Fertility Coverage Mandates by State

D.C. Law 25-49 requires state-regulated health insurance plans to cover fertility treatments including the diagnosis and treatment of infertility, in vitro fertilization (IVF) covering at least three complete egg retrievals, unlimited embryo transfers, and fertility preservation. The mandate applies to individual and small group plans on DC Health Link, as well as large employer-sponsored plans.

AB 568 and SB 566, introduced in 2025, would require health plans to cover infertility diagnosis and treatment including IVF, and fertility preservation prior to any medical treatment that could harm fertility.

HMOs are required to cover infertility services as part of basic health care services.

H 55 and H 302, introduced in 2025–2026, would require health insurers and Vermont Medicaid to cover a wide range of fertility services including IVF. Bills are pending legislative action.

S 27 (2025–2026 session) would require all HMOs and health insurance plans to offer coverage for assistive reproductive technologies including IVF, egg retrieval, ICSI, and cryopreservation. In committee.

S 40 and S 3652, both titled the In Vitro Fertilization Protection Act, were introduced in the 2025–2026 session to establish IVF access protections in South Carolina. Both pending in committee.

Rhode Island requires coverage for infertility diagnosis and treatment, including IVF, for HMO and insurance plans with pregnancy benefits. Eligible for women ages 25–42.

Oklahoma enacted legislation in 2024 (effective 2025) requiring coverage of fertility preservation services for patients whose medical treatment may cause infertility.

Ohio requires HMOs offering basic health services to cover medically necessary infertility treatment. IVF, GIFT, and ZIFT are not required. Coverage is primarily diagnostic and surgical.

Large group plans (100+ employees) must cover up to 3 IVF cycles. Medicaid covers 3 cycles of ovulation-inducing medications. Enacted 2020; fertility preservation for medical reasons also required.

S 2619, introduced Jan 2025, would remove the 3-cycle cap on IVF and expand coverage requirements for large group plans. Pending in the Senate Insurance Committee.

Requires group plans with 50+ employees and pregnancy benefits to cover up to 4 IVF cycles with ICSI, GIFT, or ZIFT, including donor eggs and gestational carriers. Applies to members under 46.

State law requires large group health plans to cover the diagnosis of infertility and medically necessary fertility treatment, including IVF. Cost-sharing must match other medical services.

One of the strongest mandates nationally. Requires coverage for IVF and the full range of ART services without narrow restrictions. No state lifetime cap, no cycle limit. Includes fertility preservation.

Mandates coverage for infertility diagnosis, treatment, IVF, and fertility preservation. Covers 3 IVF attempts per live birth with a $100,000 lifetime cap. 2024 update extended coverage to same-sex couples.

Maine's infertility law (eff. Jan 1 2024) requires coverage for IVF, donor tissue, and fertility preservation for medically necessary cases. Applies to fully insured plans; self-insured employers are exempt.

One of the strongest mandates nationally. Group plans with 25+ employees must cover IVF, GIFT, and ZIFT, including donor eggs and sperm. Extends to same-sex couples and single women 35+.

SB 1259 would require health plans to cover fertility preservation services before treatments expected to harm fertility. Bill is pending in the Illinois legislature as of mid-2026.

State law requires coverage for 1 IVF cycle for patients with at least a 5-year infertility history or qualifying conditions such as endometriosis or blocked fallopian tubes. IUI must be attempted first.

HB 1864 (2026) Passed July 10, 2026. Requires insurance coverage for fertility preservation services for individuals whose medically necessary treatment may cause iatrogenic infertility.

2025 law (eff. Jan 1 2026) requires state group health plans to cover fertility preservation for patients with iatrogenic infertility caused by cancer treatment. Storage covered up to 3 years.

Delaware mandates coverage for iatrogenic infertility including IVF with donor eggs, sperm, or embryos, and allows use of a gestational carrier. Covers 6 egg retrievals with unlimited embryo transfers.

State law requires coverage for infertility treatment including up to 2 IVF cycles, GIFT, and ZIFT, up to 4 ovulation induction cycles, and 3 IUI cycles. Applies to plans in effect 1+ year.

HB 5374, enacted May 28 2026, expanded Connecticut's infertility definition and broadened IVF coverage requirements for fully insured plans.

State law requires large group plans (100+ employees) to cover infertility diagnosis, treatment, and fertility preservation, including 3 completed oocyte retrievals and unlimited embryo transfers.

Plans with maternity benefits must cover IVF and cryopreservation, with a $15,000 lifetime cap. HMOs and self-insured employers are exempt. IUI must be attempted before IVF is covered.

AZ SB 1347 (2026) passed the Senate and would require insurers to cover fertility preservation services for reproductive-age members diagnosed with cancer whose treatment may cause iatrogenic infertility.

SF 130 would require health plans to cover various fertility services including IVF. The bill has been introduced and is pending legislative action in Iowa.

SB 729 (2024) requires large group plans (100+ employees) to cover infertility diagnosis and treatment, including up to 3 IVF egg retrievals with unlimited embryo transfers. Effective Jan 1 2026.

CA submitted an application to CMS in May 2025 to add IVF to its Essential Health Benefits benchmark plan for individual/small group coverage. If approved, takes effect Jan 1 2027.

HB 94 signed May 1 2025 (eff. Jan 1 2026) mandates coverage for medically necessary fertility preservation for patients with cancer, sickle cell disease, lupus, and similar conditions. Includes 1 year of storage.

Insurers must offer plans that include infertility benefits, but IVF is explicitly excluded by statute. Coverage includes diagnostic testing and certain treatments; IVF costs are out-of-pocket.

AB 428 (2025, eff. Jan 1 2026): Insurers must cover medically necessary fertility preservation services for breast or ovarian cancer patients whose treatment may cause infertility.

SB 516 (2023), effective 2024: insurers must cover fertility preservation services when a member is diagnosed with cancer and treatment could result in infertility. Applies to fully insured plans.

HF 1758, proposed in 2026, requires large group plans (25+ employees) offering maternity coverage to also cover infertility diagnosis and treatment, including IVF.

HF 1758 expansion bills introduced in the 2026 session would extend the mandate to individual and small group plans, not just large group. If passed, coverage would apply retroactively from Jan 1 2026.

SB 272 (Sen. Cappelletti) would mandate nearly all plans with pregnancy benefits to cover infertility diagnosis and treatment including IVF, artificial insemination, and egg/sperm/embryo preservation, without discrimination by gender or sexual orientation.

Rep. La'Tasha Mayes introduced a House companion to SB 272 in the 2025–2026 session. The bill would apply the same comprehensive infertility coverage requirements to all plans offering pregnancy-related benefits.

Insurers that offer group health plans must also offer a plan that includes IVF coverage, but employers are not required to purchase it. Eligibility criteria are among the strictest nationally.

Coverage mandate to cover IVF for cancer-related iatrogenic infertility

Utah Public Employee Health Plan provides $4,000 toward a qualified reproductive technology cycle if maternity benefit is included. A 2024 state plan amendment added Medicaid IVF coverage for carriers of certain genetic diseases.

Utah Public Employee Health Plan provides coverage for qualified reproductive technology.