For many people struggling with infertility, treatments like in vitro fertilization (IVF) can offer a path to parenthood—but the cost is daunting. A single IVF cycle can run more than $15,000, and because multiple cycles are often needed, the bills add up quickly. This leads to one of the most common questions: Will health insurance cover IVF or other fertility care? The answer is complicated and depends on state laws, your insurance plan, and whether your employer is subject to certain regulations.
Fertility Coverage Basics
Unlike maternity care, which is protected under the Affordable Care Act, fertility services are not considered essential health benefits at the federal level. This means coverage decisions are left to states and employers.
Currently, 21 states have laws that require some level of fertility coverage. What’s included varies greatly—some states only require insurers to cover diagnostic testing, while others mandate partial or full IVF benefits. Employers that self-fund their health plans (which many large companies do) may not be bound by state fertility mandates at all.
State Fertility Mandates
Where you live plays a huge role in whether fertility treatment is covered. For example:
- Massachusetts and Illinois generally require IVF coverage in most employer plans.
- New York and New Jersey mandate IVF coverage for larger employers.
- California and Texas require insurers to make fertility coverage available, but they don’t force them to include it automatically.
Because laws differ so widely, checking with your state’s insurance department or reviewing your plan documents is essential.
What Treatments Might Be Covered?
Depending on your state and insurer, your plan may include some or all of the following:
- Infertility testing and diagnostic procedures
- Medications that stimulate ovulation
- Intrauterine insemination (IUI)
- IVF, which includes egg retrieval, fertilization, and embryo transfer
- Fertility preservation, such as freezing eggs or sperm before cancer treatment
What’s usually not covered? Services like donor eggs, donor sperm, surrogacy arrangements, elective egg freezing, and experimental procedures are commonly excluded.
Common Questions About Fertility Coverage
Does Medicaid cover IVF?
In most cases, no. Medicaid does not cover IVF, although some states may offer limited infertility-related services.
Does the Affordable Care Act require IVF coverage?
No. The ACA does not classify IVF as an essential benefit.
Is egg freezing included in insurance coverage?
Sometimes. A few states, such as Illinois, require insurance to cover fertility preservation for patients undergoing medical treatments that could affect their ability to conceive in the future.
Steps to Check Your Coverage
If you’re considering fertility treatment, here are some ways to understand what your plan may include:
- Research your state’s fertility laws to see if any mandates apply.
- Review your insurance plan’s Summary of Benefits and Coverage (SBC) and look for fertility-specific sections.
- Ask your employer or insurance provider whether your plan is self-funded or fully insured, as that can change what rules apply.
- Prepare for out-of-pocket costs even if you have coverage, since medications, lab work, or other services may not be fully included.
Bottom Line
Whether or not insurance will cover IVF or other fertility treatments depends largely on where you live and what type of health plan you have. While some states have protections in place, many do not, and federal law does not guarantee fertility coverage. If you’re planning treatment, take time to carefully review your benefits and state laws so you know what financial responsibilities to expect.
