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.
The law defines treatment as including, but not limited to:
- Diagnosis and diagnostic tests;
- Surgery; and
- Gamete Intrafallopian Transfer, also known as GIFT.
The law specifically exempts insurers from having to offer in vitro fertilization coverage. Also, the law does not require employers that are religious organizations to offer coverage for treatment that conflicts with the organization's religious and ethical purposes. (California Health and Safety Code, Section 1374.55).