This bill aims to amend the Code of West Virginia by introducing a new article that mandates medical insurance providers to include infertility services in their policies. It outlines the definition of infertility, which is characterized as a disease affecting an individual's ability to conceive or carry a pregnancy to live birth. The bill emphasizes the importance of making infertility treatment accessible and affordable, citing that one in six couples are affected by infertility and that treatment can lead to significant cost savings in maternity and neonatal care. The legislation also specifies the types of coverage that must be provided, including diagnosis, medically necessary fertility treatments, and fertility preservation services for individuals undergoing medical treatments that may impair fertility.

Additionally, the bill establishes prohibited and permissible limitations on coverage, ensuring that health carriers cannot impose different deductibles, copayments, or other limitations on infertility-related services compared to other medical services. It also prohibits preexisting condition exclusions and arbitrary limitations based on factors such as age or number of attempts. The bill requires the Insurance Commissioner to propose rules for implementation and includes a severability clause to ensure that if any provision is found invalid, the remaining provisions remain effective. The effective date for this legislation is set for January 1, 2027.

Statutes affected:
Introduced Version: 33-15F-1, 33-15F-2, 33-15F-3, 33-15F-4, 33-15F-5, 33-15F-6, 33-15F-7