Fertility Insurance Mandates and The Impact on Treatment Outcomes

As of April 2021, a total of 19 states have passed fertility insurance laws. Of those, only 13 cover in vitro fertilization (IVF). In each state, the definition of infertility varies, meaning that coverages and exemptions are different based on location. However, recent research on fertility insurance mandates and their impact on treatment outcomes has revealed that states with fertility insurance mandates are associated with more positive treatment outcomes, leading researchers to conclude that legislation mandating IVF coverage may improve the outcomes for infertility patients.

Specifically, the studies showed that fewer embryos need to be transferred per procedure, and there are higher rates of live births from IVF. The retrospective study of 110,843 embryo transfers over a two-year period (2014 to 2016) compared the number of single versus multiple embryos transferred in states with insurance coverage mandates and those without. The results showed that transfers of more than one embryo per procedure were more likely to occur in states without fertility insurance mandates. 

Additionally, the researchers found that live births per cycle were significantly higher in states with IVF mandates, specifically among women aged 35 and older. It also found that IVF was more common—among all age groups—in states with mandates.

The Difference Between Mandates to Cover and Mandates to Offer

Two key definitions in regard to fertility insurance are “mandate to cover” versus “mandate to offer.” A mandate to cover is where state law requires health insurance plans sold by licensed insurers to include coverage for infertility treatment. In contrast, a mandate requires health insurers to offer coverage, but the person or group buying the policy doesn’t necessarily have to elect coverage for that benefit. That means if you live in a state with a mandate to cover, you may still not be eligible to receive coverage for infertility treatment.

How to Find Out if Your State Has a Fertility Insurance Mandate 

You can find out whether your state has a fertility insurance mandate by visiting the National Conference of State Legislatures, which lists all mandates, the definition of infertility in each state, and other important information. 

To help you navigate the costs of infertility treatment, we’ve also created a comprehensive guide to affording IVF. This is designed to help hopeful parents understand fertility insurance mandates, financing, and fertility loans available through Fertility Centers of New England to help them build their dream family. 

Let’s Take The Next Steps Together 

We believe that cost should never be a barrier to treatment, which is why we offer a variety of different payment options to make starting your family affordable. We even offer special programs for couples and individuals without fertility insurance, including our IVF Assist, EGG Assist, and Frozen EGG Assist programs. 

IVF Assist is $13,000 per cycle (not including medication). Alternatively, EGG Assist helps couples who require an egg donor to start their family, and Frozen EGG Assist helps couples purchase a cryopreserved donor egg for IVF. 

Contact Us

If you have more questions on fertility insurance mandates and the impact on treatment outcomes, or you are ready to start growing your family, get in touch with us. We offer affordable initial consultations for patients without fertility insurance, and our financial advisors are here to help each patient make the decision that is best for their financial situation.