In Texas, insurers are required to “offer” coverage for IVF treatment. However, this only means that an insurer is legally obligated to let an employer know that this coverage is available. The law does not actually require insurers to provide coverage and it does not obligate employers to include fertility treatment in their health plans.
If that wasn’t bad enough, coverage for IVF treatment is only triggered if a patient and their spouse have a documented “continuous five-year history” of unexplained infertility or the infertility is associated with (i) endometriosis, (ii) fetal exposure to diethylstilbestrol, (iii) blocked or surgical removal of fallopian tubes; or (iv) male factor, specifically oligospermia.
In addition, “religious employers” are exempt from this law, as are employers who self-insure.
Want to improve Texas’ 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?