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Maryland

The Maryland law requires health and hospital insurance policies issued or delivered in Maryland that provide pregnancy-related benefits to also cover the outpatient costs of in-vitro fertilization. HMO's must provide IVF benefits to the same extent as the benefits provided for other infertility services.

Coverage may be limited to three in vitro fertilization attempts per live birth and a maximum lifetime benefit of $100,000. The IVF is to be performed at facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists.

Patients need to meet the following conditions in order to have their IVF covered:

  • The patient must be a policyholder or subscriber or a covered spouse of the policyholder of subscriber and the patient is unable to get pregnant through less expensive covered treatments.

  • For patients whose spouse is of the opposite sex, the patient and his or her spouse must have at least a two-year history of infertility or their infertility is related to a specified condition: endometriosis; fetal exposure to diethylstilbestrol (DES); blocked or surgically removed fallopian tubes; or abnormal male factors, including oligozoospermia. The male spouse's sperm must be used to fertilize the female spouse’s eggs unless he is unable to produce or deliver functional sperm and this inability is not due to voluntary sterilization.

  • For patients whose spouse is of the same sex, there must be six attempts of artificial insemination over the course of two years failing to result in a pregnancy or their infertility is related to one of the specified conditions above.

Providers covered by this article are not responsible for costs of acquiring donor sperm.

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.

Regulations that took effect in 1994 exempt businesses with 50 or fewer employees from having to provide the IVF coverage.

(Maryland Insurance Article §15-810, Health General Article §19-706 Annotated Code of Maryland 2017 Replacement Volume).
ReproductiveFacts.org
is a patient education website of ASRM.
 

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