State Mandates for Infertility Coverage

State Mandates for Fertility Coverage-gavel-and-books

In the U.S., there are 15 State Mandates for Infertility Coverage. In the remaining states, insurance companies and employers are under no obligation by federal or state laws, to either “offer” or “provide” any type of benefits for fertility related treatment.

Of the 15 states with mandates, only 5 specifically require IVF coverage. In fact, 3 states actually exclude IVF coverage (California, Louisiana, and New York). Equally of interest, 4 states exclude basic fertility treatment coverage, and ONLY pay for IVF (Arkansas, Hawaii, Maryland, and Texas). However, all 4 of these states have very strict limitations with regard to covering IVF procedures. For example, Arkansas has a $15K lifetime limitation, and Hawaii only covers a maximum of 1 (one) IVF cycle. Maryland’s mandate is likely the broadest, by covering up to three IVF cycle attempts per live birth, with a $100K lifetime monetary benefit. Texas (like California), is only mandated to “offer”; as such, carriers are not required to provide plan coverage, and employers are not required to elect this coverage for their employees (even if offered to them).

The below chart outlines the state mandates for infertility coverage and will help clarify this information:

state mandates for infertility coverage

US Map – Coded with State Mandate Information:

Slide1 State Mandates for Infertility Coverage-Slide2

States without mandates or related laws are as follows:

Alabama, Alaska, Arizona, Colorado, Delaware, District of Columbia, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming.

Fertility Clinics in the U.S. – Find an ART clinic by REGION and STATE:

EAST COAST U.S. States

CENTRAL U.S. States

WESTERN U.S. States

ADDITIONAL information – i.e. definitions of “fertility” and “infertility”, state legal codes, etc.