For millions of individuals and couples struggling with infertility, access to fertility treatments can be life-changing,
but also financially overwhelming. The good news? A growing number of health insurance providers are now offering fertility coverage as part of their plans.
This article breaks down what fertility coverage typically includes, how to find the right plan, and what to consider when comparing options.
What Is Fertility Coverage in Health Insurance?
Fertility coverage refers to insurance benefits that help cover the cost of diagnosis and treatment of infertility. This can range from basic services like fertility testing to advanced procedures like in vitro fertilization (IVF).
Commonly Covered Services:
Initial fertility evaluation and diagnostic testing
Ovulation induction and medications
Intrauterine insemination (IUI)
In vitro fertilization (IVF)
Fertility preservation (egg/sperm freezing)
Genetic testing and counseling
✅ Note: Coverage varies widely by insurer, employer, and state.
Why Is Fertility Insurance Important?
Fertility treatments are expensive. One IVF cycle alone can cost $12,000–$20,000, not including medications, lab work, or storage fees.
Fertility coverage can:
Significantly reduce out-of-pocket costs
Provide emotional and financial relief
Make it possible to pursue more than one cycle
Increase access to family-building options
Which States Require Fertility Coverage?
As of now, 20+ U.S. states have laws requiring some form of infertility insurance coverage. However, mandates vary—some require only diagnostic coverage, while others mandate comprehensive treatment benefits.
Examples of states with more robust mandates:
Massachusetts
Illinois
Connecticut
New Jersey
New York
Rhode Island
Delaware
Always check your state’sspecific mandate and how it applies to your plan (employer-sponsored vs. individual).
How to Check If Your Plan Covers Fertility
Review your Summary of Benefits and Coverage (SBC)
Look for sections titled “Infertility Treatment” or “Reproductive Services.”
Call your insurance provider
Ask for detailed information about what's included and what's excluded.
Ask your HR department
For employer-based plans, HR may provide a fertility benefits guide.
Use fertility benefit providers
Companies like Progyny, Carrot Fertility, or WINFertility work with employers to offer additional fertility coverage and concierge support.
Tips for Getting the Most Out of Your Coverage
Ask about limitations (e.g., age caps, number of cycles, required prior treatments)
Verify provider networks—make sure your clinic is in-network
Appeal denied claims—sometimes persistence pays off
Track costs and authorizations to stay within covered guidelines
Alternatives if You're Not Covered
If your insurance doesn’t offer fertility coverage, consider:
Flexible Spending Accounts (FSA) or Health Savings Accounts (HSA)
Financing programs through fertility clinics
Grants and scholarships from fertility foundations
Crowdfunding platforms
Negotiating bundled packages with providers
Conclusion
Fertility insurance coverage is no longer a luxury—it’s becoming a critical component of reproductive healthcare. As awareness grows and more insurers expand their offerings, individuals and families have greater hope and access to building the families they dream of.
Understanding your options, reading the fine print, and advocating for coverage can make a world of difference on your fertility journey.