Fertility challenges touch a meaningful share of the workforce, and the path to building a family can come with significant medical costs. Employers who offer a health savings account (HSA) or a medical flexible spending account (FSA) already have a tool that can help. A range of fertility and infertility related expenses qualify for reimbursement through these accounts, giving employees a tax-advantaged way to manage costs that often are not fully covered by insurance. 

What Are Fertility Benefits? 

Fertility benefits are forms of financial or medical support offered to employees who are trying to conceive and need medical assistance to do so. These benefits can take many forms, from direct coverage through a health plan to reimbursement accounts like an HSA or FSA. 

Fertility treatment is often expensive, and many employees pay a substantial portion of these costs out of pocket. Helping employees understand what their HSA or FSA can cover is one practical way employers can ease that burden. 

What Do Fertility Treatments Typically Include? 

Fertility care covers a wide range of services and procedures, including: 

• In vitro fertilization (IVF) 

• Fertility medications 

• Diagnostic testing 

• Egg freezing 

• Fertility counseling and consultations 

• Adoption assistance 

What Fertility Treatments Qualify for HSA or FSA Funds? 

Fertility treatments generally qualify for HSA and medical FSA reimbursement when the procedure is performed on the account holder, a spouse or another individual whose expenses are eligible for tax-free reimbursement. Common qualifying expenses include: 

• IVF, including the temporary storage of eggs or sperm 

• Surgery, including a procedure to reverse an earlier surgery that prevented conception 

• Fertility related injections and treatments 

• Gamete intrafallopian transfer (GIFT) 

Expenses paid to or on behalf of a gestational surrogate typically do not qualify. Egg donor expenses also generally do not qualify, unless they are directly preparatory to a procedure performed on the account holder, a spouse or another eligible individual. 

What About Infertility Treatments? 

Egg Donor Fees 

Egg donor fees may be covered by an HSA or FSA when a physician determines the treatment is medically necessary and provides the documentation needed to support that determination. 

Eggs and Embryos 

HSA and FSA funds can generally be used for the temporary storage of eggs, sperm or embryos, as well as procedures to implant donor eggs or embryos and related fertility medication. Long-term storage is typically not an eligible FSA expense. 

Surrogate Expenses 

Expenses related to a surrogate mother are not eligible for reimbursement through either an HSA or an FSA. 

Helping Your Employees Plan Ahead 

Fertility benefits are becoming an increasingly important part of a competitive benefits package. Employers who take the time to explain how an HSA or FSA can be used for fertility and infertility related expenses give employees a clearer picture of the resources already available to them. 

Advantage Administrators works with employers to help employees get the most from their benefit accounts. Clear, accurate information about what is and is not eligible for reimbursement helps employees make informed decisions as they navigate the cost of building a family. 

This content is provided for educational purposes only and should not be considered legal, tax or medical advice. Individuals should consult an appropriate professional regarding their specific circumstances.