Infertility Support Group
In vitro fertilization is one of the most common and utilized ways of treating conception problems. This support group is dedicated to those beginning their journey with IVF and needing support. Join the community and share your experiences, advice, and story with people going through similar challenges starting a family.
I found this on a website and thought it be useful to some of you ladies out there! Unfortuantly Missouri does not cover anything for infertility, so if the Clomid or the injectable drugs do not work, I believe that will be the end of my TTC with assistance. Me and DH just cant afford to pay for IVF and the medicine that goes along with it.
State infertility-treatment insurance laws
By Insure.com
Not every health plan is subject to state regulation. If your employer buys health insurance for you, then state regulations apply. But if your employer has a self-funded benefits program, your health coverage is regulated only by the federal ERISA law, which has no provision for infertility treatment. Certain other types of plans, such as those purchased individually or by churches and school districts, may also be exempt from state regulation. If you have a group health plan, the best way to determine whether or not your plan is subject to state regulation is to ask your benefits manager.
Where infertility coverage is mandated
Health insurers subject to regulation in these states must provide infertility coverage as part of the plan.
Arkansas: Mandates insurance carriers (excluding HMOs) to cover in vitro fertilization, and allows insurers to impose a lifetime benefit cap of $15,000.
Hawaii: Mandates insurance carriers to cover one cycle of in vitro fertilization, and only after several conditions have been met.
Illinois: Mandates insurance carriers to cover comprehensive diagnosis and treatment of infertility, including assisted reproductive technology procedures, but limits first-time attempts to four complete oocyte retrievals, and to two complete oocyte retrievals for a second birth. Insurance carriers are not required to provide this benefit to businesses (group policies) of 25 or fewer employees.
Maryland: Mandates insurance carriers (excluding HMOs) to cover in vitro fertilization, and only after several conditions have been met. Insurance carriers are not required to provide this benefit to businesses (group policies) of 50 or fewer employees.
Massachusetts: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive-technology procedures.
Montana: Mandates HMOs to cover infertility treatment as a "preventative health care service" benefit.
New Jersey: Mandates group health insurers to cover "medically necessary" expenses incurred in the diagnosis and treatment of infertility under certain medical circumstances. Insurance carriers are not required to provide this benefit to businesses with 50 or fewer employees.
New York: Mandates group health insurers to cover "medically necessary" expenses incurred in the diagnosis and treatment of infertility under certain medical circumstances. Applies only to people between the ages of 21 and 44 and excludes coverage for in vitro fertilization and vasectomy reversal. Requires, in some cases, that insurers that provide prescription drug coverage also cover drug therapies for infertility.
Ohio: Mandates HMOs to cover infertility treatment as a "preventive service" benefit.
Rhode Island: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive technology procedures, and permits insurers to impose up to a 20 percent co-payment requirement for said benefit.
West Virginia: Mandates HMOs to cover infertility treatment as a "preventive service" benefit.
Where infertility coverage must be offered
Health insurers subject to regulation in these states must offer this coverage with their plans, but purchasers can decide not to buy it.
California: Mandates insurance carriers to offer group policyholders coverage of infertility diagnosis and treatment, excluding in vitro fertilization, but including gamete intrafallopian transfer.
Connecticut: Mandates insurance carriers to offer coverage of comprehensive infertility diagnosis and treatment, including assisted reproductive-technology procedures, to group policyholders.
Texas: Mandates insurance carriers to offer coverage of infertility diagnosis and treatment, including in vitro fertilization, to group policyholders.
Source: Resolve National Infertility Association and Insure.com
Current as of September 14, 2003
Last Updated Jun. 8, 2004
State infertility-treatment insurance laws
By Insure.com
Not every health plan is subject to state regulation. If your employer buys health insurance for you, then state regulations apply. But if your employer has a self-funded benefits program, your health coverage is regulated only by the federal ERISA law, which has no provision for infertility treatment. Certain other types of plans, such as those purchased individually or by churches and school districts, may also be exempt from state regulation. If you have a group health plan, the best way to determine whether or not your plan is subject to state regulation is to ask your benefits manager.
Where infertility coverage is mandated
Health insurers subject to regulation in these states must provide infertility coverage as part of the plan.
Arkansas: Mandates insurance carriers (excluding HMOs) to cover in vitro fertilization, and allows insurers to impose a lifetime benefit cap of $15,000.
Hawaii: Mandates insurance carriers to cover one cycle of in vitro fertilization, and only after several conditions have been met.
Illinois: Mandates insurance carriers to cover comprehensive diagnosis and treatment of infertility, including assisted reproductive technology procedures, but limits first-time attempts to four complete oocyte retrievals, and to two complete oocyte retrievals for a second birth. Insurance carriers are not required to provide this benefit to businesses (group policies) of 25 or fewer employees.
Maryland: Mandates insurance carriers (excluding HMOs) to cover in vitro fertilization, and only after several conditions have been met. Insurance carriers are not required to provide this benefit to businesses (group policies) of 50 or fewer employees.
Massachusetts: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive-technology procedures.
Montana: Mandates HMOs to cover infertility treatment as a "preventative health care service" benefit.
New Jersey: Mandates group health insurers to cover "medically necessary" expenses incurred in the diagnosis and treatment of infertility under certain medical circumstances. Insurance carriers are not required to provide this benefit to businesses with 50 or fewer employees.
New York: Mandates group health insurers to cover "medically necessary" expenses incurred in the diagnosis and treatment of infertility under certain medical circumstances. Applies only to people between the ages of 21 and 44 and excludes coverage for in vitro fertilization and vasectomy reversal. Requires, in some cases, that insurers that provide prescription drug coverage also cover drug therapies for infertility.
Ohio: Mandates HMOs to cover infertility treatment as a "preventive service" benefit.
Rhode Island: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive technology procedures, and permits insurers to impose up to a 20 percent co-payment requirement for said benefit.
West Virginia: Mandates HMOs to cover infertility treatment as a "preventive service" benefit.
Where infertility coverage must be offered
Health insurers subject to regulation in these states must offer this coverage with their plans, but purchasers can decide not to buy it.
California: Mandates insurance carriers to offer group policyholders coverage of infertility diagnosis and treatment, excluding in vitro fertilization, but including gamete intrafallopian transfer.
Connecticut: Mandates insurance carriers to offer coverage of comprehensive infertility diagnosis and treatment, including assisted reproductive-technology procedures, to group policyholders.
Texas: Mandates insurance carriers to offer coverage of infertility diagnosis and treatment, including in vitro fertilization, to group policyholders.
Source: Resolve National Infertility Association and Insure.com
Current as of September 14, 2003
Last Updated Jun. 8, 2004
deleted_user
Thank you for sharing this information. It makes me SO mad that so many insurance companies are not treating infertility like a medical condition that requires treatment.
deleted_user
I hate the fact that Missouri does not cover any infertility, I made my first RE appointment for February and they told me to be prepared to pay up front (in a nice sensitive way) because my insurance doesnt even cover RE office vists
deleted_user
Thanks for the info! I tried to check the site, either I am too sleepy or I just couldn't find the info... I am in TX. Your post said, "Texas: Mandates insurance carriers to offer coverage of infertility diagnosis and treatment, including in vitro fertilization, to group policyholders" So if my policy is not covering infertility, what does this mean??? What next???
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