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Delaware

The Delaware law requires that all individual and group health insurance policies delivered in the state provide for fertility care services including in vitro fertilization to those who suffer from a disease or condition which results in infertility.  The law defines infertility as a disease or condition that results in impaired function of the reproductive system whereby an individual is unable to procreate or to carry a pregnancy to live birth.

Standard infertility preservation services must be provided for individuals who must undergo medical treatment that may result in iatrogenic infertility. The law defines iatrogenic infertility as an impairment of fertility due to surgery, radiation, chemotherapy, or other medical treatment.

Coverage includes the following:
  • Intrauterine insemination
  • Assisted hatching
  • Cryopreservation and thawing of eggs, sperm, and embryos
  • Cryopreservation of ovarian and testicular tissue
  • Embryo biopsy
  • Consultation and diagnostic testing
  • Fresh and frozen embryo transfers
  • Six completed egg retrievals per lifetime, with unlimited embryo transfers using single embryo transfer (SET)
  • In vitro fertilization (IVF) including cycles in which donor eggs, sperm, or embryos are used and including cycles where the embryo is transferred to a surrogate
  • Intra-cytoplasmic sperm injection (ICSI)
  • Medications
  • Ovulation induction
  • Storage of oocytes, embryos, and tissue
  • Surgery, including microsurgical sperm aspiration
  • Services that reduce excess embryo creation through egg cryopreservation and thawing in accordance with an individual’s religious or ethical views
Qualifications for eligibility include:
  • A diagnosis of infertility or at risk for iatrogenic infertility; the covered individual has not been able to obtain pregnancy through less costly treatments.
    • No more than three cycles of ovulation induction or intrauterine insemination are required before IVF services are covered.
    • If IVF is medically necessary- no cycles of ovulation induction or intrauterine insemination are required before IVF services are covered.
    • IVF retrievals must be completed before the individual is 45 years old, and transfers must be completed before the individual is 50 years old.
Exemptions:
  • Restrictions may not be imposed on the coverage of fertility medications and services that are different from prescription drugs and nonfertility-related services.
  • A religious organization may, by request, have this coverage excluded from its policies and contracts if the required coverage conflicts with its bona fide religious beliefs and practices.
  • Employers who self-insure, or who have fewer than 50 employees, are exempt from requirements
  • Coverage is not required for experimental fertilization services, payments to gestational carriers or surrogates, or the reversal of voluntary sterilization after the covered individual has successfully procreated with their partner.
Delaware Code Title 18. Insurance Code § 3342 (i) Obstetrical and gynecological coverage; § 3556 (i) Obstetrical and gynecological coverage.
ReproductiveFacts.org
is a patient education website of ASRM.
 

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