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Rhode Island Infertility Insurance Mandate
Currently, there are only 15 states that have laws requiring insurance companies to offer coverage or to provide coverage for fertility treatments or IVF costs. Rhode Island is one of the states that has an infertility insurance mandate in place to provide this coverage.
Rhode Island infertility insurance law is found in Chapter 27-18 in the Rhode Island General Laws. According to this law, any health insurance plan in the state of Rhode Island that includes coverage for pregnancy-related costs must also provide coverage for the medically necessary expenses related to the diagnosis and treatment of infertility. This law does not apply to contracts that provide supplemental coverage to Medicare or other governmental programs.
Rhode Island law defines infertility as “the condition of an otherwise presumably healthy married individual who is unable to conceive or sustain a pregnancy during a period of one year.
Originally enacted in 1989, the fertility treatment insurance law was amended in 2007 to raise the maximum age of coverage for women from 40 to 42. Now, insurance plans must cover fertility treatments for women between the ages of 25 to 42.
According to Rhode Island fertility treatment insurance law, the co-pay for fertility treatments or other infertility services cannot exceed 20 percent of the cost. There is a lifetime maximum coverage limit of $100,000.