Who pays your premiums, whether your own policy covers a surrogate pregnancy, and what has to be in the contract before you sign.
The intended parents do — but in most states that is your contract talking, not the law.
Intended parents, in practice, funded through escrow alongside your compensation. In four states the statute requires it. Everywhere else it is a term you negotiate, not a right you hold.
Either your own policy, if it has no surrogacy exclusion, or one bought for you. Both happen. What matters is that the contract names which, and who pays if that changes.
Many individual plans exclude surrogacy, and one can be added at renewal. Ask for your specific policy to be reviewed, and ask in writing what happens if an exclusion is found after transfer.
Medical care for the pregnancy is not deducted from your compensation — it sits outside the $47,000–$98,000 package entirely. What varies is how that care is paid for, and that is a question about policies and premiums rather than about your fee.
Seven states legislate on insurance. Fourteen more say in as many words that they do not.
| State | Insurance | What the statute says |
|---|---|---|
| Connecticut | They pay | Intended parents must pay your health and life insurance premiums and your uncovered medical expenses, and you must carry cover through the pregnancy. |
| New York | They pay | Comprehensive health insurance from preconception through 12 months postpartum, plus life insurance of at least $750,000 — both paid by the intended parents. |
| Hawaii | They pay | Intended parents must pay your health-insurance premiums, your life-insurance premiums and any uncovered medical expenses. |
| Vermont | They pay | Intended parents are liable for your health care costs not covered by insurance, and breaching the agreement does not excuse that. |
| Illinois | You must carry | You must have health insurance covering the pregnancy at the time you sign. |
| Delaware | You must carry | You must carry health insurance for major medical and hospitalisation. |
| Washington | Must be disclosed | No mandate, but the agreement must disclose your policy’s surrogacy provisions and any liability or lien exposure. |
14 states say the opposite in as many words. Their guides state plainly that no insurance requirement exists in law, so cover is whatever your contract says and nothing more: Colorado, Idaho, Mississippi, Montana, New Mexico, North Carolina, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, West Virginia, Wisconsin, Wyoming.
Every row is read from that state’s own guide, which cites the statute directly. The remaining states are not silent by implication — they simply have no insurance provision we have been able to confirm either way, which is itself a reason to get it in writing.
Not in an email. In the agreement your own attorney reviews.
Your attorney is paid for by the intended parents in most arrangements, and by statute in several states. Use them for this — insurance is the clause most often left vague.
In practice the intended parents do, through the escrow account, and in Connecticut, New York, Hawaii and Vermont the statute says so outright. Everywhere else it is a contract term rather than a legal right, which is exactly why it belongs in writing before you sign.
Sometimes, and sometimes not. Many individual policies carry a surrogacy exclusion, and a policy can add one at renewal. Ask your agency to have your specific policy reviewed rather than assume, and ask what happens if the exclusion is found after transfer.
In Illinois and Delaware, yes — carrying health cover is a statutory eligibility condition, not an agency preference. Most agencies ask for it regardless. Where a state has no rule, whether cover is arranged for you is negotiable.
New York requires a policy of at least $750,000, in force from before medical treatment through 12 months after the pregnancy, paid by the intended parents. Connecticut and Hawaii require the intended parents to pay life-insurance premiums without setting an amount. Elsewhere it is a common but optional term.
This is the question most often left vague. Connecticut, Hawaii and Vermont put uncovered medical costs on the intended parents by statute. Elsewhere, name the deductible, the out-of-pocket maximum and co-pays explicitly in the contract, and say who pays if the policy changes mid-pregnancy.
Insurance is one clause. Start with the number, then read your state’s law.