IVF and Infertility Insurance Coverage by State

No federal law requires health insurance to cover infertility treatment or IVF. Whether your plan pays for it depends on the state where the policy is issued, the type of plan you have, and in some states the size of your employer. This guide starts with Illinois, where we are based, then summarizes the other states that have passed coverage laws.

First, check whether a state law even applies to you

State insurance mandates only reach fully insured plans, meaning plans where an insurance company carries the risk. Many large employers are self-funded: the employer pays claims itself and hires an insurer only to administer the plan. Self-funded employer plans are governed by the federal ERISA law and are not bound by state mandates, even if the insurer's name is on your ID card.

Before relying on any law below, ask your HR department or benefits administrator:

• Is our plan fully insured or self-funded? Only fully insured plans must follow state mandates.
• In which state was the policy issued? The law of the state where the group policy is written usually controls, not where you live.
• Is it individual, small group, or large group coverage? Several states apply their rules only to larger employers.
• Does the employer qualify for a religious exemption? Many states let religious employers opt out.

Illinois

Illinois has one of the broadest fertility coverage laws in the country, and it expanded on January 1, 2026.

Who must cover infertility treatment

• Any fully insured group health policy that includes pregnancy benefits and is issued or renewed in Illinois on or after January 1, 2026. The old exemption for employers with 25 or fewer employees no longer applies.
• Self-funded ERISA employer plans are exempt, as they are everywhere.
• Policies issued to religious organizations that object to the procedures on religious grounds are exempt.
• The infertility treatment mandate is written for group policies. If you buy your own coverage, check the plan's benefit summary or ask us before assuming IVF is included.

What is covered

• Diagnosis and treatment of infertility, including IVF, embryo transfer, artificial insemination, GIFT, ZIFT, low tubal ovum transfer, and (starting in 2026) surgical sperm extraction.
• Preimplantation genetic testing of embryos, including testing for chromosome problems and single gene disorders.
• Care must be considered medically appropriate under guidelines from ASRM, ACOG, or SART, and performed at a SART member clinic.

Who counts as infertile

Illinois uses a wide definition. You qualify if any of these apply:

• You have not been able to get pregnant or carry to a live birth after 12 months of unprotected intercourse (6 months if the woman is over 35). A miscarriage does not restart the clock.
• You are unable to reproduce, either as a single person or with a partner, without medical help. This language means single people and same-sex couples are not shut out.
• A licensed physician finds you infertile based on your history, age, exam, or testing.

Cost sharing protections

Plans cannot charge higher deductibles, copays, or coinsurance for infertility care than for other care, cannot add special waiting periods or benefit caps, and cannot treat fertility drugs more strictly than other prescriptions. They also cannot deny coverage because you are using a donor or a gestational carrier.

Before 2026, Illinois allowed plans to limit IVF to four completed egg retrievals (two more after a live birth). The new 2026 language does not restate that cap, so ask your plan which limit, if any, it applies.

Fertility preservation

Separately, every individual and group policy issued in Illinois since 2019 must cover standard fertility preservation (such as egg, sperm, or embryo freezing) when a medically necessary treatment like chemotherapy, radiation, or surgery may cause infertility. Insurers cannot limit this benefit based on age, sex, sexual orientation, or marital status.

State by state summary

This table covers the states with an infertility, IVF, or fertility preservation insurance law on the books as of fall 2026. All of them exempt self-funded employer plans. "Preservation" means coverage for freezing eggs, sperm, or embryos before a treatment that may cause infertility. States not listed have no general mandate, though individual plans may still offer the benefit.

State	Infertility treatment	IVF	Preservation	Key details
Illinois	Yes	Yes	Yes	Group policies with pregnancy benefits, any employer size, from Jan 1, 2026. Preservation applies to individual and group plans.
Arkansas *	IVF focused	Yes	No	Insurers that cover maternity must cover IVF, subject to a lifetime dollar limit. HMOs exempt.
California	Yes	Large group	Yes	Large group plans must cover IVF (up to 3 egg retrievals, unlimited embryo transfers) from Jan 1, 2026. Small group insurers must offer it, but employers may decline. CalPERS plans start July 1, 2027.
Colorado	Yes	Large group	Yes	Large group plans since 2023, including up to 3 egg retrievals with unlimited transfers. Individual and small group rules differ; check your plan.
Connecticut	Yes	Yes	Limited *	Individual and group plans. Plans may cap IVF at 2 lifetime cycles and may limit coverage to people under 40.
Delaware	Yes	Yes	Yes	Individual and group. Employers under 50 employees exempt. Egg retrievals must be completed before 45 and transfers before 50.
District of Columbia *	Yes	Yes	Yes	Individual, small, and large group. At least 3 egg retrievals with unlimited transfers. Phased in during 2025 and 2026.
Hawaii *	Limited	One cycle	New law	One-time IVF benefit with strict conditions. A newer law adds preservation coverage for policies issued or renewed from late 2026.
Louisiana *	Limited	No	Yes	Plans may not deny treatment of a correctable medical condition just because it causes infertility. Preservation for cancer patients.
Maine	Yes	Not named	Yes	All state-regulated plans since Jan 1, 2024. Covers fertility treatment consistent with ASRM guidelines; IVF is not named in the statute. Preservation includes at least 5 years of storage.
Maryland *	Yes	Yes	Yes	Plans may limit IVF to 3 attempts per live birth and a $100,000 lifetime maximum. Small employer exemption applies.
Massachusetts	Yes	Yes	Yes	Fully insured individual and group plans must cover non-experimental infertility procedures, including IVF, with no special cost sharing. Preservation added in 2024.
Montana *	HMOs only	No	Yes	HMOs must include infertility services as a basic benefit. Preservation requirement added in 2023.
New Hampshire	Yes	Not named	Yes	Group plans (not SHOP, not individual) since 2020. Covers medically necessary fertility treatment under ASRM standards; no caps based on age, attempts, or dollars.
New Jersey	Yes	Yes	Yes	Groups over 50 employees. IVF includes up to 4 completed egg retrievals per lifetime.
New York	Yes	Large group	Yes	Large group plans (over 100 employees) cover 3 IVF cycles. Preservation applies to individual, small, and large group plans.
Ohio *	HMOs only	No	No	HMOs must cover basic infertility services.
Rhode Island	Yes	Not named	Yes	Plans with pregnancy benefits. Treatment coverage for women age 25 to 42; plans may apply a $100,000 lifetime cap and up to 20% coinsurance.
Texas	Offer only	Offer only	Yes	Group insurers must offer IVF coverage, but the employer may reject it in writing. Preservation for cancer patients since Sept 1, 2023.
Utah *	Limited	Limited	Limited	Coverage mainly through state employee and Medicaid programs, not a broad private mandate.
West Virginia *	HMOs only	No	No	HMOs must cover basic infertility services.
Florida *	No	No	State plan	Preservation coverage for the state employee group plan starting 2026.
Georgia *	No	No	Yes	Preservation for people with cancer, sickle cell disease, or lupus, for policies from Jan 1, 2026.
Kentucky *	No	No	Yes	Preservation law passed in 2023.
Nevada *	No	No	Yes	Preservation for certain cancer patients starting 2026.
Oklahoma *	No	No	Yes	Preservation for cancer patients of reproductive age since Jan 1, 2025.

* We confirmed these rows from statute citations and state law summaries but did not review every detail in the current statute text, or the rules have unusual limits. Treat them as a starting point and confirm with your plan or your state insurance department.

Several other states have bills pending, and limits change often. For a second reference, RESOLVE: The National Infertility Association keeps a state by state summary.

What about Marketplace and individual plans?

The Affordable Care Act does not list infertility treatment as a required benefit. Each state picks a "benchmark" plan that sets the minimum for individual and small group coverage, and most benchmarks cover diagnosis of infertility but not IVF. A few states, such as Maine, the District of Columbia, Massachusetts, and Connecticut, extend their rules to individual plans. In Illinois, fertility preservation applies to individual plans, but the broader infertility treatment law is written for group coverage.

Tips if your plan does not cover IVF

• Ask whether your employer offers a separate fertility benefit through a vendor. Many self-funded employers add one voluntarily.
• If your spouse or partner has coverage through a fully insured Illinois group plan, that plan may cover your treatment as a dependent.
• Check whether a pending treatment, such as cancer care, qualifies you for fertility preservation coverage even if IVF is not covered.
• Get prior authorization in writing before starting a cycle, and appeal any denial. State mandates give you a stronger basis for an appeal.

Talk to an agent

Our licensed agents can review a group or individual plan and tell you how a state fertility law applies to it. For employer coverage questions you can also schedule a call with our group team.

Get a Free Quote

Questions? Submit a ticket or call us at (312) 726-6565.

Sources: 215 ILCS 5/356m (Illinois infertility coverage); 215 ILCS 5/356z.32 (Illinois fertility preservation); New York DFS, IVF and fertility preservation guidance; Massachusetts 211 CMR 37.00; Massachusetts Division of Insurance, fertility preservation FAQ; Maine 24-A M.R.S. 4320-U; New Hampshire RSA 417-G; Rhode Island Gen. Laws 27-18-30; Texas H.B. 1649 (2023); Colorado HB22-1008; Delaware fertility care law; RESOLVE state summary (secondary reference).