October 23, 2024 Newswires

Insurance Will Cover IVF for 9 Million Californians | Insurify

Staff WriterThe Courier-Times

As of July 1, 2025, large group health insurance plans and disability insurance policies in California must pay for the diagnosis and treatment of infertility — including paying for in vitro fertilization (IVF) and other infertility treatments. Approximately 9 million Californians will be eligible for IVF care under new legislation.

The legislation will benefit "cancer survivors, unpartnered people, professional women, LGBTQ+ folks, and those lacking the financial means to pay out of pocket," said the bill's author, State Sen. Caroline Menjivar, in a statement issued after Gov. Newsom signed the legislation into law Sept. 29.

The bill specifically expands coverage for LGBTQ+ families by revising the definition of infertility to include the "inability to reproduce either as an individual or with their partner without medical intervention."

What's changed? Understanding the new legislation

Previously, California law required health insurers and disability insurance policies to cover infertility treatments but specifically excluded IVF treatment.

The new legislation requires insurers to include coverage for a maximum of three egg retrievals — the procedure to extract eggs from the patient's ovaries for IVF — and unlimited embryo transfers, following the guidelines of the American Society for Reproductive Medicine (ASRM). The bill doesn't apply to religious employers but establishes willful violation of the law as a criminal offense.

Previously, California law required insurers to provide infertility treatment per agreed-upon terms communicated to policyholders and group contract holders. Now, the new legislation prevents health insurance companies from establishing different conditions or coverage limitations for fertility and infertility diagnosis, medications, treatment, and services.

In addition to expanding infertility coverage to LGBTQ+ families, it also prohibits health insurers from coverage discrimination based on a person's "age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation."

What's next: California becomes 14th state to back IVF coverage

Twenty-one U.S. states and Washington, D.C., have laws requiring insurance companies to cover some amount of infertility or fertility treatment care, though specific laws vary.

Only 14 states — and Washington, D.C. — specifically require health insurers to cover IVF treatment. These states include Arkansas, California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Utah.