Utah’s adoption law requires insurers that provide coverage for maternity benefits to also provide an adoption indemnity benefit of $4,000 for a child placed for adoption with the insured within 90 days of the child’s birth. This law was amended to allow the benefit to be used for the purpose of the enrollee obtaining infertility treatments, rather than seeking reimbursement for an adoption in accordance with terms designated by the insurer.

Utah Code 31A-22-610.1 Indemnity benefit for adoption or infertility treatments.

Public Employees’ Health Plan 3-year pilot program, 2018-2021:

  • The patient’s physician verifies that the patient or the patient’s spouse has a demonstrated condition recognized by a physician as a cause of infertility; or
  • The patient attests that the patient is unable to conceive a pregnancy or carry a pregnancy to a live birth after a year or more of regular sexual relations without contraception.
  • The patient attests that the patient has been unable to attain a successful pregnancy through any less-costly, potentially effective infertility treatments for which coverage is available under the health benefit plan.
For Medicaid patients (if waiver is approved) and Public Employees’ Health Plan, effective July 1, 2020:
  • Patient has been diagnosed by a physician as having a genetic trait associated with a qualified condition; and intends to get pregnant with a partner who is diagnosed by a physician as having a genetic trait associated with the same qualified condition as the individual.
  • Provides coverage for in vitro fertilization and genetic testing for certain individuals diagnosed by a physician as having a genetic trait associated with any of the following conditions: cystic fibrosis, spinal muscular atrophy, Morquio Syndrome, myotonic dystrophy, or sickle cell anemia.
2018 Utah Laws, Chap. 353 (HB 347) amended § 31A-22-610.1

2020 Utah Laws, Chap. 262, 393, 405, 246, 38 and 281 amended 63I-2-226 and 63I-2-249
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