In 2021 the IRS issued a Private Letter Ruling 202114001 which specified which infertility services were tax deductible. Generally, the IRS found that treatment for a medical condition was a deductible expense while expenses for a surrogate mother are not. IRS Publication 502 has guidance on the tax deductibility of various medical procedures and regarding fertility services. In California, only Anthem Blue Cross includes IVF in it’s infertility rider. The cost to add the rider is very high, however, and may cost more than the benefits one may receive. Anthem charges $90 per subscriber per month. A subscriber includes every employee, spouse and child enrolled in the medical insurance plan.