Introduction
The majority of health insurance plans currently do not offer coverage for the treatment of infertility. It is estimated that only 14% of large group plans, 16% of preferred provider organizations (PPOs), and 17% of point-of-service networks and health maintenance organizations (HMOs) routinely cover procedures related to assisted reproductive technologies (ARTs).  For the six million Americans struggling with a medical disorder causing infertility, cost is a significant barrier to care.  The average infertile couple will pay close to $60,000 for a successful delivery using ARTs - well out of reach for many Americans without the benefit of health insurance coverage.

State Laws
13 states have enacted some form of an infertility insurance mandate, although a smaller number are meaningful on a broad scale.  Restrictions on the number of treatment cycles, strict eligibility requirements for coverage, and limited reimbursement policies ensure that many couples, even in states which provide coverage, are still denied access to needed fertility services.  For example:

• Illinois mandates insurance carriers to cover comprehensive diagnosis and treatment of infertility, although first child attempts are limited to 4 complete oocyte retrievals and second birth attempts are limited to 2.  Small businesses with less than 25 employees and government agencies are excluded from the mandate.

 
• California, Connecticut, and Texas only require insurance companies to offer coverage for the treatment of infertility.  This means that employees must be made aware that coverage exists, although insurers are not obligated to provide that coverage and employers are not required to include it in their health benefit plans.

 
• Arkansas, Texas, and Maryland require that fertilization occur with the spouse's sperm.  This excludes single women from treatment, as well as couples with male factor infertility.