If you have Medicaid or Medicare, you've probably already run into a hard wall: most fertility clinics don't accept it for IVF, and ours are no exception. We want to be straight with you about that - and then spend the rest of this guide making sure you leave with real options, not a dead end.

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Why we can't put you on a Gaia plan right now

Here's the honest version. Our partner clinics are private fertility clinics, and they aren't in- network with Medicaid or Medicare. That means treatment with us would be entirely self-pay - and if self-pay isn't workable for you, we're not able to help with a Gaia plan at this time.

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We'd rather tell you that plainly than have you find out three appointments in. What we can do is point you toward the support, grants, and lower-cost routes that other people in your position have used to make treatment happen. None of this is a substitute for coverage - but together it can move the number from impossible to maybe.

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If anything changes

If your coverage situation changes, or you decide self-pay is something you want to explore at one of our partner clinics, tell us - well pick the conversation right back up.

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Where to start: national support & education

Before you spend a dollar, spend an hour here. These two are the orientation map for anyone navigating fertility care in the US - free, trustworthy, and built for exactly this moment.

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RESOLVE

The National Infertility Association. Free peer-led support groups (in-person and virtual), a helpline, financial-assistance directories, and advocacy for insurance coverage in your state. Start here.

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Visit: www.resolve.org

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Gaia's Learn Library

Plain-language guides on what to expect, questions to ask your doctor, treatment options, and costs - written with members, not at them. Yours to read whether or not you ever become a Gaia member.

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Visit: www.gaiafamily.com/learn

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Fertility grants worth applying for

Grants are real money toward treatment that you don't pay back. They're competitive and most have application windows and fees, so apply early and to more than one. These three fund IVF and related care for people across the US.

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BabyQuest Foundation

Funds IVF, IUI, egg freezing, donor eggs/sperm, and surrogacy. Awards vary by cycle and applicant need; open to applicants nationwide.

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Visit: www.babyquestfoundation.org

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The Cade Foundation

Family-building grants of up to $10,000 toward fertility treatment or domestic adoption. One application round per year, so check the deadline.

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Visit: www.cadefoundation.org

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Fertility Within Reach

Helps you advocate for fertility benefits through your employer and insurer, and connects you to financial-assistance programs. Especially useful if there's any chance of pushing for coverage.

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Visit: www.fertilitywithinreach.org

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Want more? Donor Nexus keeps a 2026 roundup of IVE grants and scholarships with current deadlines — a good place to find additional programs beyond the three above.

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Financing & lending

If you decide to self-pay, a loan can spread the cost over time. Borrow carefully - compare the APR, the total you'll repay, and any prepayment penalties before signing.

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Gaia plan payment plan

This isn't general-purpose financing. It's a payment plan for your Gaia plan treatment package, available in certain states if you self-pay at one of our partner clinics. Payments only start once treatment begins - not for diagnostics or your initial consultation. Ask us whether your state is eligible; we'll tell you straight.

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Outside of that, these lenders work with fertility patients:

Upstart

Our partner lending marketplace - compares multiple offers in one application.

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SoFi

Personal loans with no fees and fixed monthly payments.

LendingTree

A marketplace that lets you compare rates from many lenders at once.

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Save on medication

Fertility medication is one of the biggest out-of-pocket lines, and it's also one of the easiest to bring down. A few programs exist specifically to help - but read the eligibility note first, because it matters a lot for you.

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Important if you have Medicaid or Medicare

The headline discounts you've probably seen - EMD Serono's Fertility Instant Savings program behind TrumpRx.gov - are only for self-pay patients who are not enrolled in a government health program (Medicaid, Medicare, TRICARE or VA). If you're enrolled in one of those, you generally can't use that particular discount. The good news: cash-pay options like Costco's program below don't have that restriction.

• Costco's cash-pay fertility program. Through a partnership with Sesame and IVI RMA, Costco members get up to ~80% off fertility medications (including pricey injectables like Follistim), plus care coordination, for a monthly membership fee. Because it's cash-pay rather than insurance, it's open to you even with Medicaid or Medicare — you just can't combine it with your government coverage.
• TrumpRx & manufacturer programs. If you ever pay fully out of pocket without using government coverage, EMD Serono's program (via TrumpRx.gov) can cut up to ~ 84% off Gonal-f, Cetrotide and Ovidrel. Ferring's HEART Program and other manufacturer compassionate-care programs may also help — ask your clinic's pharmacy what you qualify for.
• Donated-medication programs. Programs like the Heart Beat Program match unused, in-date fertility meds from people who've finished treatment with people who can't afford them. Free to apply, and open regardless of coverage.
• Specialty-pharmacy price checks. Prices for the same drug vary a lot between pharmacies. Get cash quotes from two or three fertility specialty pharmacies before you fill.

A heads-up: even if you self-pay for treatment, sorting out which medications your Medicaid plan might still cover — and how that interacts with cash-pay discount programs — can get complicated. This isn't medical advice; please work it through with your doctor, clinic pharmacy, and Medicaid plan directly.

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Lower-cost paths & clinical trials

A full private IVF cycle isn't the only route. Depending on your diagnosis and where you live, some of these may bring the cost down dramatically — or to nothing.

• Sliding-scale & low-cost clinics. Some clinics publish flat, lower per-cycle pricing and offer income-based discounts. Ask any clinic directly about financial-hardship pricing — many have it but don't advertise it.
• Less invasive treatment first. Not everyone needs IVF. For some diagnoses, IUI or medicated cycles cost far less and are worth discussing with a doctor before committing to IVF.
• Clinical trials & research studies. University fertility centers and research programs sometimes offer free or reduced-cost treatment to study participants. Search clinicaltrials.gov for "in vitro fertilization" plus your state.

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Check what your state covers

Medicaid and state mandates vary widely. A handful of states require some fertility coverage, and a few cover fertility diagnosis or preservation even when treatment isn't covered. It's worth thirty minutes to know exactly where you stand.

• Call the number on your Medicaid card and ask specifically what fertility services — diagnosis, medication, IUI, IVF, fertility preservation — are covered in your state.
• RESOLVE keeps an up-to-date map of state insurance laws — a fast way to see whether your state mandates any coverage. resolve.org → insurance coverage
• If you have a medical diagnosis driving infertility (like endometriosis or PCOS), some related care is often covered even when IVF isn't. Ask your doctor to code what they can.

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Smart ways to stretch your dollars

A few financial moves can quietly take a meaningful chunk off the real cost of a cycle. Most people leave these on the table.

• HSA / FSA dollars. Fertility treatment and medication are generally eligible expenses. Paying with pre-tax HSA or FSA money is effectively a discount equal to your tax rate.
• Medical-expense tax deduction. If your out-of-pocket medical costs pass the IRS threshold for the year, IVF and related expenses may be deductible. Keep every receipt and ask a tax professional.
• Bundle / multi-cycle pricing. Many clinics discount packages that cover several attempts versus paying cycle-by-cycle. If you expect to need more than one try, ask about it up front.

This isn't tax or financial advice — please confirm anything money-related with a qualified professional for your situation.

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You don't have to do this alone

The logistics are heavy and the feelings are heavier. Free and low-cost support exists for both — lean on it.

• Peer support groups. RESOLVE runs free, judgment-free support groups across the country and online. Talking to people walking the same road changes things.
• LGBTQ+ family building. Family Equality offers guidance, community, and a Family Building Helpline for LGBTQ+ paths to parenthood.
• Military & veteran families. If you or your partner serve or have served, the VA and several military-family nonprofits offer fertility benefits and grants worth checking before you self-pay.
• Low-cost counseling. Many therapists offer sliding-scale fees, and some specialize in fertility and reproductive grief. Ask RESOLVE or your clinic for a referral.