Coverage Mandate 1:
Scope of Mandate 2:
Coverage Cap 3:
Requirements or Limitations on Coverage 4:
La. Stat. Ann. § 22:1036 prohibits the exclusion of coverage for the diagnosis and treatment of a correctable medical condition otherwise covered by the policy, contract, or plan solely because the condition results in infertility. However, the law does not require insurers to cover fertility drugs, in vitro fertilization, other assisted reproductive techniques, or reversal of a tubal ligation/vasectomy.
1 Does the state have a coverage mandate, Y/N. Include effective date of the mandate. Specify if the mandate is to “offer” services or to “cover” them.
2Which insurers are required to comply with the mandate. If not applicable, put N/A.
3Is there a cap (annual/lifetime)?
4Does the law impose age restrictions on eligibility for coverage? Does it limit the number of IVF cycles covered (or require at least a certain number of services be covered)? Does it mandate a waiting period? Other limitations? How is “infertility” defined? Is it inclusive (e.g.: does it apply only to married or -opposite sex couples, or is it inclusive?)
5What, if any, exemptions apply to coverage under the mandate? For example: an exemption for small businesses or religious organizations.