Last updated November 12, 2026 · Reviewed by the Gala Health team
First: does your state's law apply to your plan?
A state mandate only helps if your plan is subject to it. RESOLVE suggests asking your employer three questions:
- Is the plan fully insured or self-funded? Fully insured plans must follow state insurance law. Self-funded plans are exempt, and KFF's 2025 Employer Health Benefits Survey puts 67% of covered workers in them.
- Is there a size threshold? Many laws exempt employers below a set size, such as fewer than 25, 50 or 100 employees, or apply only to certain markets.
- Was the policy written in the state with the law? Generally, the policy must be written in, or based in, that state.
Religious employers are also exempt from several of these laws. Our guide to whether insurance covers fertility testing has a call script for the rest.
States with fertility insurance laws
Diagnosis and testing means the law requires coverage of the workup: tests such as bloodwork, semen analysis and ultrasound. Fertility preservation means freezing eggs or sperm before a medical treatment, such as chemotherapy, that can cause infertility.
| State | Diagnosis and testing | IVF | Who it covers, key limits | Law |
|---|---|---|---|---|
| Arkansas | Not required | Yes | Individual and group plans with maternity benefits; $15,000 lifetime maximum; HMOs exempt | Ark. Code §§23-85-137, 23-86-118 |
| California | Yes, large group | Yes, large group | Fully insured large group plans (more than 100 employees) from January 2026; small group plans must only offer treatment, not IVF; fertility preservation | Cal. Health & Safety Code §1374.55; Ins. Code §10119.6 (SB 729) |
| Colorado | Yes, large group | Yes, large group | Large group plans (more than 100 employees) since 2023; 3 egg retrievals with unlimited transfers; fertility preservation | C.R.S. 10-16-104(23) |
| Connecticut | Not detailed in RESOLVE's summary | Yes | Lifetime limits of 4 ovulation induction cycles, 3 IUI and 2 IVF cycles; 12 months on the plan first; fertility preservation | Connecticut laws of 2005 and 2017 |
| Delaware | Yes, including consultation | Yes | Individual and group plans, except employers with fewer than 50 employees; 6 egg retrievals per lifetime; fertility preservation | Del. Code tit. 18, §§3342, 3556 |
| District of Columbia | Yes | Yes | Individual, small and large group plans since 2025; 3 rounds of IVF; Medicaid and Alliance cover diagnosis and ovulation drugs | 70 D.C. Reg. 010351 |
| Florida | No | No | Fertility preservation for cancer, state employee plan only, from 2026 | Fla. Stat. §110.12303(7) |
| Georgia | No | No | Fertility preservation before treatment that can cause infertility, from January 2026 | O.C.G.A. Title 33, Ch. 24 |
| Hawaii | Not required | Yes, 1 cycle | One IVF cycle after a 5-year history of infertility or a listed condition; fertility preservation for policies from December 31, 2026 | HRS §431:10A-116.5, §432:1-604 |
| Illinois | Yes | Yes | Group plans and HMOs, except employers with fewer than 25 employees; 4 egg retrievals, plus 2 after a live birth; fertility preservation | 215 ILCS 5/356m, 5/356z.29 |
| Kentucky | No | No | Fertility preservation before treatment that can cause infertility | KRS Chapter 304, Subtitle 17A |
| Louisiana | Partial | No | Plans cannot exclude diagnosis and treatment of a correctable condition only because it causes infertility; fertility preservation for cancer; IVF and fertility drugs not required | La. R.S. 22:1036 |
| Maine | Yes | Yes | All carriers since 2024: diagnostic care, treatment for fertility patients and fertility preservation | 24-A MRSA §4320-S |
| Maryland | Not required | Yes | 3 IVF attempts per live birth, $100,000 lifetime maximum; employers with fewer than 50 employees exempt; fertility preservation | MD Ins. Code §15-810 |
| Massachusetts | Yes | Yes | Plans with pregnancy benefits: diagnosis and treatment, including IVF; no different limits than other benefits | M.G.L. c.175 §47H; 211 CMR 37.00 |
| Montana | HMO plans only | No | HMOs cover basic infertility services; fertility preservation for cancer since 2024 | MCA 33-22-1521, 33-31-102(2)(v) |
| Nevada | No | No | Fertility preservation for breast or ovarian cancer, from 2026 | A.B. 428 (2025) |
| New Hampshire | Yes | Yes | Group plans: diagnosis, medically necessary treatment and fertility preservation; no arbitrary limits on attempts, dollars or age | NH RSA 417-G |
| New Jersey | Yes | Yes | Group plans and HMOs, except employers with fewer than 50 employees: diagnosis, medications, IUI and IVF | N.J.S.A. 17:48-6x |
| New York | Yes, including semen analysis, blood tests and ultrasound | Yes, large group | Group plans cover listed diagnostic tests and fertility drugs; up to 3 IVF cycles in large group plans (100 or more employees); fertility preservation in all commercial markets | NY Ins. Law §3216(13), §3221 |
| Ohio | HMO plans only | No | HMOs cover basic infertility services, including diagnostic procedures | Ohio Rev. Code §1751.01(A)(7) |
| Oklahoma | No | No | Fertility preservation for cancer, since 2025 | 36 O.S. §6060.8b |
| Rhode Island | Yes | Yes | Insurers and HMOs: diagnosis and treatment for women aged 25 to 42; $100,000 cap; up to 20% copay; fertility preservation | R.I. Gen. Laws §27-18-30 |
| Texas | No | Offer only | Insurers must offer IVF coverage, but employers can decline it; fertility preservation for cancer | Tex. Ins. Code §3.51-6; Health & Safety Code ch. 161 |
| Utah | Limited | Limited | IVF and genetic testing for listed genetic conditions; public employee pilot; Medicaid fertility preservation for cancer | Utah Code 31A-22-653 |
| West Virginia | HMO plans only | No | HMOs cover basic infertility services | W.Va. Code §33-25A-2 |
Summaries of RESOLVE's state law pages and KFF State Health Facts (data as of November 2025), checked on November 12, 2026. Self-funded employer plans are exempt in every state. This is a summary, not legal advice: confirm with your plan.
States that require coverage of fertility testing
If what you need is the workup, the states that matter are the ones that require coverage of diagnosis: California and Colorado (large group plans), Delaware, the District of Columbia, Illinois, Maine, Massachusetts, New Hampshire, New Jersey, New York and Rhode Island, with HMO-only rules in Montana, Ohio and West Virginia.
New York's law is the most specific about testing: group policies must cover diagnostic tests and procedures including semen analysis, blood tests and ultrasound, even in plans too small for its IVF rule.
Medicaid and fertility testing
Medicaid rarely covers fertility treatment, but some states cover parts of the diagnosis. According to KFF, Medicaid covers diagnosis of male or female infertility in Michigan, counseling and diagnosis in Massachusetts and Minnesota, office visits, diagnostic tests and fertility drugs in New York, diagnosis and drugs in the District of Columbia, an infertility assessment including lab testing in Georgia, and lab tests for conditions affecting reproductive health in Connecticut. Benefits can vary between Medicaid managed care plans.
No mandate in your state: what now
About half the states have no fertility insurance law, including Pennsylvania, North Carolina, Michigan, Arizona, Washington and Virginia. KFF lists no private insurance requirement in Minnesota as of November 2025. In these states your coverage is whatever your plan includes. Your options:
- Ask anyway. Plans in states without a law can still cover infertility diagnosis, and a self-funded employer may add a fertility benefit. Use the questions in does insurance cover fertility testing.
- Use pre-tax money. IRS Publication 502 counts laboratory fees that are part of medical care as medical expenses, and HSA qualified expenses follow that definition.
- Compare cash prices. On the price lists we checked, an AMH test cost $78 to $141 and a semen analysis $145 to $295. See AMH test cost, semen analysis cost and how much fertility testing costs.
- Test both partners at once. Paying test by test for two people adds up fast, which is where a single-price program like Gala Fertility helps.
Gala Fertility: the same price in every state
Gala Fertility does not depend on your state's insurance law. One program checks both partners: her bloodwork at a Quest lab, including AMH, and preconception screening; her pelvic ultrasound near you; his semen analysis with a kit sent home and his bloodwork if indicated; and one video visit where a clinician explains both partners' results together. The medical team is led by Medical Director Dr. Joshua Klein, MD, FACOG, a board-certified reproductive endocrinologist.
You start with a $29.99 introductory video meeting with the care team, credited to your first payment if you join the program. The at-home semen analysis kit does not ship to Alaska or Hawaii; couples there can still join and have his kit delivered to another address in the continental US. Gala Fertility does not do IUI or IVF; if you need them, your clinician refers you to a clinic, and the table above tells you what your plan may owe you there. See fertility telehealth by state and online fertility doctor, or go back to Gala Fertility. Ready? Start together.
Frequently asked questions
Which states require insurance to cover IVF?
RESOLVE counts 15 states with IVF insurance mandates. In the table, laws requiring IVF coverage include California and Colorado (large group plans), Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York (large group plans) and Rhode Island, with narrower rules in Arkansas, Hawaii and Utah.
Which states require insurance to cover fertility testing?
States whose laws require coverage of infertility diagnosis include California and Colorado (large group), Delaware, the District of Columbia, Illinois, Maine, Massachusetts, New Hampshire, New Jersey, New York and Rhode Island. Montana, Ohio and West Virginia require it for HMOs.
Does Texas require insurance to cover IVF?
No. Texas requires insurers to offer IVF coverage to group plans, but employers can decline it. Texas does require coverage of fertility preservation before cancer treatment.
Does California require IVF coverage?
Yes, for fully insured large group plans with more than 100 employees, starting in 2026. Small group plans must only offer infertility treatment, not IVF, and self-funded plans are exempt.
Do state fertility mandates apply to self-funded plans?
No. State insurance laws do not apply to self-funded employer plans, which cover 67% of covered workers according to KFF's 2025 Employer Health Benefits Survey.
What if my state has no fertility insurance law?
Your coverage depends on your plan. Ask your insurer or employer, use HSA or FSA funds where allowed, compare cash prices, or use a single-price program such as Gala Fertility.
Ready to talk to a provider?
Your answers go to a licensed provider, who decides whether treatment is right for you. Learn more about Gala Fertility.
More Gala Fertility guides
Sources
- RESOLVE: The National Infertility Association. Insurance coverage by state (state law summaries). Checked 2026-11-12.
- KFF State Health Facts. Infertility coverage: private insurance and Medicaid, as of November 2025. Checked 2026-11-12.
- KFF. 2025 Employer Health Benefits Survey: summary of findings (self-funding). Checked 2026-11-12.
- KFF. Coverage and use of fertility services in the U.S. 2020.
- IRS. Publication 502, Medical and Dental Expenses. Checked 2026-11-12.
- IRS. Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans. Checked 2026-11-12.
This article is for general information and is not medical advice. Talk to a licensed provider about your own health.