IVF Insurance Mandates by State

An interactive guide for employers

From enacted mandates to pending legislation, here's what HR and benefits leaders need to know about state fertility insurance requirements — and how to stay ahead of them.

The IVF mandate landscape is moving faster than most benefit plans can keep up. As of 2026, 25 states have laws requiring at least some level of fertility coverage — and over half of all U.S. states introduced or carried over fertility legislation this session alone. 

For HR and benefits leaders managing employees across state lines, this interactive map does the heavy lifting. Use it to track enacted laws, active legislation, and key coverage details — updated as things change.

  • Comprehensive fertility
  • Partial fertility
  • Legislation pending
  • No mandate

AB 568 / SB 566 — Fertility Coverage (2025)

Pending

AB 568 and SB 566, introduced in 2025, would require health plans to cover infertility diagnosis and treatment including IVF, and fertility preservation prior to any medical treatment that could harm fertility.

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Limited Infertility Services Mandate

Active

West Virginia requires fully insured plans to cover infertility services, but scope is limited and may not function as a broad IVF mandate. Carrier interpretation and medical necessity criteria apply.

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EHB Benchmark Update (2026)

Pending

Washington's EHB benchmark plan is being updated to include coverage of artificial insemination starting in 2026 for individual and small group plans. Broader IVF legislation remains under review.

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HB 328 — IVF Mandate (2026)

Pending

HB 328, enrolled in 2026, would require the Bureau of Insurance to select a new EHB benchmark plan for 2028 that includes up to 3 IVF cycles per lifetime plus fertility treatment and diagnosis coverage.

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Pending Legislation (H 55 / H 302)

Pending

H 55 and H 302, introduced in 2025–2026, would require health insurers and Vermont Medicaid to cover a wide range of fertility services including IVF. Bills are pending legislative action.

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Fertility Treatment & Contraception Protection Act

Active

HB 533, signed Apr 24 2025 (eff. Jul 1 2025), codified the right to obtain fertility treatments and contraception in Tennessee. Insurers must offer plans with IVF benefits, but employers choose whether to purchase.

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HB 595 / SB 463 — Freedom to Grow Our Tennessee Families Act

Pending

HB 595 / SB 463 (2025) would require all health plans to cover fertility diagnostic care, treatment, and preservation including 3 egg retrievals with unlimited embryo transfers. Pending in the legislature.

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S 27 — Reproductive Rights & IVF Coverage

Pending

S 27 (2025–2026 session) would require all HMOs and health insurance plans to offer coverage for assistive reproductive technologies including IVF, egg retrieval, ICSI, and cryopreservation. In committee.

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S 40 / S 3652 — IVF Protection Acts

Pending

S 40 and S 3652, both titled the In Vitro Fertilization Protection Act, were introduced in the 2025–2026 session to establish IVF access protections in South Carolina. Both pending in committee.

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Comprehensive Fertility Mandate

Active

Rhode Island requires coverage for infertility diagnosis and treatment, including IVF, for HMO and insurance plans with pregnancy benefits. Eligible for women ages 25–42. Among the most generous lifetime coverage limits nationally.

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Fertility Preservation Mandate (2024)

Active

Oklahoma enacted legislation in 2024 (effective 2025) requiring coverage of fertility preservation services for patients whose medical treatment may cause infertility.

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Limited Infertility Mandate (HMOs)

Active

Ohio requires HMOs offering basic health services to cover medically necessary infertility treatment. IVF, GIFT, and ZIFT are not required. Coverage is primarily diagnostic and surgical.

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Comprehensive Fertility Mandate

Active

Large group plans (100+ employees) must cover up to 3 IVF cycles. Medicaid covers 3 cycles of ovulation-inducing medications. Enacted 2020; fertility preservation for medical reasons also required.

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S 2619 — Expanded IVF Coverage (2025)

Pending

S 2619, introduced Jan 2025, would remove the 3-cycle cap on IVF and expand coverage requirements for large group plans. Pending in the Senate Insurance Committee.

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Comprehensive Fertility Mandate

Active

Requires group plans with 50+ employees and pregnancy benefits to cover up to 4 IVF cycles with ICSI, GIFT, or ZIFT, including donor eggs and gestational carriers. Applies to members under 46.

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Fertility Mandate (Large Group Plans)

Active

State law requires large group health plans to cover the diagnosis of infertility and medically necessary fertility treatment, including IVF. Cost-sharing must match other medical services.

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Comprehensive Fertility Mandate

Active

One of the strongest mandates nationally. Requires coverage for IVF and the full range of ART services without narrow restrictions. No state lifetime cap, no cycle limit. Includes fertility preservation.

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Comprehensive Fertility Mandate

Active

Mandates coverage for infertility diagnosis, treatment, IVF, and fertility preservation. Covers 3 IVF attempts per live birth with a $100,000 lifetime cap. 2024 update extended coverage to same-sex couples.

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Comprehensive Fertility Mandate

Active

Maine's infertility law (eff. Jan 1 2024) requires coverage for IVF, donor tissue, and fertility preservation for medically necessary cases. Applies to fully insured plans; self-insured employers are exempt.

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Comprehensive Fertility Mandate

Active

One of the strongest mandates nationally. Group plans with 25+ employees must cover IVF, GIFT, and ZIFT, including donor eggs and sperm. Extends to same-sex couples and single women 35+.

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SB 1259 — Fertility Preservation Expansion

Pending

SB 1259 would require health plans to cover fertility preservation services before treatments expected to harm fertility. Bill is pending in the Illinois legislature as of mid-2026.

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IVF Coverage (Limited)

Active

State law requires coverage for 1 IVF cycle for patients with at least a 5-year infertility history or qualifying conditions such as endometriosis or blocked fallopian tubes. IUI must be attempted first.

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HB 1684 — Iatrogenic Infertility (2026)

Pending

HB 1684 (2026) passed the House and would require insurance coverage for fertility preservation services for individuals whose medically necessary treatment may cause iatrogenic infertility.

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State Employee Fertility Preservation

Active

2025 law (eff. Jan 1 2026) requires state group health plans to cover fertility preservation for patients with iatrogenic infertility caused by cancer treatment. Storage covered up to 3 years.

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Broader IVF Coverage Bill (2025–2026)

Pending

A broader companion bill introduced in the 2025–2026 session would extend IVF and fertility treatment coverage to all fully insured plans beyond the state employee plan. Pending in committee.

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Comprehensive Fertility Mandate

Active

Delaware mandates coverage for iatrogenic infertility including IVF with donor eggs, sperm, or embryos, and allows use of a gestational carrier. Covers 6 egg retrievals with unlimited embryo transfers.

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Comprehensive Fertility Mandate

Active

State law requires coverage for infertility treatment including up to 2 IVF cycles, GIFT, and ZIFT, up to 4 ovulation induction cycles, and 3 IUI cycles. Applies to plans in effect 1+ year.

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HB 5374 — Expanded IVF Coverage (2026)

Active

HB 5374, enacted May 28 2026, expanded Connecticut's infertility definition and broadened IVF coverage requirements for fully insured plans.

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Comprehensive Fertility Mandate

Active

State law requires large group plans (100+ employees) to cover infertility diagnosis, treatment, and fertility preservation, including 3 completed oocyte retrievals and unlimited embryo transfers.

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IVF Access Protection (HB 1259)

Active

HB 1259 (2025) codified the right to pursue fertility care, addressing gamete and embryo use and donation, and prohibiting actions against fertility providers.

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Fertility Insurance Mandate

Active

Plans with maternity benefits must cover IVF and cryopreservation, with a $15,000 lifetime cap. HMOs and self-insured employers are exempt. IUI must be attempted before IVF is covered.

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RESTORE Act (2025)

Active

Arkansas became the first state to pass restorative reproductive medicine legislation. The 2025 RESTORE Act promotes natural fertility methods and allows providers to refuse ART on religious grounds.

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Pending Legislation (SB 1347)

Pending

AZ SB 1347 (2026) passed the Senate and would require insurers to cover fertility preservation services for reproductive-age members diagnosed with cancer whose treatment may cause iatrogenic infertility.

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IVF Provider Protection Act (SB 159)

Active

SB 159 (2024) grants civil and criminal immunity to IVF providers following the Alabama Supreme Court embryo ruling. Alabama does not mandate insurance coverage for fertility treatment.

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Pending Legislation (SF 130)

Pending

SF 130 would require health plans to cover various fertility services including IVF. The bill has been introduced and is pending legislative action in Iowa.

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Comprehensive Fertility Mandate (SB 729)

Active

SB 729 (2024) requires large group plans (100+ employees) to cover infertility diagnosis and treatment, including up to 3 IVF egg retrievals with unlimited embryo transfers. Effective Jan 1 2026.

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EHB Benchmark Expansion

Pending

CA submitted an application to CMS in May 2025 to add IVF to its Essential Health Benefits benchmark plan for individual/small group coverage. If approved, takes effect Jan 1 2027.

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Fertility Preservation Mandate (HB 94)

Active

HB 94 signed May 1 2025 (eff. Jan 1 2026) mandates coverage for medically necessary fertility preservation for patients with cancer, sickle cell disease, lupus, and similar conditions. Includes 1 year of storage.

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IVF Access Protection (HB 428)

Active

HB 428 signed May 1 2025 (eff. Jul 1 2025) codified that nothing in Georgia state law prohibits or prevents an individual from obtaining IVF treatments.

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Offer Mandate for Fertility Plans

Active

Insurers must offer plans that include infertility benefits, but IVF is explicitly excluded by statute. Coverage includes diagnostic testing and certain treatments; IVF costs are out-of-pocket.

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IVF Provider Protections (2025)

Active

2025 legislation modernized Louisiana's IVF statutes with updated provider protections, clarifying the legal framework for IVF practitioners operating in the state.

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EHB Benchmark Infertility Coverage

Active

New Mexico updated its ACA Essential Health Benefits benchmark plan to require infertility coverage. Individual and small group plans must cover infertility services; scope varies by carrier.

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Cancer Fertility Preservation (AB 428)

Active

AB 428 (2025, eff. Jan 1 2026): Insurers must cover medically necessary fertility preservation services for breast or ovarian cancer patients whose treatment may cause infertility.

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IVF Access Protection (AB 176)

Active

AB 176 (2025) prohibits governmental interference with an individual's right to use or obtain IVF services in Nevada.

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Cancer Fertility Preservation Mandate

Active

SB 516 (2023), effective 2024: insurers must cover fertility preservation services when a member is diagnosed with cancer and treatment could result in infertility. Applies to fully insured plans.

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Building Families Act (HF 1758)

Active

HF 1758, effective Jan 1 2026, requires large group plans (25+ employees) offering maternity coverage to also cover infertility diagnosis and treatment, including IVF.

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HF 1758 Expansion — All Plan Types (2026)

Pending

HF 1758 expansion bills introduced in the 2026 session would extend the mandate to individual and small group plans, not just large group. If passed, coverage would apply retroactively from Jan 1 2026.

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SB 272 — Comprehensive IVF Mandate

Pending

SB 272 (Sen. Cappelletti) would mandate nearly all plans with pregnancy benefits to cover infertility diagnosis and treatment including IVF, artificial insemination, and egg/sperm/embryo preservation, without discrimination by gender or sexual orientation.

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House Companion Bill (Rep. Mayes)

Pending

Rep. La'Tasha Mayes introduced a House companion to SB 272 in the 2025–2026 session. The bill would apply the same comprehensive infertility coverage requirements to all plans offering pregnancy-related benefits.

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IVF Offer Mandate

Active

Insurers that offer group health plans must also offer a plan that includes IVF coverage, but employers are not required to purchase it. Eligibility criteria are among the strictest nationally.

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State Employee IVF Pilot Program

Active

Utah Public Employee Health Plan provides $4,000 toward a qualified reproductive technology cycle if maternity benefit is included. A 2024 state plan amendment added Medicaid IVF coverage for carriers of certain genetic diseases.

View source

Expanded Coverage Legislation

Pending

Utah has seen ongoing legislative interest in expanding fertility coverage beyond the current pilot program. Additional legislation is expected in the 2026–2027 sessions.

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Paid Family & Medical Leave

Pending

Comprehensive fertility mandate legislation passed in 2023 and is being phased in. Full IVF coverage requirements take effect for plan years starting 2025.

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Paid Family & Medical Leave

Pending

Comprehensive fertility mandate legislation passed in 2023 and is being phased in. Full IVF coverage requirements take effect for plan years starting 2025.

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Select state

Click any state on the map to view its fertility mandate and paid family leave details

Not sure where your organization stands? We can help you figure that out.

Adding fertility coverage to stay compliant is the easy part. Managing what happens next — utilization spikes, cost exposure, high-risk pregnancies across 5 states or 45 — is where point solutions fall short.

Maven's fully managed platform is built for exactly that. We help you meet IVF mandate requirements, support employees through every path to parenthood, and keep costs in check — because 30% of Maven members conceive without ever needing treatment, and integrated maternity care drives 27% lower NICU rates and 15% fewer C-sections. That's up to $9,600 in savings per birth, one platform, and a benefit your employees will actually use. 

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Maven's fully managed platform is built for exactly that. We help you meet IVF mandate requirements, support employees through every path to parenthood, and keep costs in check — because 30% of Maven members conceive without ever needing treatment, and integrated maternity care drives 27% lower NICU rates and 15% fewer C-sections. That's up to $9,600 in savings per birth, one platform, and a benefit your employees will actually use.