Which states make insurers cover IVF, and with what limits?

By Berkcan K., editor · Published 2026-10-23

We read each state’s law on its own legislature’s website. In that text, 12 states and the District of Columbia require at least some insurers to cover infertility treatment, and 9 of those 13 laws name IVF or set a number of egg retrievals. Texas only makes insurers offer IVF coverage to employers, who can turn it down in writing. Even in a mandate state, a law reaches only the plans it regulates: in New York, for example, the insurance regulator says plainly that its IVF law “does not apply to self-funded ERISA plans.”

This page describes laws. It is not legal advice, and it cannot tell you what your own plan covers.

Which states have an IVF or infertility coverage law?

The table lists every law whose text we fetched from an official state website on 2026-10-23. The limits column shows only limits the statute itself states; insurers’ rules and state regulations can add more. The last column counts the clinics in that state that reported 2022 cycles to the CDC and have a page on this site (449 nationally, from the CDC 2022 Final services and profiles file).

State	Statute	What it requires	Limits stated in the text	CDC-reporting clinics
Colorado	C.R.S. 10-16-104(23)	Large employer plans issued or renewed from January 1, 2023 must cover diagnosis and treatment of infertility and fertility preservation	“Three completed oocyte retrievals with unlimited embryo transfers”; individual and small group plans only after a federal determination	8
Connecticut	Gen. Stat. 38a-536	Group policies must cover diagnosis and treatment, naming in-vitro fertilization	May limit IVF to two lifetime cycles, with no more than two embryo implantations per cycle; less expensive treatment first	7
Delaware	18 Del. C. 3556(i), 3342(i)	Group and individual policies must cover fertility care, including IVF	Six completed egg retrievals per lifetime with unlimited transfers; retrievals before 45, transfers before 50; group rule exempts self-insured employers and those under 50 employees	2
District of Columbia	D.C. Code 31-3834.06	Large group, small group and individual plans from January 1, 2025 must cover diagnosis and treatment, including IVF	At least 3 complete oocyte retrievals with unlimited embryo transfers	2
Hawaii	HRS 431:10A-116.5	Individual and group policies with pregnancy benefits must include IVF	A “one-time only benefit”; spouse’s sperm; five years of infertility or a listed condition	5
Illinois	215 ILCS 5/356m	Group policies with pregnancy benefits must cover diagnosis and treatment, including IVF (through 2025 only groups of more than 25 employees)	4 completed oocyte retrievals, plus 2 more after a live birth; less costly treatment first	21
Maine	24-A M.R.S. 4320-U	Carriers must cover fertility diagnostic care, fertility treatment and preservation	IVF not named; no waiting period; limits must follow clinical guidelines	1
Maryland	Ins. 15-810	Insurers and HMOs with pregnancy benefits may not exclude outpatient IVF	3 IVF attempts per live birth, $100,000 lifetime; some small-employer policies exempt	5
Massachusetts	G.L. c. 175, 47H	Policies with pregnancy benefits must cover diagnosis and treatment of infertility	IVF not named; no limits stated in the section	8
New Hampshire	RSA 417-G:2	Group policies must cover diagnosis, medically necessary fertility treatment and preservation	IVF not named; no limits based only on number of attempts, dollar amounts or age	1
New Jersey	P.L.2001, c.236	Contracts for groups of more than 50 with pregnancy benefits must cover diagnosis and treatment, including IVF	Four completed egg retrievals per lifetime; IVF may be limited to age 45 or younger (text as enacted in 2001)	14
New York	Ins. Law 3221(k)(6)(C), 4303(s)(3)	Large group policies (more than 100 employees) must cover IVF from January 1, 2020	Three IVF cycles over the insured’s life; no annual dollar limits	44
Rhode Island	R.I. Gen. Laws 27-18-30	Policies with pregnancy benefits must cover diagnosis and treatment for women aged 25 to 42	IVF not named; copayment up to 20%; lifetime cap of $100,000 allowed	1
Texas	Ins. Code 1366.003-.005	Offer only: group plans with pregnancy benefits must offer outpatient IVF coverage; a rejection must be in writing	Spouse’s sperm; five continuous years of infertility or a listed condition; less costly treatment first	44

The 12 states and DC that require coverage hold 119 of the 449 CDC-reporting clinics (26.5%). The 9 laws that name IVF or count retrievals hold 108 (24.1%). New York and Illinois account for 65 of them. Texas adds 44 clinics, but its law only requires an offer.

Which states did we leave out, and why?

KFF’s state tracker, which we used only to decide which statutes to read, also lists California, Arkansas and Utah. We could not get their text from an official host for this check: California’s legislature site refused our requests, we found no copy of Arkansas’s statute on a state-run site, and Utah’s code viewer returned no section text. Rather than summarize them second-hand, we left them out. California matters most here: it has 85 of the 449 clinics, more than any other state, so check the California clinic list and your plan documents directly.

Laws that only cover fertility preservation before cancer treatment, or only require HMOs to cover basic services, are outside the scope of this table.

Does a state mandate cover my plan?

Not necessarily. The text itself names its own exemptions. Delaware’s group statute says “employers who self-insure or who have fewer than 50 employees are exempt.” New York’s Department of Financial Services answers the question directly: “No. The IVF law does not apply to self-funded ERISA plans.” So a state’s coverage rule may not reach a self-funded employer plan, even when you live and work in that state.

Size thresholds matter too. New York’s IVF requirement applies to large groups, which DFS defines as “a group of more than 100 employees.” New Jersey’s applies to groups of more than 50. Colorado’s applies to large employer plans. Religious employers can ask for an exclusion in Colorado, Connecticut, Delaware, Illinois, Maryland and New Jersey.

The practical test is the plan document, not the state. Ask HR or your insurer whether the plan is fully insured or self-funded, and which state’s law it was issued under.

What limits do these laws allow?

Where a statute sets a number, it is usually counted in egg retrievals or cycles:

Retrievals or cycles: Delaware allows six completed retrievals, Illinois four (plus two after a live birth), New Jersey four, Colorado and DC three, New York three cycles, Maryland three attempts per live birth, Connecticut two cycles.
Dollar caps: Maryland and Rhode Island allow a $100,000 lifetime limit. New York bars annual dollar limits on IVF.
Age: Rhode Island covers women 25 to 42. Delaware requires retrievals before 45 and transfers before 50. New Jersey’s 2001 text lets insurers limit IVF to people 45 or younger. New Hampshire forbids limits based only on age.
Older eligibility rules: Hawaii and Texas tie IVF to the patient’s spouse’s sperm and five years of infertility or a listed condition. Maryland’s spouse-sperm rule applies only to married opposite-sex couples and has a medical exception.

Laws that do not name IVF (Maine, Massachusetts, New Hampshire, Rhode Island) still require coverage of infertility treatment. Whether a plan treats IVF as part of that depends on how the insurer and the state regulator read the law.

How to use this alongside the clinic data

Check your state’s row, then confirm with your plan whether it is fully insured and above the size threshold.
Ask the questions in questions to ask a fertility clinic about costs, especially the ones about cycle limits and medication coverage.
Compare clinics in the state. The longest lists in mandate states are New York (44), Illinois (21), New Jersey (14) and Massachusetts (8). Texas has 44 under its offer-only law. Clinics in states with one or two reporting clinics, such as Maine, Rhode Island or Delaware, are on the A to Z list of clinics.
Set two or three side by side in the clinic comparison tool. A plan’s cycle limit is easier to judge once you know a clinic’s live-birth rate per retrieval for your age band.

Laws change; each row reflects the text we fetched on 2026-10-23. Only your plan document and your insurer can tell you what is covered for you.

How many IVF clinics are in each state: the full state-by-state count behind the last column.
IVF success rates by age across clinics: what a covered cycle has produced, band by band.
Questions to ask a fertility clinic about costs: what a quote leaves out, and what to ask HR.