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Does Insurance Cover IVF: What you Need to Know

By CNY Fertility Published on
Does Insurance Cover IVF: What you Need to Know

The cost of in vitro fertilization (IVF) can be a significant concern for many people pursuing fertility treatments. A common question is whether insurance will help cover the expenses. The answer depends on a variety of factors, including where you live, the type of insurance you have, and your specific policy.  

Some plans provide substantial coverage, while others offer little to no assistance. Understanding the details of your insurance plan is key to navigating the financial aspects of IVF. 

In this article, we’ll explore how insurance coverage for IVF works, outline the specifics of state mandates and offer tips for maximizing your benefits. 

What Does Insurance Cover?  

Approximately 25% of Americans have insurance that includes coverage for IVF treatments specifically.  

However, many more have plans that cover certain aspects of the IVF process, such as diagnostic testing, monitoring, or other related services, which can help reduce overall out-of-pocket costs.  

While some insurance policies exclude all fertility-related expenses, others may provide coverage for related treatments, part of IVF, or the full spectrum of care, including:   

  • Full or partial coverage for the entire IVF process including diagnostic testing, medications, egg retrieval, laboratory fertilization, and embryo transfer. 

3 Factors Influencing Insurance Coverage for IVF 

The three main factors you’ll need to account for when answering the question “Does insurance cover IVF?” are:  

  • Benefits provided by your employer: Some employers offer fertility benefits as part of their health plans. Larger companies or those in progressive industries may provide more comprehensive coverage. 
  • State mandates: Coverage availability often depends on where you live. Certain states require insurance plans to include fertility treatments, though the specifics vary widely. 
  • Your policy type: Whether you are insured under a private insurance plan, standard employer insurance plan, or self-funded employer plan, and the size of your employer company are all factors that will dramatically impact coverage for fertility treatments, even in states with mandates.  
  • Private insurance plan: A health insurance policy purchased individually or through an employer, managed by an insurance company.   
  • Standard employer insurance plan: A fully insured health plan where the insurance company assumes the financial risk and handles claims under state regulation.   
  • Self-funded employer plan: A health plan where the employer directly funds employee healthcare costs and assumes financial risk, governed by federal law.   

To help you determine your coverage, click here to fill out our comprehensive questionnaire.  

Additionally, we recommend reading your health insurance plan carefully, and calling your insurance provider or HR department. 

When you contact your insurance provider or HR department, be sure to ask about:  

  • Coverage for IVF and related treatments. 
  • Out-of-pocket costs, such as deductibles, co-pays, and maximum limits. 
  • Requirements, such as prior authorization or proof of infertility diagnosis. 

Keep in mind that even if IVF is covered by your health insurance plan, reimbursement may be impacted by your deductible. For some plans this can mean having to spend over $10,000 out of pocket before your benefits are dispersed. 

That said, let’s explore the two primary ways that insurance will cover part or all of your IVF treatment. 

  • State mandates 
  • Employee insurance packages 

IVF Insurance Coverage by State 

A number of states have laws that mandate some form of fertility coverage. However, of the 17 states that have laws pertaining to infertility coverage, only 9 of those states have laws that mandate IVF coverage in some form.  

Many of the laws mandating IVF coverage are written in a way that excludes a large percentage of people from coverage.  

For instance, some laws exclude plans offered by employers with less than 100 employees; according to the United States Small Business Administration, this alone leaves out approximately half the workforce. 

Here’s a brief overview of the laws in states where IVF coverage is mandated in some form.  

Arkansas 

Arkansas has a $15,000 lifetime max for fertility coverage. This covers IVF, but has the following stipulations. 

  • The individual or couple must have at least a 2-year history of infertility, or the infertility must be caused by a diagnosis of: endometriosis, blocked or surgically removed fallopian tubes (not from an elective tubal ligation), DES exposure, abnormal male factors contributing to the infertility. 
  • The woman’s eggs must be fertilized by their spouse’s sperm. 
  • One must have been unable to obtain a successful pregnancy through less costly treatments. This means that the majority of that $15,000 will likely be used before IVF on less expensive, but far less effective treatments, like IUI.  

California 

A California law taking effect in July 2025 requires coverage for IVF under large-group health insurance plans. This includes up to three completed egg retrievals and unlimited embryo transfers. Group plans for companies with less than 100 employees are not mandated to cover IVF.  

The law broadens the definition of infertility to encompass individuals and couples unable to reproduce without medical intervention, including same-sex couples and single individuals.  

Colorado 

Colorado mandates that all large group (100 or more employees) health benefit plans issued or renewed on or after January 1, 2023, provide coverage for infertility diagnosis, treatment, and standard fertility preservation services, including up to three completed oocyte retrievals and unlimited embryo transfers.  

These plans must follow American Society for Reproductive Medicine (ASRM) guidelines and cannot impose higher costs, exclusions, or restrictions on fertility treatments compared to other medical services covered under the plan.  

Exceptions include individual and small group policies, religious organizations, and employers who self-insure, all of which are exempt from mandated IVF coverage.  

Connecticut 

The Connecticut law is one of the most inclusive and comprehensive. It mandates coverage of both Individual and group health insurance policies and includes coverage for services such as IUI and IVF.  

Some restrictions include: 

  • Under the age of 40 
  • Lifetime maximum of two IVF cycles 

Delaware 

Delaware’s insurance law includes up to 6 IVF retrievals with an unlimited number of transfers from those retrievals and also covers donor egg cycles. 

Some restrictions include: 

  • Retrievals must be completed before the age of 45, and transfers before the age of 50. 
  • Employers who self-insure, or who have fewer than 50 employees, are exempt from state requirements. 

Hawaii 

Hawaii has laws that mandate coverage of one cycle of IVF. However, this mandate is subject to many rules and stipulations. 

  • Coverage is only required if the patient or spouse has at least a 5-year history of infertility or if the infertility is associated with one of the following conditions: endometriosis, DES exposure, blocked or surgically removed fallopian tubes, abnormal male factors contributing to infertility. 
  • The eggs must be fertilized with the spouse’s sperm. 
  • Coverage is only given if other treatments failed. 
  • Self-insured employers are exempt from providing coverage. 

Illinois 

Each person is covered for four egg retrievals. However, if a live birth occurs in one of those cycles, two additional egg retrievals will be covered with a true lifetime maximum of six retrievals. 

Exclusions include:  

  • Employers with fewer than 25 employees and religious organizations are exempt from this mandate. Additionally, self-insured employers are not required to provide this coverage. 

Maine 

Maine’s fertility insurance mandate requires coverage for fertility diagnostic care, treatments including IVF, and medically necessary fertility preservation services, such as egg or sperm freezing before procedures like chemotherapy. 

Massachusetts 

Each person is covered for four egg retrievals. However, if a live birth occurs in one of those cycles, two additional egg retrievals will be covered with a true lifetime maximum of six retrievals. 

Some key details include: 

Infertility is defined as the inability to conceive after one year of unprotected intercourse for women aged 35 or younger, or after six months for women over 35. 

Self-insured employers and certain religious organizations are exempt from this mandate. 

Maryland 

The state of Maryland requires individual and group insurance policies that provide pregnancy-related benefits to cover the cost of IVF with the following limitations. 

  • Coverage may be limited to three IVF attempts per live birth and have a lifetime maximum of $100,000. 
  • Must attempt to get pregnant with less expensive treatment options first.  
  • Must have at least a two-year history of infertility or have infertility caused by: endometriosis, blocked or surgically removed fallopian tubes (non-voluntary), abnormal male factors, or fetal exposure to diethylstilbestrol (DES). 
  • The male spouse’s sperm must be used to fertilize the woman’s eggs unless he is unable to produce or deliver functional sperm (and this inability is not related to voluntary sterilization). 
  • For same-sex couples, there must be six previously failed attempts of artificial insemination over the course of two years or have infertility related to one of the conditions mentioned above. 
  • Religious organizations may be exempt. 

New Hampshire 

Provides coverage for medically necessary fertility treatments. Coverage does not apply to individual health plans, plans available through the Small Business Health Options Program (SHOP), or Extended Transition to Affordable Care Act-Compliant Policies. 

The law prohibits insurers from imposing coverage limitations based solely on arbitrary factors such as the number of attempts, dollar amounts, or age. However, insurers may require that patients undergo less costly, “medically appropriate” treatments before before IVF. 

New Jersey 

Coverage includes 4 Egg retrievals per lifetime and requires the patient to be 45 years of age or younger. Employers with less than 50 employees are exempt. 

New York 

Private health plans from employers with 100 or more full-time employees must provide coverage for up to three cycles of IVF (frozen embryo transfers count as a cycle). 

Rhode Island 

Coverage is provided for those between 25 and 42 years of age, and there is a $100,000 cap on treatment. The insurer may also charge a 20% co-payment. 

Rhode Island was the first state to require coverage for fertility preservation services prior to medical procedures that impair fertility, such as chemotherapy or radiation.  Preservation includes egg or sperm freezing.  

Companies that offer IVF Insurance 

Many U.S. corporations offer comprehensive insurance coverage for in vitro fertilization (IVF) and other fertility treatments.  

Ten companies known for their exceptional fertility benefits, include: 

  • Starbucks: Financial support for IVF, surrogacy, and adoption, with benefits available to both full-time and part-time employees.  
  • Walmart: Fertility benefits, including IVF coverage.  
  • Google: Comprehensive fertility benefits, including coverage for IVF treatments, egg freezing, and surrogacy assistance.  
  • Microsoft: Extensive fertility benefits, covering IVF treatments and related services.  
  • Facebook (Meta): Generous fertility benefits, including coverage for IVF, egg freezing, and adoption assistance. 
  • Apple: Comprehensive fertility benefits, covering IVF treatments, egg freezing, and surrogacy assistance.  
  • Amazon: Fertility benefits, including coverage for IVF treatments and related services.  
  • Johnson & Johnson: Fertility benefits, including coverage for IVF treatments.  
  • Salesforce: Comprehensive fertility benefits, including coverage for IVF treatments and related services. 
  • Bank of America: FullfFertility benefits, including coverage for IVF treatments.  

What to Do If Insurance Doesn’t Cover IVF?  

For patients whose insurance does not cover IVF, alternative options include: 

Lower cost clinics: CNY Fertility offers IVF at 1/3 the national average. For many people the total out-of-pocket costs at CNY rival the insurance deductibles at more expensive clinics.  

Payment plans and clinic financing: Many fertility clinics, including CNY Fertility, offer flexible financing or bundled packages to reduce costs. 

Fertility grants: Nonprofit organizations and fertility-focused grants may help cover a portion of treatment expenses. There are numerous grants available to LGBTQ couples. The CNY Fertility IVF Grant is open to all applicants. 

Does Insurance Cover IVF? The Bottom Line  

Navigating insurance coverage for IVF can be complex, but understanding your options is key to managing costs and accessing care. Coverage varies widely based on state mandates, employer-provided benefits, and the type of insurance plan you have. If your insurance does not cover IVF, alternative options such as lower-cost clinics, payment plans, and fertility grants can help make treatment more affordable and accessible, bringing you one step closer to building the family you envision.