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Ohio Infertility Insurance Mandate

Currently, there are only 15 states that have infertility insurance laws in place that require insurance companies to offer coverage or provide coverage for fertility treatment and IVF costs. Ohio is one of the states that has an infertility insurance mandate in place, though its guidelines for coverage remain vague.

Ohio law on insurance coverage for fertility treatment costs is found in Chapter 1751 of the Ohio Revised Code Annotated, which was enacted in 1991. According to this Ohio infertility insurance law, health maintenance organizations (HMOs) are required to cover basic health services, which means medical procedures or services that are medically necessary. Ohio law specifies that preventive health care services, including “infertility services,” must be covered.

However, Ohio code does not define “infertility services,” so there is no further explanation of which fertility treatment services would be covered. Ohio law does not specifically mention IVF costs, but it does state that the fertility procedures must be medically necessary.

According to Ohio fertility treatment insurance law, experimental procedures will not be covered, since they do not fall under “basic health care services.”

A previous Ohio law on fertility treatment coverage was recently repealed. Chapter 1742 of the Ohio Revised Annotated placed a cap of $2,000 on infertility services if a couple experiences the inability to conceive solely as a result of infertility problems, such as unexplained infertility . However, since this law was repealed, the $2,000 cap no longer applies.

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