IVF coverage is not required in most states.

Indiana may be the next state to mandate coverage for fertility treatments

Indiana state representative Robin Shackleford (D) recently drafted House Bill 1059, a proposal that would mandate the offer of coverage for women seeking infertility treatments.

In order to qualify for in vitro fertilization coverage under the proposal, women must have exhausted all other options. The proposal notes that eligible patients must prove unable to "attain a successful pregnancy through a less costly infertility treatment for which coverage is available under the accident and sickness insurance policy." Other qualifying patients are those who have a history of infertility dating as far back as five years, or one of four preexisting medical conditions that inhibit pregnancy. 

In its current form, language in the bill stipulating that the procedure can only be covered when executed "with the sperm of the patient's spouse." This indicates that coverage does not apply if donor sperm is used, which isn't unusual.

If passed in its current form, the bill would become effective July 1, 2017.  

Averages cost for infertility treatments 

"The total combined cost can easily exceed $50,000."

According to the National Conference of State Legislators, about 12 percent of women seek out infertility treatments. The "less costly" infertility treatments referenced in Shackleford's bill most commonly consist of artificial insemination – which on average costs anywhere between $300 and $1000 – or hormone therapy – which will typically run patients $2,500 to $3,500 per month.   

Women who are unable to conceive through other methods may be recommended for IVF, which costs, on average, $12,000 per treatment, according to Forbes contributor Jennifer Gerson Uffalussy. She added that additional medications will tack on another $3,000 to $5,000.

The total combined cost for IVF paired with other infertility treatments can easily exceed $50,000.

States that currently mandate coverage
As of this writing, 15 states have laws in place regarding the coverage of infertility treatments

  • Arkansas
  • California
  • Connecticut
  • Hawaii
  • Illinois
  • Louisiana
  • Maryland
  • Massachusetts
  • Montana
  • New Jersey
  • New York
  • Ohio
  • Rhode Island
  • Texas
  • West Virginia 

It's worth nothing that California insurers cannot cover IVF. In Louisiana and New York, insurers are forbidden to exclude medical treatment for patients "solely because the medical condition results in infertility," but they are not required to offer coverage for infertility treatments. 

Other exclusions may vary according to state law, for instance, treatments that use donor eggs or sperm.

If passed, House Bill 1049 would make Indiana only the 16th state to have an active law regarding infertility insurance coverage.