Health Insurance That Covers Fertility Treatment

Health Insurance That Covers Fertility Treatment
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Your ability to obtain health insurance covering infertility treatment depends on whether you work in the public or private sector, as well as your state of residence. It also depends on the type of infertility treatment you're seeking. Some states -- including New York and California -- don't permit insurance companies to cover in-vitro fertilization, although insurers must cover other types of fertility treatment. No federal law requires such coverage.

The Affordable Care Act and Infertility

If you've received health insurance coverage under the Affordable Care Act, that doesn't mean you're covered for infertility treatments. The ACA covers "essential health benefits," as defined by a state's benchmark plan. As of the time of publication, only six states require that in-vitro fertilization be covered in the small group and individual market: Massachusetts, New Jersey, Rhode Island, Connecticut, Hawaii and Illinois. Nine other states mandate some sort of other fertility coverage.

Public and Private Insurance

Public health insurance, such as Medicaid, doesn't cover infertility treatment. Even in a state that mandates infertility coverage, self-insuring companies don't have to comply with the mandates. If your private insurer operates in a state mandating coverage, it must offer fertility coverage as a policy staple. If it operates in a "mandate to offer" state, it must offer such coverage, but the employee must purchase and pay for it, not the employer.