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Maine Will Require Insurance Coverage for Fertility Treatments
Governor Janet Mills of Maine signed L.D. 1539, “An Act to Provide Access to Fertility Care.” What does this mean? Maine will require insurance coverage for fertility treatments for families seeking care. Maine and Vermont are the only New England states that do not have fertility coverage.
Understanding Maine’s Fertility Insurance Law
Keep in mind that the basic definition of infertility differs in each state, and, accordingly, coverages and exemptions may also look different.
Infertility Definition in Maine: “An individual or couple with infertility, an individual or couple who is at increased risk of transmitting a serious inheritable genetic or chromosomal abnormality to a child, or an individual unable to conceive as an individual or with a partner because the individual or couple does not have the necessary gametes for conception.”
What Does the Maine Infertility Insurance Mandate Cover?
The law requires insurance to provide coverage for three separate segments of fertility care:
- Fertility Diagnostic Care
- Fertility Treatment
- Fertility Preservation: Preservation that is medically necessary to freeze egg or sperm before undergoing chemotherapy or any fertility-impairing medical procedure.
When Does the Law Take Effect?
This law takes effect on January 1, 2024. Coverage will depend on open enrollment dates or specific enrollment because some employers start their insurance plans later than January 1.
Prepping for Your Fertility Coverage
- If your health insurance is through your job, the first step you should take to determine what your insurance may or may not cover is to talk to your employer or Human Resources department. Click here for a few important questions to ask.
- Am I fully insured or self-insured? Fully insured plans are required to follow state insurance laws, whereas self-insured or self-funded insurance plans are exempt from state law.
- Make an appointment with us at any one of our three NH locations (Portsmouth, Bedford and Nashua) for evaluation and fertility services preparation. Initial consultations for new patients are FREE for those without infertility insurance coverage.
Contact Us
Regardless of your insurance coverage, we’re here to help you get the treatment you need. If you have more questions how Maine will require insurance coverage for fertility treatments or want to inquire about financing options, please contact us!
*Your consultation is FREE if you don’t have infertility insurance coverage.
