Table 1:
Summary of fertility benefit in states with laws related to infertility coverage
| State | Covered Treatment | Restriction of Use | Law/Code |
|---|---|---|---|
| California | Diagnosis, diagnostic testing, medication, surgery, gamete intrafallopian transfer | Exempts IVF | Cal. Health & Safety Code §1374.55, Cal. Insurance Code §10119.6 |
| Connecticut | Diagnosis of infertility; treatment of iinfertility including intrauterine insemination, embryo transfer, GIFT, ZIFT, low tubal embryo transfer | Conn. Gen. Stat. §38a-509, §38a-536 | |
| Illinois | embryo transfer, artificial insemination, GIFT, ZIFT, intracytoplasmic sperm injection | 1 yr. history of infertility or inability to carry pregnancy to term | Ill. Rev. Stat. ch. 215, §5/356m |
| Louisiana | Diagnosis and treatment of correctable medical condition | Exceptions include coverage of fertility drugs; IVF, ART, tubal ligation removal and vasectomy | La. Rev. Stat. Ann. §22:1036 |
| Massachusetts | Artificial insemination, GIFT, sperm/egg/inseminated egg retrieval (donor); ICSI, ZIFT; insurers can choose to cover experimental procedures | 1-yr. history of infertility | Mass. Gen. Laws Ann. Ch. 175, §47H, ch. 176A, §8, ch. 176B, §4J, ch. 176G, §4; 211 Code of Mass. Reg. 37.00 |
| Montana | Infertility services as part of basic preventative health care services | No definition of infertility or scope of services | Mont. Code. Ann. §33-22-1521, §33-31-102(2)(v) |
| New Jersey | Diagnosis, medication, surgery, embryo transfer, artificial insemination, GIFT, ZIFT, ICSI | 2-yr. history of infertility (under age 35) or 1-yr. history of infertility (over age 35) | N.J. State. Ann §17:48A-7w, §17:48E-35.22, §17B:27-461x |
| New York | Diagnosis and treatment of infertility | Between 21 and 44 yrs of age, excludes IVF, GIFT, ZIFT, experimental procedures | N.Y. Insurance Law §3216(13), §3221(6), §4303 |
| Ohio | Basic preventative health services including infertility | No definition of services but must be medically necessary; does not cover experimental procedures | Ohio Rev. Code Ann. §1751.01(A)(7) |
| West Virginia | Medically necessary infertility services | No definition of services | W. Va. Code §33-25A-2 |
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This table does not include Arkansas, Hawaii, Maryland, Rhode Island, Texas. These four states have a fertility benefit that only requires coverage of female infertility diagnosis or treatment.