Maryland Infertility Insurance Mandate

The state of Maryland is one of only 15 states that has an infertility insurance mandate in place, which requires health insurance plans to offer coverage or provide coverage for fertility treatment costs. Maryland infertility insurance law can be found in the Maryland Insurance Article Section 15-810.

According to this law, health and hospital insurance policies that provide pregnancy-related benefits must also include benefits from expenses resulting from in vitro fertilization (IVF) procedures. Health maintenance organizations (HMOs) are required to provide in vitro fertilization benefits to the same extent as the benefits provided for other fertility treatments or infertility services. This 2000 Maryland fertility treatment insurance law is an amendment of the original 1985 law.

The Maryland infertility insurance mandate exempts employers from 50 or fewer employees from having to cover IVF costs. Religious organizations whose beliefs or practices conflict with fertility treatments may be exempt from this requirement, at the request of the religious organization.

Maryland Infertility Insurance Mandate Limitations

Like many of infertility insurance plans in operation by other states, Maryland’s infertility insurance law does contain a number of limitations. In order for IVF costs to be covered by insurance, the following conditions must be met:

• The patient’s eggs must be fertilized by her husband’s sperm
• The couple must have a two-year history of infertility, unless the infertility is associated with the following conditions: endometriosis, exposure in utero to diethylstilbestrol (DES), blockage or surgical removal or one or both fallopian tubes, or abnormal male factor infertility, including oligospermia (low sperm count)
• The IVF procedure must be performed at a fertility clinic or medical facility that conforms to standards and guidelines set by the American Society for Reproductive Medicine (ASRM) or the American College of Obstetricians and Gynecologists

The Maryland infertility insurance mandate also sets three as the maximum number of IVF cycles that can be covered. IVF costs from these three cycles cannot exceed the maximum lifetime benefit of $100,000.