The bill amends Section 27-18-30 of the General Laws to improve health insurance coverage for infertility treatments. Key changes include a comprehensive definition of "infertility," which now covers a wider range of medical conditions affecting an individual's ability to conceive. The bill mandates that health insurance policies providing pregnancy-related benefits must cover medically necessary expenses for infertility diagnosis and treatment without imposing age restrictions, as the previous limitation of coverage to women aged 25 to 42 has been removed. Additionally, it requires coverage for standard fertility-preservation services and prohibits discrimination based on age, gender identity, and marital status.

Further amendments include the removal of a lifetime cap of $100,000 on infertility treatment coverage and the prohibition of various limitations such as deductibles, copayments, and pre-existing condition exclusions. Insurers are also barred from imposing arbitrary restrictions based on factors like age or the use of donor gametes. The bill emphasizes that clinical guidelines for infertility treatment must align with current standards from recognized medical organizations, ensuring that healthcare providers can exercise their clinical judgment. Overall, the legislation aims to provide equitable and comprehensive support for individuals facing infertility challenges, with the new provisions taking effect for health plans entered into or renewed on or after January 1, 2026.

Statutes affected:
691: 27-18-30, 27-19-23, 27-20-20, 27-41-33