States That Expanded Coverage (2025–2026)
- California (Jan 2026): SB 729 now requires large group plans to cover IVF with no lifetime dollar cap. Previously only covered fertility diagnostics. Covers up to 3 fresh IVF cycles. One of the strongest mandates in the country.
- Virginia (July 2025): Added IVF coverage requirement for plans with 20+ employees. Includes a $30,000 lifetime max but covers diagnostics, IUI, and IVF.
- Georgia (2025): Expanded existing mandate to include IVF (previously limited to diagnostics and medication). $50,000 lifetime cap.
- Arizona (2025): New mandate requiring coverage of fertility preservation for cancer patients. Doesn’t yet cover elective IVF but opens the door.
- Hawaii (2026): Updated existing mandate to remove the requirement of 5 years of infertility before coverage kicks in. Now requires only 1 year (or 6 months for patients 35+).
What “Mandated Coverage” Actually Means
Here’s what most people miss: state mandates only apply to state-regulated insurance plans. Self-funded employer plans (common at large companies) are regulated by federal ERISA law and are not required to follow state mandates. Approximately 60% of insured Americans are on self-funded plans. So even in a state with a strong mandate, your plan might not cover fertility treatment.
How to check: call the number on the back of your insurance card and specifically ask: “Is my plan subject to state insurance mandates, or is it a self-funded ERISA plan?” Then ask about fertility benefits specifically.
1. Check your state’s current mandate at ConceiveGuide’s comprehensive state-by-state guide. 2. Call your insurer to verify your specific plan. 3. If your plan doesn’t cover IVF, explore HSA/FSA options and IVF grants.