What to know about insurance and taxes

When Rep. Alexandria Ocasio-Cortez recently announced on social media that she was freezing her eggs, she called attention to the cost of the procedure. The decision had taken time, the Democratic representative for New York’s 14th congressional district said in an Instagram story, “to consider, weigh and save up for.”

So-called elective egg freezing has become more common as women delay motherhood to focus on their education and careers, studies show. Ocasio-Cortez, who is 36, recently said on ABC’s “This Week” that she hasn’t ruled out a future presidential and U.S. Senate campaign.

However, the expense of egg freezing — compounded by a widespread lack of insurance coverage — remains an obstacle for many women.

“A single egg freezing cycle in the United States typically costs $10,000 to $20,000,” said Dr. Stephanie Kuku, a former gynecologist and senior adviser to the World Health Organization. The total tab can be much higher if multiple cycles are needed, and after factoring in additional costs such as storage and implantation.

Kuku, who also has worked with several tech firms on projects related to IVF accessibility, has found in her new research that reducing fertility treatment costs increases birth rates.

For comparison, in France, elective egg freezing is fully covered by the country’s public health insurance.

Egg freezing is framed mostly as a technology that gives women “more reproductive choice,” said Natalie Lampert, the author of “The Big Freeze.”

“But that choice is still disproportionately available to people who can afford it or have good fertility benefits,” Lampert said.

Ocasio-Cortez did not respond to a request for comment.

A single egg freezing cycle, including hormone stimulation and the retrieval procedure, costs around $16,000, on average, according to FertilityIQ, a fertility data and education platform. The price varies significantly by location.

But many women need to undergo multiple cycles to get their desired egg count, said Dr. Marcelle Cedars, a professor and director at the University of California, San Francisco’s Center for Reproductive Health. Ideally, women under the age of 35 will freeze at least 20 eggs, Cedars said. Women over that age typically need a higher number.

The total egg-freezing costs for a 38-year-old woman in New York City who needs three cycles can reach $47,000, according to a FertilityIQ analysis.

It’s not just age that impacts the required cycle number. The patient’s overall health and the facility’s techniques are also factors.

“For people without insurance coverage, that combination of upfront cost and uncertainty can make the decision especially difficult,” said Danielle Melfi, CEO of RESOLVE: The National Infertility and Family Building Association.

“My insurance does not cover one penny of this,” Ocasio-Cortez said on social media about her egg freezing procedure.

Indeed, health insurance coverage for elective egg freezing is still the exception rather than the rule, Melfi said. Though she added: “Where we are seeing meaningful growth is through workplace benefits.”

Around 22% of employers with 500 or more workers provided coverage for elective egg freezing in 2025, up from 5% in 2015, according to Mercer. Among companies with over 5,000 employees, 40% offered the benefit last year, compared with only 8% a decade earlier.

Even among companies that cover egg freezing, a maximum lifetime benefit of around $20,000 is common, Mercer found.

Those who aren’t eligible for a workplace health insurance plan will usually have to pay for the entire procedure out of pocket, Melfi said.

The Affordable Care Act marketplace “does not establish a federal requirement for plans to cover IVF or elective egg freezing,” she said. And no states cover elective egg freezing for those on Medicaid.

There’s one exception: More than a dozen states mandate fertility preservation coverage before certain medical treatments, such as chemotherapy, that can impact the body’s ability to make sperm or eggs, Melfi said. But even this protection doesn’t reach all plans, she added.

“And of course, if they decide to use the eggs, they’ll have to pay the costs to thaw and then implant the eggs,” said McClanahan, a member of the CNBC Financial Advisor Council. “That, of course, costs a lot.”

As a result, most couples try to conceive naturally before turning to frozen eggs or embryos, she said. Health insurance coverage for IVF is more common when it’s due to infertility than personal choice.

Those who decide to freeze their eggs also have to consider taxes, McClanahan said.

If your company pays for elective egg freezing, that benefit amount “would count as earned income and be taxed,” she said. In such cases, your employer will likely add the benefit to your W-2.

That could generate a significant tax bill. For a $20,000 benefit amount, a single woman earning $80,000 a year would owe an extra $4,400 to the IRS, according to an example provided by McClanahan.

If you freeze your eggs due to a medical condition, the fees may qualify for the medical expense deduction, McClanahan said.

“If a woman is diagnosed with cancer and the treatment is going to affect her future fertility, it would be a deductible expense,” she said. “Freezing eggs because you want to delay childbirth is considered a personal choice and isn’t deductible.”