Insurance Reforms Expand Fertility Coverage Across US States

Insurance Coverage by State

Updated on June 17, 2024

Health Insurance Landscape and Fertility Benefits

In an effort to expand access to fertility treatments for millions of individuals struggling with infertility, several states have implemented specific insurance requirements that mandate coverage for in vitro fertilization IVF procedures. These laws m to alleviate financial barriers by ensuring that employees have a broader range of reproductive health options through their employer-provided insurance plans.

Overview and States Affected

As depicted on the accompanying map:

• California serves as a beacon for comprehensive coverage, requiring state-regulated health insurers to cover up to three cycles of IVF, with annual and lifetime maximums. This exemplifies a robust policy designed to support fertility treatments for qualifying individuals.

• Colorado, among other states like New York, enforces its own insurance requirements that m to provide broader access to fertility services, though specifics may vary in terms of coverage limits and eligibility criteria.

Questions for Employers

For employees residing or working in states with existing infertility laws, the following inquiries are crucial:

1. Plan Type: Is your employer’s health plan fully-insured or self-insured? The former must adhere to state insurance laws, whereas self-funded plans might not be bound by such regulations.

2. Employee Count: Does your employer have more than a specified number of employees e.g., 25, 50? Coverage requirements may differ based on company size under certn states' laws.

3. Plan Market Type: Is the insurance plan written for individualsmall group, or large group** markets? Some laws provide fertility coverage only in specific policy categories.

Exploring Further

For comprehensive detls about each state's insurance law and its implications, click on the respective hyperlinked state name below:

1. California Insurance Law

2. Colorado Insurance Law

3. New York Insurance Law

To gn insights into employer-provided insurance coverage across various states or to advocate for new or expanded insurance legislation in your state, please reach out to our advocacy team by emling: [email protected].

If you are an employee seeking coverage directly with your employer and need guidance on how your specific plan aligns with state law, contact us at [email protected] for personalized support.

As of June 17th, 2024, there exist numerous states equipped with laws that enforce fertility insurance requirements, ming to alleviate financial burdens associated with reproductive health treatments. and access to these benefits, it is essential for individuals to understand the nuances of their employer’s plan and state-specific regulations.

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