In New Jersey, insurers are required to cover the expenses related to the diagnosis and treatment of infertility when the insurer covers more than 50 people and includes pregnancy-related benefits. Infertility is defined as being unable to get pregnant after two years of unprotected sex when a woman is under the age of 35, or one year of unprotected sex when a woman is over the age of 35.
The state’s fertility mandate covers a myriad of diagnostic procedures and treatments including: (i) IVF with intracytoplasmic sperm injection, (ii) embryo transfer, (iii) artificial insemination, (iv) gamete intrafallopian transfer, and (v) zygote intrafallopian transfer. However, there is a lifetime limit of four egg retrievals. In addition, employers with less than 50 employees and companies not based in New Jersey are exempt from the fertility mandate, along with employers that are self-insured. Furthermore, religious organizations are exempt from the mandate.
Want to improve New Jersey’s 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?