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Insurance Coverage for Infertility in Sacramento, CA

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Fertility diagnosis, fertility treatments and fertility drugs can be expensive. Currently, there are only 15 states that mandate insurance coverage for infertility treatment. Luckily for Sacramento residents, California is one of these states.

The California Health and Safety Code, Section 1374.55 describes the state’s mandate for infertility insurance coverage. According to this code, all insurers must offer coverage for infertility services, including diagnosis and treatment. All plans that cover hospital, surgical, or other medical expenses must offer the coverage, though they do not require employers to provide the coverage in their plans.

This code defines infertility as a condition recognized by a doctor which impedes the ability to conceive or carry a pregnancy to term. If this occurs over a year’s time, it meets the code’s definition of infertility. The code lists diagnostic tests, surgery, medication, and GIFT as infertility treatments.

The California code does have a few exclusions. It explicitly excludes IVF from the list of approved procedures and treatments. Also, certain religious organizations are exempt from offering the coverage if their beliefs contradict with infertility treatments.

Each insurance plan is different, so it is helpful to talk with your plan provider before you begin your infertility treatments.

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