Navigating infertility is a layered experience that stretches you and a partner pretty thin. On the same day that you could be processing unmet grief, you may also have to Google, “Does my state mandate my insurance to cover more than one round of IVF?”
Across the United States, for instance, for 1 in 5 women who are unable to get pregnant after a year of trying, the reality of infertility is ever-present — emotionally, physically, and financially.
Forbes found that the cost of a single IVF cycle can range from $15,000 to $30,000 for those who are navigating infertility and choose to try IVF. In 20 states, state laws have helped codify some level of financial support for those people who struggle with infertility.
What is state-mandated fertility coverage?
States with mandated fertility coverage have passed laws that hold private insurance responsible for either covering or offering some variation of fertility testing, diagnosis, or treatment. The hard part about state-mandated fertility coverage is that each of the 20 states can define “fertility coverage” however they deem fit.
Each state may vary in the following:
- How long you have struggled with infertility before qualifying for treatment
- What kind of treatment is covered
- How many rounds of IVF may be covered
- Whether same-sex couples are covered
- Whether unmarried individuals are covered
The distinction between a “mandate to cover” and a “mandate to offer” is also important to note.
According to RESOLVE: The National Infertility Association, a mandate to cover requires health insurance companies to include infertility treatment in every policy, while a mandate to offer only requires health insurance policies to offer a policy that does include fertility treatments, but does not require employers to subsidize those.
Which states have some kind of state-mandated fertility coverage?
The states that mandate private insurers to cover some form of fertility coverage are Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas, Utah, and Virginia.
“As of June 2022, 20 states have passed fertility insurance coverage laws, 14 of those laws include IVF coverage, and 12 states have fertility preservation laws for iatrogenic (medically-induced) infertility,” notes Resolve: The National Infertility Association.
The list of states that offer state-mandated fertility has been growing steadily since the 1980s with New York being one of the latest states to update its policy even further. Now in the state of New York, patients are eligible for up to 3 rounds of IVF and can also tap medically necessary fertility preservation should they encounter infertility caused by medical treatment.
How can you advocate for yourself within your state?
Turning to your employer or your private health insurance policy are a good place to start when navigating state-mandated fertility benefits.
RESOLVE has a database breakdown of each eligible state’s laws, qualifications, and most recent updates.
Speaking to your doctor and ensuring that each visit is properly documented can also make it easier whenever you petition for fertility treatment in states that require you to have been trying for a specific amount of time.
While it's rare to find a policy that completely covers fertility treatments, understanding the ones that do can help take some of the burden off already heavy shoulders.
Vivian Nunez is a writer, content creator, and host of Happy To Be Here podcast. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.