State advocacy

Fact Sheet: Alabama Protecting Fertility Healthcare 

The Alabama Legislature

Alabama Department of Insurance

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Alaska Protecting Fertility Healthcare

The Alaska State Legislature

The Alaska Division of Insurance

Mandate: As of the 31st Legislature (2019-2020), it specifically states that the department will not cover infertility services (7 AAC 105.110. noncovered services)

Fact Sheet: Arizona Protecting Fertility Healthcare

Arizona State Legislature

Arizona Department of Insurance

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Arkansas Protecting Fertility Healthcare

Arkansas State Legislature

Arkansas Insurance Department

Mandate

Year: 1987

Source: Arkansas Code Annotated Section 23-85-137, 23-86-118, and Section 23-79-510

Coverage:

All accident and health insurance companies shall include in vitro fertilization as a covered expense

The Arkansas comprehensive Health Insurance Pool shall not cover any expense or charge for IVF, artificial insemination, or any other artificial means used to cause pregnancy.

Patient Requirements: None listed

Exemptions: None listed

Fact Sheet: California Protecting Fertility Healthcare

California Legislative Information

California Department of Insurance

Mandate

Year: 1990, 2019

Source: California Insurance Code Section 10119.6, California Health and Safety Code Section 1374.551
Coverage:

Every insurer that covers hospital, medical, or surgical expenses on a group basis must offer infertility treatment coverage except IVF

Does not cover infertility treatment in the case of Iatrogenic Infertility

Patient Requirements: Inability to conceive or carry a pregnancy to live birth after one year of regular sexual relations

Exemptions: Religious organizations

Fact Sheet: Colorado Protecting Fertility Healthcare

Colorado General Assembly

Colorado Department of Regulatory Agencies

Mandate

Year: 2020

Source: Colorado Building Families Act

Coverage:

All individual and group health plans must provide coverage for the diagnosis and treatment for infertility and standard fertility preservation services

Includes three completed oocyte retrievals with unlimited embryo transfers, using single embryo transfer when recommended and medically appropriate

Patient Requirements:

For women under age 35: Patient is unable to establish a clinical pregnancy after twelve months of regular, unprotected sexual intercourse or therapeutic donor insemination

For women age 35 or older: Patient is unable to establish a clinical pregnancy after six months of regular, unprotected sexual intercourse or therapeutic donor insemination

Conception resulting in miscarriage does not restart the twelve- or six-month period

Exemptions: Religious organizations

Fact Sheet: Connecticut Protecting Fertility Healthcare

Connecticut General Assembly

Connecticut Insurance Department

Mandate

Year: 2017

Source: Connecticut General Statutes §38a-536 and §38a-509

Coverage:

Infertility diagnosis and treatment including but not limited to: ovulation induction, intrauterine insemination, in-vitro fertilization, uterine embryo lavage, embryo transfer, gamete intra-fallopian transfer, zygote intra-fallopian transfer, and low tubal ovum transfer.

Limit coverage to an individual until the individual reaches age 40.

Lifetime maximums: 4 cycles of ovulation induction, 3 cycles of intrauterine insemination, 2 cycles (with not more than 2 embryo implantations per cycle) of IVF, GIFT, ZIFT, or low tubal ovum transfer (provided each such fertilization or transfer shall be credited toward such maximum as one cycle).

Patient Requirements: Patient is unable to conceive or produce conception or sustain a successful pregnancy during a one-year period or such treatment is medically necessary.

Exemptions: Religious organizations

Fact Sheet: Delaware Protecting Fertility Healthcare

Delaware General Assembly

Delaware Department of Insurance

Mandate

Year: 2018

Source: Delaware Insurance Code § 3342 and § 3556

Coverage:

All individual health insurance policies, contracts, or certificates that are delivered, issued for delivery, renewed, extended, or modified in Delaware that provide for medical or hospital expenses must include coverage for fertility care services

In vitro fertilization services for individuals who suffer from a disease or condition that results in the inability to procreate or carry a pregnancy to live birth

Standard fertility preservation services for individuals who must undergo medically necessary treatment that may cause iatrogenic infertility

Intrauterine insemination; assisted hatching; cryopreservation and thawing of eggs, sperm, and embryos; cryopreservation of ovarian tissue; cryopreservation of testicular tissue; embryo biopsy; consultation and diagnostic testing; fresh and frozen embryo transfers; six completed egg retrievals per lifetime, with unlimited embryo transfers in accordance with ASRM guidelines; IVF, including IVF using donor eggs, sperm, or embryos, and IVF where the embryo is transferred to a gestational carrier or surrogate; ICSI; medications; ovulation induction; storage of oocytes, sperm, embryos, and tissue; surgery, including microsurgical sperm aspiration; medical and laboratory services that reduce excess embryo creation through egg cryopreservation and thawing in accordance with an individual’s religious or ethical beliefs.

These benefits must be provided to covered individuals, including covered spouses and covered non-spouse dependents to the same extent as other pregnancy-related benefits

Patient Requirements: 

Patient must be diagnosed with infertility or be at risk for iatrogenic infertility as verified by a board-certified or board-eligible obstetrician-gynecologist, subspecialist in reproductive endocrinology, oncologist, urologist, or andrologist

After diagnosis of infertility, the patient has not been able to obtain a successful pregnancy with less costly infertility treatments covered by the policy, contract, or certificate except as follows:

- No more than 3 treatment cycles of ovulation induction or intrauterine inseminations may be required before IVF services are covered

- If IVF is medically necessary, no cycles of ovulation induction or intrauterine inseminations may be required before IVF services are covered

- IVF procedure must be performed at a practice that conforms to ASRM and ACOG guidelines

- For IVF services, retrievals are completed before the individual is 45 years old and transfers are completed before the  individual is 50 years old

Exemptions: None listed

Council of the District of Columbia

District of Columbia Department of Insurance, Securities and Banking

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Florida Protecting Fertility Healthcare

Florida Legislature

Florida Department of Financial Services

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Georgia Protecting Fertility Healthcare

Georgia General Assembly

Georgia Office of Insurance and Safety Fire Commissioner

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Hawaii Protecting Fertility Healthcare

Hawaii State Legislature

Hawaii Department of Commerce and Consumer Affairs

Mandate

Year: 2013

Source: Hawaii Revised Statute §432:1-604 and §431:10A-116.5
Coverage: Individual and group health insurance plans that provide pregnancy-related benefits must also include a one-time-only benefit for all expenses arising from IVF procedures

Patient Requirements: Patient’s oocytes must be fertilized with the patient’s spouse’s sperm; patient and patient’s spouse have a history of infertility of at least five years duration, or patient’s infertility is associated with one or more of the following medical conditions: Endometriosis; exposure in utero to DES; blockage of, or surgical removal of one or both fallopian tubes; abnormal male factors contributing to the infertility

The patient has been unable to attain a successful pregnancy through other covered infertility treatments

Exemptions: None listed

Fact Sheet: Idaho Protecting Fertility Healthcare

Idaho Legislature

Idaho Department of Insurance

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Illinois Protecting Fertility Healthcare

Illinois General Assembly

Illinois Department of Insurance

Mandate

Year: 1997, 2019

Source: Illinois Compiled Statutes ch. 215 section 5/356m and section 5/356z.32

Coverage: Coverage for the diagnosis and treatment of infertility will be provided without discrimination. A health insurance policy may not limit or exclude the coverage of fertility medications or services in a way different from the limitations or exclusions imposed on non-fertility related medications or services. 

Fact Sheet: Indiana Protecting Fertility Healthcare

Indiana General Assembly

Indiana Department of Insurance

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Iowa Protecting Fertility Healthcare

Iowa Legislature

Iowa Insurance Division

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Kansas Protecting Fertility Healthcare

Kansas Legislature

Kansas Insurance Department

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Kentucky Protecting Fertility Healthcare

Kentucky Legislature

Kentucky Department of Insurance

Per the 2023 Kentucky Revised Statutes, health insurance plans must provide coverage fro oocyte and sperm preservation when medically necessary treatment may cause iatrogenic infertility. Coverage is required to include evaluation, laboratory work, medication and treatment related to oocyte and sperm cryopreservation procedures for up to one year. 

Fact Sheet: Louisiana Protecting Fertility Healthcare 

Louisiana Legislature

Louisiana Department of Insurance

Mandate

Year: 2001/2008

Source: Louisiana Revised Statute Section 22:1036

Coverage:

Health insurance policies cannot exclude coverage for diagnosis and treatment of a correctable medical condition otherwise covered by the policy solely because the condition results in infertility

This law does not require coverage of fertility drugs; IVF or other assisted reproductive techniques; reversal of tubal ligation, vasectomy, or any other method of sterilization

Patient Requirements: None listed.

Exemptions: None listed

Fact Sheet: Maine Protecting Fertility Healthcare

Maine Legislature

Maine Bureau of Insurance

Effective January of 2024, health insurance plans offered in Maine must provide coverage for fertility diagnostic care, fertility preservation services, and fertility treatment to fertility patients. Experimental fertility procedures and non-medical costs related to donors and surrogates are not covered. 

Fact Sheet: Maryland Protecting Fertility Healthcare

Maryland General Assembly

Maryland Insurance Administration

Mandate

Year: 2000, 2018, 2020

Source: Maryland Insurance Code Section 15-810

Coverage:

Entities subject to Section 15-810 that provide pregnancy-related benefits may not exclude benefits for all outpatient expenses arising from in vitro fertilization procedures

Cover 3 IVF attempts per live birth, with a maximum lifetime benefit of $100,000

Patient Requirements:

For a married patient whose spouse is of the opposite sex, the patient’s oocytes must be fertilized with the spouse’s sperm unless:

- The spouse is unable to produce and deliver functional sperm and that this inability does not result from a vasectomy or other method of voluntary sterilization

Patient has been unable to become pregnant after 1 year through either intercourse or 3 attempts of artificial insemination, or if the patient or patient’s spouse has the following medical conditions:

- Endometriosis; exposure in utero to DES; blockage of, or surgical removal of one or both fallopian tubes; or abnormal male factors, including oligospermia, that contribute to the infertility

Patient has been unable to attain a successful pregnancy through less costly covered treatments

Exemptions: Religious organizations

Fact Sheet: Massachusetts Protecting Fertility Healthcare

Massachusetts Legislature

Massachusetts Department of Insurance

Mandate

Year: 1987, 2010

Source: Massachusetts General Laws ch. 175 Section 47H; ch. 176A Section 8K; ch. 176B Section 4J; ch. 176G Section 4; Code of Massachusetts Regulations ch. 211 Section 37

Coverage: Any blanket or general policy of insurance that provides hospital or surgical expense insurance which includes pregnancy-related benefits shall provide coverage for medically necessary expenses of diagnosis and treatment of infertility. Insurers shall provide coverage for all non-experimental infertility procedures including but not limited to:

AI; IUI; IVF; ET; GIFT; sperm, egg, and/or inseminated egg procurement and processing, and baking of sperm or inseminated eggs, to the extent such costs are not covered by the donor’s insurer, if any; ICSI for the treatment of male factor infertility; ZIFT; assisted hatching; cryopreservation of eggs

Insurers shall not impose exclusions, limitations, or other restrictions on coverage for infertility-related drugs that are different from those imposed on any other prescription drugs

Patient Requirements:

Patient must be unable to conceive or produce conception for 1 year if the woman is age 35 or younger, or for 6 months if the woman is over age 35

If a person conceives but is unable to carry that pregnancy to live birth, then that period of time she attempted to conceive prior to achieving that pregnancy shall be included in the 1 year or 6-month time frame

Exemptions:

Medicaid

Experimental procedures

Surrogacy

Reversal of voluntary sterilization

Fact Sheet: Michigan Protecting Fertility Healthcare

Michigan Legislature

Michigan Department of Insurance and Financial Services

Currently, there are no laws requiring infertility treatment coverage.

Fact Sheet: Minnesota Protecting Fertility Healthcare

Minnesota Legislature

Minnesota Department of Commerce

Minnesota Statute Section 256B.0625 specifically states that medical assistance covers drugs, except for fertility drugs when specifically used to enhance fertility.