Understanding how to get IVF covered by insurance is one of the most important steps for anyone pursuing IVF. IVF treatment and related infertility services are expensive medical or hospital expenses, including fertility treatments, fertility medications, fertility preservation services, and fertility services broadly. Fertility preservation services often include standard fertility preservation services, which are crucial for individuals facing medical or other treatments that may threaten fertility. It can feel overwhelming to sort through health insurance plans, insurance policies, insurance providers, and insurance coverage rules, but as of 2025 there are more options, more laws, and more employer benefit plans, making IVF coverage more accessible for many than ever before, even though gaps remain.
At Made in the USA Surrogacy we believe surrogates deserve clarity, support, and compassion. This guide will show you what infertility coverage looks like in 2025, what state insurance laws are doing, what employer plans offer, what to ask your insurance company, and what to do if your coverage is limited or absent.
What Does IVF and Related Infertility Treatment Mean in Insurance Terms
What is IVF, Fertility Treatments, Fertility Services
In vitro fertilization, or IVF, is one type of fertility treatment, one of many fertility services or assisted reproductive technology. IVF procedures include egg retrieval, fertilization in a lab, embryo transfer, and sometimes genetic testing. Fertility treatments also include less invasive procedures such as intrauterine insemination, therapeutic donor insemination, diagnostic testing, ovulation induction, and infertility services more broadly. Fertility preservation services are another category, used when medical or other treatments might threaten fertility, or for future family planning.
Why Insurance Coverage Matters
IVF treatments are expensive, often costing tens of thousands of dollars per cycle, plus fertility medications, diagnostic testing, embryo transfers, and sometimes donor materials. Clarity about what health insurance coverage, what fertility insurance coverage or what infertility treatment coverage is available matters deeply for planning, stress management, and financial responsibility. Insurance plans may also cover other prescription medications needed during treatment. Access to these health services is crucial for patients seeking to achieve pregnancy.
State Laws, Mandates, and 2025 Changes in IVF Coverage
States Requiring IVF Coverage Under Certain Policies
As of 2025, 22 states plus Washington D.C. have passed laws related to fertility insurance coverage and infertility coverage in some form. Among those, 15 states have laws that specifically include IVF coverage under some of their state-regulated insurance plans.
One major example is California. California passed Senate Bill 729, signed in 2024, that requires fully insured large group health plans to provide coverage for diagnosis and treatment of infertility, including IVF, with a maximum of 3 completed oocyte retrievals and unlimited embryo transfers. The law’s effective date is January 1, 2026 for many plans.
Another example is Tennessee, whose Fertility Treatment and Contraceptive Act, effective July 1, 2025, codified access to IVF and other fertility services.
What State Mandates Usually Cover, and What They Don’t
State insurance laws requiring IVF coverage under health insurance plans vary widely. Some require:
- Infertility diagnosis and coverage of diagnostic testing or genetic testing
- Coverage for infertility treatment and in vitro fertilization itself, sometimes including fertility medications and other medical or hospital expenses of IVF procedures or embryo transfers
- Fertility preservation services in certain states for medical conditions that threaten fertility, including iatrogenic infertility caused by other medical treatment
But there are frequent limitations:
- Self insured plans (often large employers) are usually exempt from state mandates, meaning even in mandate states many people with employer-sponsored insurance or private insurance may not get IVF coverage
- Some plans limit coverage by number of IVF cycles, number of egg retrievals, or dollar caps for fertility treatments or infertility services
- Prior authorization, showing “medical necessity,” or requiring that less invasive treatments are tried before IVF is allowed
California’s SB 729 in Detail
SB 729 in California is changing the landscape of fertility insurance. Here are key points:
- Requires large group fully insured health benefit plans to cover infertility treatment including IVF with 3 egg retrievals and unlimited embryo transfers
- Covers diagnosis and treatment of infertility and fertility services, making IVF and related services a standard benefit for many commercial plans in California by 2026
- Expands eligibility beyond traditional definitions and prohibits discrimination based on sexual orientation
Federal Plans and Employer Health Benefit Plans
FEHB Plans for Federal Employees
The Federal Employees Health Benefits (FEHB) program has expanded infertility services, IVF coverage, and fertility insurance benefits in 2025. For example:
- Many FEHB plan options now cover in vitro fertilization services with IVF coverage without cycle or dollar limits in select plans
- All FEHB carriers are required to cover three cycles of IVF-related drugs
Employer-Provided Fertility Benefits
Outside of federal plans, many private employers are offering fertility benefits. Some key facts:
- Among employers that offer fertility benefits, 76 percent of group health plans cover IVF treatments
- Basic fertility benefits may include diagnostic testing, partial coverage for fertility medications, or infertility services. More comprehensive plans include IVF, fertility preservation services, donor support, and genetic testing
These employer and private health insurance plans vary greatly by size, state, and by whether the plan is self insured or fully insured.
How to Check If Your IVF Could Be Covered by Your Health Plan or Insurance Policy
Here are steps you can take to find out whether IVF treatments, infertility treatment coverage, fertility services, or fertility preservation coverage are included in your insurance plan.
Step-By-Step Guide
- Determine what kind of insurance plan you have, whether it is a fully insured or self insured health plan, whether it’s individual, small group, or large group.
- Obtain your insurance policy documents especially the Summary Plan Description or Evidence of Coverage, which spell out what infertility coverage is included.
- Look for specific terms such as infertility diagnosis, assisted reproductive technology, in vitro fertilization, IVF coverage, fertility services, fertility treatments, fertility medications, embryo transfer, cryopreservation or fertility preservation services.
- Ask your health insurance company directly for what they cover, how many IVF cycles they allow, what medical conditions qualify, whether prior authorization is required, whether any medical necessity proof is needed.
- Check state insurance laws in your state to see what mandates apply for infertility coverage, fertility insurance coverage, particularly those that include IVF treatments.
- Check what your employer’s health benefit plan offers if employer‐sponsored. Many employer benefit plans now include fertility benefits, sometimes IVF procedures, diagnostic testing, genetic testing, and fertility medications.
Key Questions to Ask Your Insurance Provider or Insurance Company
- Does your insurance policy or insurance plan provide IVF coverage, or does it exclude IVF treatments?
- How many IVF cycles are covered, if any, or egg retrievals, or embryo transfers?
- Are fertility medications included, meaning prescription drugs needed for stimulation and monitoring?
- Does the plan cover fertility preservation services if there is a medical condition or treatment that may cause infertility?
- Does the plan cover diagnostic testing or genetic testing or assisted reproductive technology procedures?
- What is the out-of-pocket cost, co-pays, deductible, coinsurance for infertility treatment and IVF related medical or hospital expenses?
- Does your insurance plan require prior authorization or proof of medical necessity, infertility diagnosis, or having tried less-invasive treatments first?
What If Your IVF Coverage Is Limited or Not Included
Even with the best planning sometimes IVF insurance benefits or infertility coverage are limited, or your plan may exclude them entirely. Here are options to explore.
Financial Assistance, Grants, and Loans
- There are nonprofit organizations offering grants for infertility treatment, IVF treatments, or fertility preservation services
- Some fertility clinics offer financing programs to help spread cost of IVF procedures, fertility medications, diagnostic testing, embryo transfers
- Medical financing companies or specialized lending services may provide loans for fertility treatments
Timing Treatment with Law Changes
If your state is passing a new mandate soon, or employer is renewing or issuing new health insurance policies, you may align treatment so that your policy becomes subject to updated infertility insurance coverage or IVF coverage laws.
Review Clinic Packages, Transparency, and Cost Estimates
Choose fertility clinics that provide transparent cost estimates for IVF cycles, embryo transfers, fertility preservation, and medication costs. Compare what your insurance provider says and what clinic bills. Sometimes clinics negotiate with insurance companies or offer discounted cash prices if insurance does not cover.
Special Considerations in Surrogacy IVF Coverage
Who Pays for IVF and What a Surrogate Needs to Know
In gestational surrogacy, the IVF treatments are not the responsibility of the surrogate. IVF costs are always covered outside of the surrogate’s personal insurance. Surrogates should never be expected to shoulder the costs of IVF treatments themselves.
How Our Agency Helps with IVF Coverage
At Made in the USA Surrogacy we help ensure contracts clearly define which IVF services, fertility services, fertility medications, and medical expenses will be covered. We support medical partners who provide transparent diagnostic testing, embryo transfers, and genetic testing, so that surrogates know up front what is covered and what is not.
Challenges and Common Barriers to IVF Coverage
Medical Necessity Requirements, Prior Authorization, and Diagnostic Criteria
Insurance companies often require proof of infertility diagnosis, proof of unsuccessful attempts via less invasive fertility treatments before approving IVF meaning in vitro fertilization. Diagnoses may include physical findings, hormone levels, or unexplained infertility. Overcoming these requirements involves working closely with reproductive endocrinologists, documenting medical history, diagnostic testing, and sometimes genetic testing.
Variability by State, Plan, and Employer
IVF coverage, infertility insurance coverage, fertility insurance benefits, and health insurance coverage vary greatly from state to state, between fully insured and self insured policies, employer plans, and between individual and group policies. Even in states with mandates many health insurance plans or insurance providers may exclude certain services, limit coverage amounts, limit the number of cycles, limit dollar amounts, or require exclusions for donor materials.
Cost, Out-of-Pocket, and Hidden Expenses
Even when insurance covers IVF treatments or fertility treatments, fertility medications, or diagnostic testing, there may still be large out-of-pocket costs, co-pays, coinsurance, deductibles, and medical or hospital expenses not fully covered. Be sure to get the full estimated cost from a clinic, and ask your insurance company what they will cover versus what you will owe.
What Has Changed or Is Changing in 2025
- More states are expanding coverage mandates, including mandates that include infertility treatment, infertility coverage, IVF treatments, and fertility preservation services
- FEHB Plans have expanded number of plan options offering IVF services, some with IVF coverage without cycle or dollar limits, and all FEHB carriers are required to cover three IVF-related drugs
- Health insurance companies in states with new laws are preparing to treat IVF and related fertility services as part of standard benefits in some commercial fully insured policies, even before full legal deadlines
Frequently Asked How To Get IVF Covered By Insurance Questions
Is IVF ever fully covered by insurance?
Yes in some cases. If your plan is subject to a state mandate that requires IVF coverage, or if your employer health insurance plan offers fertility benefits, or if you are covered under FEHB, you may have IVF treatments, fertility medications, medical treatment, diagnostic testing, and fertility services covered with minimal out-of-pocket cost. But often coverage is partial, limited by cycles, or requires prior authorization.
Will my insurance plan cover IVF in every situation?
Coverage varies. Some policies include IVF procedures if they cover assisted reproductive technology and fertility services broadly. However, many policies still exclude certain IVF costs.
What if my state doesn’t mandate IVF coverage?
You still have options. Check employer health plan options, see if future renewal or policy change might bring IVF coverage, use financial assistance, grants, clinic financing, or charitable help. Also monitor proposed state laws or legislation in your area, since many states are actively considering expanding infertility insurance coverage, fertility preservation coverage, and IVF coverage mandates.
Does Made in the USA Surrogacy require IVF coverage to become a surrogate?
No. Surrogates are never expected to pay for IVF treatments, fertility medications, diagnostic testing or medical or hospital expenses of IVF.
How many IVF cycles are typically covered if coverage exists?
This depends on the insurance plan, insurance provider, and what state law requires. Some plans under mandates allow up to 3 completed egg retrievals and unlimited embryo transfers. Some federal plans also have cycle or dollar limits, while others cover without cycle limits. Always check policy details.
Final Thoughts
Navigating how to get IVF covered by insurance in 2025 takes research, asking the right questions, timing things well, and sometimes advocating. Change is happening, more fertility insurance coverage and infertility treatment coverage and IVF insurance benefits are being built into state laws and employer health benefit plans.
At Made in the USA Surrogacy we work with experienced medical, legal, and insurance experts to ensure contracts clearly define which IVF treatments, fertility services, fertility medications, and medical or hospital expenses are included. If you are ready to explore becoming a surrogate or want to learn more, contact us today for a free consultation so you can move forward with clarity and confidence.
