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Infertility Insurance Coverage in San Jose, CA

Currently, 15 states across the US mandate insurance plans to offer infertility insurance or provide some degree of infertility treatment coverage. Infertility insurance mandates vary from state to state and coverage can range from the cost of diagnostics and surgical correction, to fertility treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF).

California is one of the states that “offer” fertility treatment, but what does this mean for you?

Infertility Insurance Coverage in San Jose, CA

  • California’s mandate requires insurers to offer coverage for infertility treatments, excluding in vitro fertilization (IVF). Employers have the option of including infertility coverage in their employee health plan, meaning it is up to the employer to decide if infertility treatment is covered.
  • Coverage is not required. Employers can select the degree of coverage, including diagnostic testing, fertility drug therapy, corrective surgery (laparoscopy, etc), or Gamete Intrafallopian Transfer (GIFT; sperm and egg are placed inside the fallopian tube where natural fertilization may occur rather than fertilized in a lab).
  • Religion-affiliated organizations are exempt from the infertility insurance coverage mandate, as are employers who self-insure.

Fertility treatment costs can add up quickly depending on the number and type of fertility drugs prescribed and number of IVF cycles needed to get pregnant. It is important to consult your insurance plan and speak with a financial counselor at your fertility clinic to verify coverage. You may be surprised to find some fertility tests, or even your consultation, visit are covered even if you do not have infertility treatment coverage.

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