The bill amends existing health insurance laws to require that any individual and group health insurance policies providing pregnancy-related benefits must cover medically necessary expenses for the diagnosis and treatment of infertility, as well as standard fertility-preservation services, regardless of the insured's age. The definition of infertility is expanded to include a broader range of medical conditions and circumstances, ensuring comprehensive support for individuals facing infertility. Additionally, the bill removes the previous lifetime cap of $100,000 on coverage for these services, allowing individuals to access necessary treatments without financial limitations.

The bill prohibits insurers from imposing certain restrictions on infertility treatment coverage, such as deductibles, copayments, coinsurance, benefit maximums, waiting periods, or pre-existing condition exclusions. It mandates that coverage must be provided without discrimination based on age, ancestry, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation. Insurers are required to cover a minimum of four complete oocyte retrievals with unlimited embryo transfers and must include medical costs related to embryo transfers to third parties. Coverage cannot be limited based on the use of donor gametes or embryos.

The provisions of this act will apply to health plans that are entered into, amended, extended, or renewed on or after January 1, 2026, thereby enhancing access to infertility treatments and protections for individuals seeking assistance.

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