Navigating Surrogacy Insurance Changes in 2026: What Intended Parents Need to Know

Surrogacy insurance has always been one of the most complex parts of the family building journey. As we approach 2026, major shifts in insurance coverage especially in California are creating new questions and new planning considerations for Intended Parents.

To help families stay informed, ACRC Surrogacy recently hosted a live webinar featuring Sarah Paige, CEO of Art Risk Solutions, one of the most experienced surrogacy insurance experts in the field. During the session, we explored what is changing, why it matters, and how Intended Parents can plan with confidence moving forward.

Below is a summary of the most important takeaways. For a deeper explanation and real world examples, we highly recommend watching the full webinar.

Why 2026 Is a Turning Point for Surrogacy Insurance

Historically, California has been considered one of the most surrogacy friendly states, both legally and medically. However, insurance coverage is becoming increasingly limited.

As Sarah explained, California has shifted from having multiple surrogacy friendly insurance carriers to essentially one primary option, and even that option comes with significant limitations.

These changes mean that Intended Parents must now plan more carefully around:

• Insurance carrier availability

• Provider access for Surrogates

• Potential reimbursement risks

• Higher overall budgeting requirements

Understanding these shifts early can prevent delays, unexpected expenses, and stress later in the journey.

The Challenge With Anthem HMO Plans in California

Anthem has long been considered a strong option for surrogacy coverage. However, many California counties now only offer Anthem HMO plans, which come with strict limitations.

Key issues include:

• Limited OB provider availability

• Provider caps on HMO patients

• Difficulty securing prenatal care even after pregnancy confirmation

• Increased risk of delayed or interrupted care

In some cases, Surrogates are weeks or months into pregnancy before being accepted by an OB provider. While Anthem may still be used, Sarah emphasized that Intended Parents should fully understand the risks before selecting this option.

What Is a “Lien” and Why It Matters

Many alternative ACA plans such as Blue Shield and Kaiser include a right to reimbursement, often referred to as a lien.

A lien allows the insurance company to seek reimbursement for pregnancy related medical costs, typically up to the Surrogate’s compensation amount or a portion of it.

Important points to understand:

• The insurance company does not take the Surrogate’s compensation directly

• Intended Parents are contractually responsible for reimbursement

• Some carriers, such as Kaiser, cap reimbursement at a reduced percentage

• Actual reimbursement depends on total medical costs

While lien based plans are still major medical insurance and often provide strong coverage, they require careful financial planning and transparency.

Lloyd’s of London: A Specialty Surrogacy Insurance Option

When ACA plans are not viable, Lloyd’s of London specialty maternity insurance is often used.

This type of policy is:

• Specifically written for surrogacy

• Accepted nationwide

• Highly flexible with providers and delivery locations

• Financially stable and well established

One major update discussed in the webinar is that Lloyd’s policies are expected to offer monthly payment options in 2026, making them more accessible for many Intended Parents.

While Lloyd’s coverage is typically more expensive, it provides predictability and flexibility that can be especially valuable in complex situations.

When Lloyd’s of London Makes Sense

Sarah highlighted several situations where Lloyd’s may be the best option:

• Delivery planned in a different state than the Surrogate’s residence

• Preference for specific OB providers or hospitals

• Need to begin the journey immediately without waiting for open enrollment

• Avoiding lien based reimbursement risks

For Intended Parents seeking certainty and flexibility, Lloyd’s can provide peace of mind despite the higher upfront cost.

Is California Still the Best Choice for Surrogacy?

One of the most important discussions in the webinar addressed whether California should still be the default choice.

While California remains legally strong, insurance challenges are making other states increasingly attractive. States such as Nevada, Florida, Tennessee, Ohio, Minnesota, and Colorado often offer more accessible insurance options with fewer complications.

Choosing a Surrogate outside of California may significantly reduce insurance related stress and overall costs without compromising legal protections.

Budget Planning: What Intended Parents Should Prepare For

To stay financially prepared, Sarah recommended that Intended Parents plan for approximately $40,000 in insurance related costs to cover various scenarios.

This planning cushion allows flexibility whether using:

• ACA plans

• Lien based coverage

• Lloyd’s of London specialty insurance

Having these funds allocated early can prevent delays and difficult decisions later in the journey.

Watch the Full Webinar for In Depth Guidance

This blog only scratches the surface of the detailed information shared during the webinar. The full discussion includes real world examples, practical budgeting insights, and nuanced explanations that are invaluable for anyone considering surrogacy in 2026.

Watch the full webinar on YouTube here: https://www.youtube.com/watch?v=yOG3yNITyXg

Need Personalized Guidance?

Every surrogacy journey is unique. If you have questions about insurance options, budgeting, or choosing the right state for your journey, ACRC Surrogacy offers complimentary consultations with our experienced team.

We are here to help you navigate these changes with clarity, confidence, and support every step of the way.

ACRC Surrogacy

Compassionate. Transparent. Global.

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