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If you're considering in vitro fertilization (IVF) or surrogacy, you're likely concerned about the cost.
Growing your family is a significant investment. Fortunately, there are some states that mandate coverage for IVF and infertility treatments, which can help reduce your expenses.
Understanding your state’s laws is a great first step toward the path to parenthood. This article breaks down what states mandate IVF coverage, how those laws work and what’s included. For more free information, fill out our online form.
How Fertility Insurance Laws Differ by State
There are currently 21 states with mandated infertility insurance coverage. Some require coverage for diagnostic services only, while others mandate full IVF coverage, including fertility preservation.
Here’s what varies:
Some states require couples to be married or have a specific infertility diagnosis. IVF, intracytoplasmic sperm injection (ICSI), fertility drugs and preservation services are not included in every state mandate. Some states limit the number of IVF cycles or put lifetime dollar caps on coverage. Most laws apply to large group plans, and many exclude Medicaid or self-insured employer plans.
What States Mandate IVF Coverage?
Here's what you should know about the states that mandate IVF coverage:
Arkansas mandates IVF coverage for policyholders or their spouses who meet strict infertility criteria. The law sets a $15,000 lifetime max and does not apply to health maintenance organizations (HMOs) or self-insured employers.Arkansas
California
Large group plans must cover infertility diagnosis and IVF starting in 2025. Small group plans must offer coverage but not necessarily IVF. The law is inclusive of hopeful LGBTQ+ couples and single parents.
Large group plans must cover three egg retrievals and unlimited embryo transfers. Coverage includes standard fertility preservation and can't impose more restrictions than for other medications.Colorado
Connecticut
This state mandates coverage for up to two IVF cycles, along with other infertility services, if less expensive options have not succeeded. This coverage applies only to individuals who have maintained insurance under the policy for at least 12 months.
Delaware offers one of the most inclusive mandates in the country. It includes coverage for six egg retrievals, unlimited embryo transfers and IVF using donor eggs or embryos, including cases involving gestational surrogacy. This mandate applies to all group and blanket insurance plans.Delaware
Hawaii
Hawaii law requires insurance plans to cover one IVF cycle if the patient or their spouse has a five-year history of infertility or meets specific medical criteria. To qualify, the IVF procedure must use the patient’s egg and the spouse’s sperm.
Illinois law requires insurance to cover up to six IVF cycles, or four if a live birth has not yet occurred. Coverage also includes fertility preservation for individuals experiencing iatrogenic infertility. This mandate applies to group health plans with 25 or more employees.Illinois
Kentucky
Kentucky law mandates coverage for oocyte and sperm preservation when an individual is undergoing medical treatment that could cause infertility. This coverage includes both the evaluation process and the storage of reproductive material for up to one year.
Louisiana only mandates insurance coverage for fertility preservation services when medically necessary for cancer patients. IVF and other assisted reproductive technology procedures are not included under this mandate.Louisiana
Maine
This state requires insurance coverage for infertility diagnosis, treatment and preservation services. However, it does not cover the use of donor gametes or surrogacy-related costs.
This state mandates coverage for up to three IVF attempts per live birth, with a lifetime cap of $100,000. The coverage applies to both individual and group health plans that offer pregnancy-related benefits.Maryland
Massachusetts
Massachusetts mandates broad infertility coverage with no lifetime dollar caps and minimal limitations. This coverage includes IVF, egg freezing, ICSI and other fertility services.
This state mandates fertility preservation coverage for cancer patients whose treatments may impair fertility. Coverage is required under both individual and group health plans, including Medicaid.Montana
New Hampshire
This state covers IVF, egg and sperm preservation and the use of donor gametes. However, it does not extend coverage to gestational carriers.
New Jersey mandates coverage for up to four IVF egg retrievals and unlimited embryo transfers, provided they follow the guidelines set by the American Society for Reproductive Medicine (ASRM). This mandate applies to group health plans with 50 or more employees.New Jersey
New York
This state covers up to three IVF cycles under large group health plans. The coverage also includes fertility preservation services and prohibits discrimination based on age, sex or sexual orientation.
Ohio only requires coverage for basic infertility services under HMOs. IVF coverage is not mandated under this law.Ohio
Oklahoma
Starting in 2025, cancer patients of reproductive age will be covered for fertility preservation before treatment.
This state covers IVF and preservation services for women aged 25 to 42. There is a lifetime cap of $100,000, with a 20% copay required.Rhode Island
Texas
This state requires insurers to offer IVF coverage, but it does not mandate that coverage be included in all plans. The coverage is limited to certain patients, and it must involve the use of the patient’s and spouse’s gametes.
In Utah, public employee and Medicaid plans include IVF for specific genetic conditions and fertility preservation.Utah
Washington, D.C.
Starting in 2025, mandates three IVF cycles and preservation coverage for most private and Medicaid plans.
What Is an IVF Insurance Mandate, and Why Does It Matter for Surrogacy?
An IVF insurance mandate is a state law that requires certain insurers to provide (or offer) coverage for infertility services. These mandates are meant to ease the financial burden of treatments like IVF — and that can significantly impact your surrogacy costs.
If your insurance covers IVF, you may be able to complete embryo creation before beginning the surrogacy process. This can make a huge difference in your total budget and timeline.
IVF Coverage and Surrogacy: What’s Actually Included?
Even in states with mandated IVF coverage, is surrogacy covered by insurance? Usually, no. Here’s what to expect:
Intended parents’ medical costs for IVF and embryo creation may be covered under their own insurance. The surrogate’s medical expenses (screening, embryo transfer, prenatal care, etc.) typically aren’t covered by the intended parents’ plan. You may need separate surrogacy insurance depending on your plan and your surrogate's coverage.
You should always verify your benefits with your provider and work with an experienced agency to avoid unexpected costs.
Do IVF Mandates Apply to Surrogates or Just Intended Parents?
IVF insurance mandates usually apply only to the policyholder. That means even if you live in a state with strong IVF mandates, the surrogate's care will likely not be covered unless she has her own applicable insurance (which is rare).
This distinction is key: You’ll likely need a separate surrogacy-specific policy to cover your surrogate’s pregnancy and delivery.
How American Surrogacy Helps Intended Parents Navigate Insurance
Trying to figure out fertility coverage laws while planning your family can be overwhelming. That’s where our team comes in.
At American Surrogacy, we:
Help you understand your current insurance benefits Guide you through coverage options for your surrogate Provide cost breakdowns and budgeting support
We make it easier and more affordable to pursue surrogacy, regardless of whether your state mandates IVF coverage.
Every day counts when you're building your family, and there's no reason to wait any longer. Start your journey with free information today.