Fertility Insurance Coverage: What You Need to Know
If you’re exploring fertility treatments, one of the first questions that comes up is: Does my insurance cover it? Fertility insurance coverage varies greatly depending on your state, employer, and specific health plan. Knowing your benefits upfront can save time, stress, and money.
State Fertility Insurance Mandates
As of 2025, 22 states plus Washington D.C. have laws requiring some level of fertility coverage, but the scope differs:
- Some only cover fertility testing
- Others include medications, IUI or IVF
- Restrictions may include age limits, lifetime dollar caps, or a set number of treatment cycles
Even in states with mandates, some employers (like small businesses or religious organizations) may be exempt
If you’re unsure about your state’s laws, check your state’s Department of Insurance website or ask your HR department
What Fertility Treatments Might Be Covered?
Your fertility insurance coverage could include:
- Diagnostic testing (bloodwork, ultrasounds, semen analysis)
- Ovulation induction medications
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF) - sometimes with cycle limits
- Egg or sperm storage in medically necessary situations
Common Limitations to Know
- Pre-authorization requirements before starting treatment
- Waiting periods (time trying to conceive before coverage applies)
- Age caps for certain treatments like IVF
- Out-of-network restrictions - your preferred fertility clinic may not be covered at the same rate as in-network clinics
How to Check Your Fertility Insurance Coverage
- Call your insurance provider and request fertility coverage details
- Ask about covered treatments, cycle or dollar limits, and referral requirements
- Get all coverage details in writing
If You Don’t Have Coverage
- Ask your employer to consider adding fertility benefits
- Explore discount programs, grants, or clinic financing
- Use HSA or FSA funds for eligible expenses
- At Denver Fertility Care, if you do not have any fertility insurance coverage, we do provide a substantial discount to our self-pay patients
Fertility coverage can be complex, but understanding your state laws, employer benefits, and plan details can help you make informed decisions. At Denver Fertility Care, our financial team works closely with patients to review insurance coverage and explore payment options, so you can focus on what matters most: your path to parenthood.
