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State fertility mandates: which states require coverage

A state-by-state breakdown of what's actually mandated.

Last updated February 18, 2026

What states are covered

Twenty-five states (plus Washington, D.C.) currently have some form of infertility insurance law on the books. Fifteen require IVF coverage, and twenty-one require fertility preservation when medical treatment risks impairing fertility. The map below shows the current landscape — click any state to jump to its full summary.

Alabama — No state insurance mandateALArizona — No state insurance mandateAZArkansas — IVF and fertility preservation coverageARCalifornia — IVF and fertility preservation coverageCAColorado — IVF and fertility preservation coverageCOConnecticut — IVF and fertility preservation coverageCTDelaware — Fertility preservation coverageDEDistrict of Columbia — IVF and fertility preservation coverageDCFlorida — Fertility preservation coverageFLGeorgia — Fertility preservation coverageGAIdaho — No state insurance mandateIDIllinois — IVF and fertility preservation coverageILIndiana — No state insurance mandateINIowa — No state insurance mandateIAKansas — No state insurance mandateKSKentucky — Fertility preservation coverageKYLouisiana — Fertility preservation and some infertility coverageLAMaine — IVF and fertility preservation coverageMEMaryland — IVF and fertility preservation coverageMDMassachusetts — IVF and fertility preservation coverageMAMichigan — No state insurance mandateMIMinnesota — No state insurance mandateMNMississippi — No state insurance mandateMSMissouri — No state insurance mandateMOMontana — Fertility preservation and some infertility coverageMTNebraska — No state insurance mandateNENevada — Fertility preservation coverageNVNew Hampshire — IVF and fertility preservation coverageNHNew Jersey — IVF and fertility preservation coverageNJNew Mexico — No state insurance mandateNMNew York — IVF and fertility preservation coverageNYNorth Carolina — No state insurance mandateNCNorth Dakota — No state insurance mandateNDOhio — Some infertility coverageOHOklahoma — Fertility preservation coverageOKOregon — No state insurance mandateORPennsylvania — No state insurance mandatePARhode Island — Fertility preservation coverageRISouth Carolina — No state insurance mandateSCSouth Dakota — No state insurance mandateSDTennessee — No state insurance mandateTNTexas — Fertility preservation and offer (not require) infertility or IVFTXUtah — IVF and fertility preservation coverageUTVermont — No state insurance mandateVTVirginia — No state insurance mandateVAWashington — No state insurance mandateWAWest Virginia — Some infertility coverageWVWisconsin — No state insurance mandateWIWyoming — No state insurance mandateWY
IVF and fertility preservation coverage
IVF coverage
Fertility preservation and some infertility coverage
Fertility preservation and offer (not require) infertility or IVF
Fertility preservation coverage
Some infertility coverage
No state insurance mandate

Hover or tap a state to see its category. Click to jump to its summary below. Source: RESOLVE — The National Infertility Association.

Mandates apply to fully-insured plans regulated by the state. Self-funded employer plans (about two-thirds of US employer coverage) are governed by federal ERISA law and are exempt from every state mandate listed here. The first question to ask your HR team is always: “Is our health plan fully insured or self-funded?”

State-by-state summaries

Each entry below summarizes how the state defines infertility, what coverage is required, and what's exempt. Sourced from RESOLVE: The National Infertility Association.

Questions to ask your employer

If you live or work in a mandate state and want to know whether you're actually covered, get clear answers from HR on three things:

  • Fully-insured or self-insured? Fully-insured plans must follow state insurance laws. Self-funded plans are exempt.
  • How many employees does the plan cover? Several mandates exempt employers under a certain headcount (e.g., 25 or 50 employees), and some apply only to large group plans.
  • What state is the policy written in? Generally the policy must be written and/or sitused in the state whose mandate you want to invoke.

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Sources

Cited figures (cycle counts, dollar ranges, mandate lists) reflect publicly available data as of early 2026. Always confirm specific numbers against the linked sources before relying on them — pricing, protocols, and laws change.

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