California
The California law requires certain insurers to offer coverage for infertility diagnosis and treatment. That means group health insurers covering hospital, medical or surgical expenses must let employers know infertility coverage is available. However, the law does not require those insurers to provide the coverage; nor does it force employers to include it in their employee insurance plans.The law defines infertility as:
- The presence of a demonstrated condition recognized by a licensed physician and surgeon as a cause of infertility; or
- The inability to conceive a pregnancy or carry a pregnancy to a live birth after a year or more of sexual relations without contraception.
- Diagnosis and diagnostic tests;
- Medication;
- Surgery; and
- Gamete Intrafallopian Transfer, also known as GIFT.
Health insurance companies are required to cover, as a basic healthcare service, the cost of standard fertility preservation services for patients undergoing a covered treatment- such as surgery, chemotherapy, or radiation- that can directly or indirectly cause infertility. The law does not include Medi-Cal managed care health care service plan contracts or any other entity that offers coverage through California’s Division 9 of the Welfare and Institutions Code. (California Health and Safety Code Section 1374.551).