach dem Verursacherprinzip?

Beim Verursacherprinzip übernimmt die private Krankenversicherung des Partners die Kosten der Kinderwunschbehandlung, bei dem die medizinische Ursache für die Kinderlosigkeit liegt. Dies gilt oft für die gesamten Behandlungskosten beider Partner.

Welche Altersgrenzen gelten für die Kostenübernahme durch die GKV?

Die GKV beteiligt sich an den Kosten, wenn die Frau zwischen 25 und 40 Jahre alt ist und der Mann zwischen 25 und 50 Jahre. Für die PKV gibt es meist keine so starren Altersgrenzen, dies ist aber tarifabhängig.

Können auch unverheiratete Paare Zuschüsse bekommen?

Die GKV-Regelleistung (50% Zuschuss) gilt nur für verheiratete Paare. Einige Bundesländer haben ihre Förderprogramme im Rahmen der Bundesinitiative jedoch auch für unverheiratete Paare geöffnet. PKV-Leistungen sind oft nicht an den Familienstand gebunden.

Wie viele Behandlungszyklen werden maximal bezuschusst?

Die GKV bezuschusst in der Regel bis zu drei Zyklen einer IVF- oder ICSI-Behandlung. Staatliche Förderprogramme können sich ebenfalls auf eine bestimmte Anzahl von Zyklen (z.B. die ersten vier) beziehen. In der PKV ist die Anzahl der Zyklen oft nicht pauschal begrenzt, solange medizinische Notwendigkeit und Erfolgsaussicht bestehen.

Was ist das Embryonenschutzgesetz und was regelt es?

Das deutsche Embryonenschutzgesetz (ESchG) von 1990 regelt den Umgang mit menschlichen Embryonen. Es verbietet u.a. die Eizellspende, Leihmutterschaft und die Forschung an Embryonen. Es erlaubt die Übertragung von maximal drei Embryonen pro Zyklus.

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nextsure – Your digital platform for health and protection insurance. Transparent comparisons, easy online sign-up, and personal expert support make it possible.

nextsure – Your digital platform for health and protection insurance. Transparent comparisons, easy online sign-up, and personal expert support make it possible.