Before beginning any discussion about insurance coverage, it’s important to explain the status of fertility benefits in the United States. Not every employer is required to cover fertility treatments; this benefit is delineated per state.
States that do require some benefit level for infertility treatments are called “mandated to cover” states, although specific rules may vary from state to state: Arkansas, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island and West Virginia are “mandated to cover” states.
Others, called “mandated to offer” states, require infertility benefits to be offered for additional purchase: California, Connecticut and Texas are “mandated to offer” states (This list may have changed as of the printing of this article).
To make it more complicated, large, national corporations oftentimes offer the same benefits company-wide, resulting in exceptions to the states’ directive. For example, you may live in a state that mandates coverage, but work for a company that is not required by the federal government to meet the state’s benefit mandate. On the other hand, if you live in a state that does not require fertility coverage; you may still be covered through your employer. In addition to these complications, many times your healthcare plan may cover some parts of your treatment even if you work in a state that does not mandate coverage. It is extremely important, therefore, that you contact your Human Resources department and your healthcare plan provider to discuss in detail your benefits.
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