Massachusetts has one of the strongest and broadest fertility mandates in the country. The state requires insurers, including state-funded health programs, to treat infertility just like any other medical condition. There is no cap on the amount of available coverage, nor on the number of IVF attempts. Though, individual health insurance policies have the option to include a specific limit on the total number of covered IVF cycles.
In other words, The “no cap” coverage applies to general insurance policies, non-profit hospital service corporations, medical service corporations and health maintenance organizations. However, policies offered on the individual market have the option to limit the number of cycles. So, basically, it boils down to the type of health policy a resident has that could dictate the number of IVF cycles they can utilize.
The state defines “infertility” as women under the age of 35 who have been unable to get pregnant for one year and women over the age of 35 who have been unable to get pregnant for six months. In addition, if someone gets pregnant but is unable to carry that pregnancy all the way to birth, this period of time is included in the calculation so they can obtain infertility treatment coverage sooner rather than later.
Want to improve Massachusetts’ fertility coverage mandates? Contact RESOLVE and ask how to help lobby for coverage in your area. You never know.
Do insurance companies have to cover IVF?