Does health insurance cover IVF and other fertility treatments?

According to the World Health Organization, infertility affects approximately one in six adults worldwide.¹ And a single cycle of in vitro fertilization (IVF) will generally cost between $15,000 and $20,000.² It’s easy to see why the question of insurance coverage for infertility and IVF is often asked.

Unfortunately, the answer to whether insurance covers IVF isn’t a simple yes or no. Health insurance coverage for IVF and other fertility treatments varies from one state to another and from one health plan to another.

The Trump administration announced some initiatives in 2025 that aim to make fertility treatment more affordable. But it's important to understand that these federal initiatives do not require any employers or entities to offer coverage for fertility treatment.

Instead, the administration has announced a drug pricing agreement that will reduce the prices on some IVF medications such as Gonal-f, Ovidrel, and Cetrotide, along with an option (not a requirement) for employers to offer stand-alone fertility benefits that don't have to comply with the regular consumer protections that go along with comprehensive group health coverage.³

Limitations of state laws and variations in state regulations

Before we get to a summary of state rules, it’s important to clarify that state insurance mandates never apply to self-insured group plans.¹³ And the majority of people with employer-sponsored health insurance in the United States are covered under self-insured plans.¹⁴

So states can impose coverage requirements on individual/family health plans and small- or large-group health plans that are fully insured (meaning they are purchased from an insurance company as opposed to being self-insured by the employer). But those requirements do not apply to self-insured group plans.

It’s also important to note that states can make rules that apply only to certain types of coverage, but not to all state-regulated health plans. Some states require coverage mandates only for the state employee health plan (ie, the coverage provided to state employees), but not to other health plans. Florida's new fertility preservation coverage mandate is an example of this.¹⁵

So although half of the states that have imposed some level of fertility coverage requirements on at least some state-regulated health plans, the specifics vary quite a bit state-to-state in terms of what plans are affected and what services have to be covered.

There are numerous state-to-state variations that are important to keep in mind, including:

• How infertility is defined (for example, how long a couple must try to conceive before coverage becomes available),
• Age limits for coverage,
• Whether same-sex couples or single parents are eligible for coverage,
• Whether donor eggs or sperm are covered or can be used,
• Whether the policy must have been in force for a certain amount of time before the coverage is applicable,
• Whether less-expensive procedures (IUI, for example) must fail before more expensive procedures (IVF, for example) can be covered.
• For fertility preservation, whether the coverage applies to any medical treatment that could result in infertility, or only to cancer treatment that could result in infertility.

There also tend to be exceptions for religious employers, as well as exclusions on coverage of infertility treatment to address the reversal of a voluntary sterilization procedure.

With all of that in mind, the following states have laws that require insurers to cover the diagnosis of infertility, treatment of infertility (which can include IVF), and/or fertility preservation services.⁷

State-by-state laws requiring coverage of infertility

States with infertility coverage in their EHB benchmark plan

If a state’s Essential Health Benefits (EHB) benchmark plan includes coverage for infertility treatment, all ACA-compliant individual and small-group health plans in the state (meaning non-grandfathered/grandmothered plans) must also cover – at a minimum – those same services.

There is quite a bit of overlap between states that have some level of infertility coverage in their EHB benchmark plan and the states listed above that have laws requiring some level of infertility coverage for individual and small-group health plans.

But some states that don’t have laws requiring infertility coverage do have some level of infertility coverage in their EHB benchmark plan. That will mean that all individual and small-group plans in those states must provide at least the same benefits as the EHB benchmark plan, even though there isn’t a specific coverage law in the state.

But most of the EHB benchmark plans that include infertility coverage limit it to coverage of diagnosis of infertility and some lower-cost treatment options. Here’s a summary:³⁸

Two states and DC have EHB benchmark plans that include coverage for the diagnosis of infertility:

• Arizona
• Tennessee
• DC (the EHB benchmark is being expanded in 2026 to include extensive fertility treatments,¹¹ but state legislation began requiring fertility coverage starting in 2025.)

Seven states have EHB benchmark plans that include coverage for the diagnosis of infertility and treatment of the underlying causes of infertility (for example, removing uterine fibroids):

• Kansas
• Michigan (legislation introduced in late 2024 would require comprehensive infertility coverage starting in 2026³⁹)
• Missouri
• New Hampshire
• New Mexico (as of 2022)
• Virginia
• West Virginia

The EHB benchmark plans in five states include coverage for the diagnosis of infertility and artificial insemination:

• Montana
• Nevada
• New York
• Pennsylvania
• Colorado
• Washington (starting in 2026¹¹)

The EHB benchmark plans in two states include the diagnosis of infertility and medical stimulation of ovulation:

• Iowa
• North Carolina

In five states, the EHB benchmark plans include more comprehensive coverage, including IVF coverage. But as noted above, most of these states also have laws requiring this coverage for individual and small group plans:

• Connecticut
• Hawaii
• Illinois (State law only requires coverage on group plans with 25 or more employees, but the EHB benchmark extends this coverage to individual and smaller group plans.)
• Maryland
• Massachusetts
• DC (2026 update to EHB benchmark includes full spectrum of fertility treatment;¹¹ as noted above, more extensive coverage starts in 2025 due to state legislation)

California applied to the federal government in May 2025, seeking to update its EHB benchmark plan for 2027. The application was still pending federal approval in late 2025, but one of the proposed changes is the addition of coverage for the treatment of infertility.⁴⁰ This was also addressed in legislation that California enacted in October 2025.⁴¹

Virginia enacted legislation in May 2025 that requires the Virginia Health Insurance Reform Commission to consider adding fertility-related services to Virginia's essential health benefits plan.⁴² But it only instructs them to consider it, and does not require the benefit to be added.

Evolving state requirements for infertility coverage

The lists above show states where either a law or EHB benchmark plan requires some degree of infertility coverage on at least some health plans. The District of Columbia and six states – Colorado, Delaware, Maine, New Hampshire, New Mexico, and Utah – have joined those lists since 2018, due to new state laws or, in the case of New Mexico, an updated EHB benchmark plan. Washington's EHB benchmark plan is being updated to include coverage of artificial insemination starting in 2026, and DC's EHB benchmark plan is also being updated in 2026 to include coverage of the full range of fertility treatments (as noted above, DC began requiring extensive fertility coverage as of 2025, under the terms of state legislation enacted in 2023).

Several additional states enacted legislation related to fertility coverage in 2025:

• Arkansas: Requires health plans to cover "restorative reproductive medicine"⁴³ (which is controversial among reproductive medicine specialists).⁴⁴
• Florida: Requires the state employee health benefit plan to cover fertility preservation for enrollees diagnosed with cancer whose treatment could cause infertility.¹⁵ (This only applies to people covered by the state employee benefit plan.)
• Georgia: Requires health plans to cover fertility preservation services before a person undergoes medical treatment that is expected to result in infertility.⁹
• Nevada: Requires coverage of fertility preservation services following a diagnosis of breast or ovarian cancer.¹⁰
• Virginia: Requires the Virginia Health Insurance Reform Commission to consider adding fertility-related services to Virginia's essential health benefits plan, but does not require them to do so.⁴⁵

Various other bills were still under consideration in numerous states as of late 2025:

• Hawaii (SB23 would expand on the state's current fertility coverage requirements to ensure equal access regardless of gender, sexual orientation, or marital status, add to the benefits that must be covered, and reduce the time a person must have been experiencing infertility from five years to six months. And SB642 would require insurers to offer optional coverage for fertility preservation services before a person receives cancer treatments that are expected to result in infertility.)⁴⁶
• Illinois (SB1259 would require health plans to cover fertility preservation services, starting in mid-2026.)⁴⁷
• Iowa (SF130 would require health plans to cover various fertility services.)⁴⁸
• Massachusetts (H1346 would require coverage for fertility preservation services before a treatment expected to harm fertility.)⁴⁹
• Minnesota (HF1758 and SF1961 would require fertility coverage on state-regulated plans, as well as Medical Assistance (Medicaid) and MinnesotaCare (Basic Health Program). Notably, the legislation clarifies that the state will reimburse health insurers for costs associated with this coverage.)⁵⁰
• Nebraska (LB233 would require the Nebraska State Insurance Program to cover IVF for state employees, with various restrictions)⁵¹
• New Jersey (A2002 would require carriers to cover fertility preservation when diagnosed with certain menstrual disorders, and A4027/S1413 would require coverage for preimplantation genetic testing and IVF in situations where one or both partners are known carriers of certain genetic disorders that could be passed to their children)⁵²
• New York (S5734, S885, S5545, and A7175 would require large group health plans to cover three oocyte retrievals and unlimited embryo transfers)⁵³
• Pennsylvania (SB351 and SB272 would require policies that provide pregnancy-related benefits to cover various infertility treatments, including IVF, and HB922 would require coverage of fertility preservation before a medical treatment that could result in infertility.)⁵⁴
• South Carolina (S27 would require health maintenance organizations (HMOs) to cover assistive reproductive technologies, including IVF)⁵⁵
• Tennessee (HB595 and SB463 would require health plans to cover a comprehensive range of fertility-related services, starting in January 2026)⁵⁶
• Vermont (H55 and H302 would require health insurers and Vermont Medicaid to cover a wide range of fertility services.)⁵⁷
• Wisconsin (AB568 and SB566 would require health plans to cover the diagnosis and treatment of infertility, including IVF, as well as fertility preservation services prior to a medical treatment that could harm fertility)⁵⁸

Several other states considered legislation related to fertility coverage in 2024 or 2025, but the bills were unsuccessful:

• Tennessee (HB2549, SB2629, HB2064, and SB1935 would have required coverage of fertility preservation only.)⁵⁹
• Maryland (HB985 would have added coverage of fertility treatment to Medicaid.)⁶⁰
• Minnesota (HF1658 would have required coverage of infertility diagnosis and treatment on all state-regulated health plans and Medicaid.)⁶¹
• Mississippi (SB2781 would have required coverage of fertility preservation only)⁶²
• Missouri (HB2341 would have required coverage for IVF.)⁶³
• Montana (HB565 and SB527 would have required health insurers to cover infertility diagnosis and treatment, including IVF)⁶⁴
• Nevada (SB217 would have required group plans with over 100 enrollees to cover at least three oocyte retrievals and unlimited embryo transfers, as well as fertility preservation services for members with medical conditions that could cause infertility. The legislation passed, but was vetoed by the governor,⁶⁵ who called it "fiscally impossible."⁶⁶
• New Hampshire (SB558 would have required group plans to cover up to six rounds of IUI per year.)⁶⁷
• New Mexico (HB95 would have required health plans to cover fertility preservation services for individuals whose medical condition or treatment could cause infertility)⁶⁸
• North Dakota (HB1282 would have ensured comprehensive fertility benefits for public employees in North Dakota, and HB1284 would have required coverage of fertility preservation services for public employees)⁶⁹
• Oregon (HB2959 and SB535 would have required state-regulated plans in Oregon to cover a comprehensive list of fertility treatments)⁷⁰
• Rhode Island (S103 would have expanded on the state's current requirement by adding "preimplantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF)" to the list of services that must be covered. But the legislation wouldn't have changed anything about the state's existing $100,000 benefit limit for infertility coverage.⁷¹ However, HB5629 and S691 would have removed the $100,000 cap, and required various fertility-related services to be covered on state-regulated health plans.⁷²)
• Texas (HB618 would have required health benefits plans for certain state employees to cover IVF)⁷³
• Virginia (HB560 would have required coverage of fertility treatment and would have recommended that such coverage be included in an updated essential health benefits benchmark plan for Virginia.)⁷⁴
• West Virginia (HB4024, in 2024, and HB2824 and SB669, in 2025 would have required health plans to cover various infertility treatments.)⁷⁵
• New York (S9535 would have required individual health plans to cover IVF, as is already the case for large group plans in NY.)⁷⁶
• Michigan (SB1182, introduced in late 2024, would require comprehensive infertility coverage starting in 2026.)⁷⁷

Under rules finalized by HHS in 2024, it will be easier for states to modify their EHB benchmark plans and add required benefits. So we might see some states adjust their EHB benchmark plans to include various levels of fertility coverage in future years.

For example, as noted above, California is in the process of updating its EHB benchmark plan for 2027, and one of the proposed benefit additions (awaiting CMS approval as of late 2025) is the treatment of infertility.⁴⁰

And both DC and Washington received approval to update their EHB benchmark plans starting in 2026 to include various fertility benefits.¹¹

How to get IVF covered by insurance, along with other infertility treatments and tests

No matter where you are on your reproductive journey, you may need help understanding the infertility insurance landscape.

If you’re in need of infertility testing or treatment, here are some questions you’ll want to ask your health plan, broker, or human resources department to make sure you understand your coverage and can access any benefits that might be available to you:

• Does my plan offer any benefits related to infertility? And if so, how does the plan define infertility?
• Does my plan cover office visits, tests, and procedures necessary for the diagnosis of infertility?
• Does my plan cover any treatments for infertility, including IUI, IVF, etc.?
• If so, what are the coverage limitations (rounds of treatment, dollar limit, etc.) and what can I expect in terms of out-of-pocket costs?
• If the plan provides any infertility benefits, am I limited to only using in-network providers, or is there also any out-of-network coverage?

How various types of health insurance cover IVF

Here’s an overview of the various types of health insurance and what you can expect when it comes to IVF coverage:

ACA Marketplace coverage

If you buy your own health insurance – as opposed to getting coverage from an employer, Medicare, or Medicaid – coverage for IVF is going to depend almost entirely on the state where you live. It’s possible for individual/family health plans (including Marketplace plans and off-Marketplace plans) to offer fertility coverage even if it’s not required, but this is very unlikely.

If you’re in Arkansas (PPOs only), Connecticut, Delaware, DC (as of 2025), Hawaii, Illinois, Maine, Maryland, Massachusetts, or Rhode Island, the plans available in the individual market – including Marketplace plans – will cover IVF (California will join this list in 2027, if the state's proposed benchmark plan modification is approved by CMS).⁷⁸ The coverage rules and limitations will vary by state, and out-of-pocket costs will vary by plan.

If you’re in one of the other states listed above where state laws or EHB benchmark rules require infertility coverage, the specifics of what’s covered will vary by state (for example, fertility preservation services, diagnosis of infertility, etc.).

Employer-sponsored group health plan

Employer-sponsored health insurance covers nearly half of all individuals in the United States, and is by far the nation’s largest coverage sector.⁷⁹ And overall, the number of employer-sponsored plans that cover IVF and other fertility treatments has been increasing significantly in recent years, particularly among large employers. Forty-two percent of U.S. employers covered fertility treatments in 2024, up from 30% in 2020.⁸⁰

Of those with employer-sponsored health benefits, 67% of covered workers are in self-insured plans,¹⁴ which aren’t subject to state insurance laws or mandates. For these plans, coverage of fertility services is entirely up to the employer.

If you’re enrolled in an employer-sponsored plan that your employer purchases from an insurance company, coverage of infertility services will depend on the size of your employer (small-group plans and large-group plans can have different rules) and the state where the plan is based.

(See details above regarding the laws in various states. Note that if the coverage rule stems from the EHB benchmark as opposed to a state law, the requirement won’t apply to large-group plans. In most states, large-group coverage applies to employers with 50 or more employees.⁸¹)

State legislation related to Medicaid coverage of fertility services

Some states are considering legislation in 2025 that would add fertility benefits to the state's Medicaid program:

• Vermont: Legislation would require Vermont Medicaid to cover a wide range of fertility services.⁸⁸
• New Jersey: Legislation would require New Jersey Medicaid to cover fertility preservation services before a medical treatment that's expected to result in infertility.⁸⁹ Separate bills introduced in New Jersey in 2025 would require the Medicaid program to cover ovulation-enhancing drugs and their administration, for enrollees experiencing infertility.⁹⁰ Additional legislation  would require coverage for preimplantation genetic testing and IVF in situations where one or both partners are known carriers of certain genetic disorders that could be passed to their children.⁹¹
• Minnesota: Legislation would add infertility coverage to Medicaid (Medical Assistance) and MinnesotaCare (the state's Basic Health Program).⁵⁰
• Massachusetts: Legislation would require health plans and Medicaid to cover fertility treatments regardless of sexual orientation, gender identity, or familial status.)⁹²

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.