This law requires all health insurers that cover maternity benefits to cover the cost of in vitro fertilization (IVF) Health maintenance organizations, commonly called HMOs, are exempt from the law. Patients need to meet the following conditions in order to get their IVF covered:
- The patient must be the policyholder or the spouse of the policyholder and be covered by the policy;
- The patient's eggs must be fertilized with her spouse's sperm;
- The patient and her spouse must have at least a two-year history of unexplained infertility, OR the infertility must be associated with one or more of the following conditions:
- Fetal exposure to diethylstilbestrol, also known as DES;
- Blocked or surgically removed fallopian tubes that are not a result of voluntary sterilization; or
- Abnormal male factors contributing to the infertility.
- The patient has not been able to achieve a successful pregnancy through any other less costly infertility treatment for which coverage is available under the policy.
- IVF procedure must be performed at a medical facility licensed or certified by the Arkansas Department of Health. Those facilities certified by the Department of Health must conform to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization clinics or meet the American Fertility Society's (sic) minimal standards for programs of in vitro fertilization.
The IVF benefits are subject to the same deductibles and co-insurance payments as maternity benefits. The law also permits insurers to limit coverage to a lifetime maximum of $15,000. (Arkansas Statutes Annotated, Sections 23-85-137 and 23-86-118).