The Hawaii law requires certain insurance plans to provide a one-time only benefit for outpatient costs resulting from in vitro fertilization. Those plans include individual and group health insurance plans, hospital contracts or medical service plan contracts that provide pregnancy-related benefits. Patients need to meet the following conditions in order to get their IVF covered:
- The patient's eggs must be fertilized with her spouse's sperm;
- The patient or the patient's spouse must have at least a five-year history of infertility;
- The patient has been unable to get and stay pregnant through other infertility treatments covered by insurance;
- The IVF is performed at medical facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists; and
- 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; or
- Abnormal male factors contributing to the infertility.
(Hawaii Revised Statutes, Sections 431-lOA-116.5 and 432.1-604).