The bill would require health plans that cover obstetrical services to cover fertility treatment. Covered care could include fertility medication, artificial insemination, in vitro fertilization, embryo testing, and preservation of eggs, sperm, or embryos. Coverage would not depend on a diagnosis of infertility, and plans could not apply higher cost-sharing or different limits than they apply to other medical care. The bill also addresses coverage through Medicare, Medicaid, federal employee health plans, TRICARE, and the Department of Veterans Affairs.
If the bill became law, people enrolled in covered plans that provide obstetrical services could receive coverage for fertility treatment recommended by a health care provider, subject to the bill’s requirements. The bill would not require anyone to undergo treatment. Most provisions would take effect on different dates, including six months after enactment for many plans, October 1, 2026, for Medicaid, and January 1, 2026, for Medicare services.
The bill provides no estimate of total costs. It limits cost-sharing for covered fertility treatment to amounts no greater than those for other medical services. For Medicare, it sets payment at 100 percent of the lower of the actual charge or the applicable payment amount and waives the deductible for fertility treatment.
No publicly available information.
No publicly available information.