Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;40(3):581-587.
doi: 10.1007/s10815-022-02697-5. Epub 2022 Dec 21.

In vitro fertilization: a cross-sectional analysis of 58 US insurance companies

Michael Ha  1 , Abigail Drees  1 , Madalyn Myers  1 , Emily R Finkelstein  2   3 , Mary Dandulakis  4 , Maxine Reindorf  5 , Dana M Roque  6 , Stephanie A Beall  4 , Sheri Slezak  1 , Yvonne M Rasko  1
Affiliations

In vitro fertilization: a cross-sectional analysis of 58 US insurance companies

Michael Ha et al. J Assist Reprod Genet. 2023 Mar.

Abstract

Purpose: Infertility affects one in eight women in the USA. In vitro fertilization (IVF) is an effective but costly treatment that lacks uniform insurance coverage. We evaluated the current insurance coverage landscape for IVF in America.

Methods: We conducted a cross-sectional analysis of 58 insurance companies with the greatest state enrollment and market share, calculated to represent the majority of Americans with health insurance. Individual companies were evaluated for a publicly available policy on IVF services by web-based search, telephone interview, or email to the insurer. Coverage status, required criteria, qualifying risk factors, and contraindications to coverage were extracted from available policies.

Results: Fifty-one (88%) of the fifty-eight companies had a policy for IVF services. Thirty-five (69%) of these policies extended coverage. Case-by-case coverage was stated in seven policies (14%), while coverage was denied in the remaining nine (18%). The most common criterion to receive coverage was a documented diagnosis of infertility (n = 23, 66%), followed by care from a reproductive endocrinologist (n = 9, 26%). Twenty-three (45%) of the companies with a policy had at least one contraindication to coverage. Three companies (6%) limited the number of IVF cycles to be covered, capping payments after 3-4 lifetime cycles.

Conclusion: Most Americans with health insurance are provided a public policy regarding IVF. However, there is great variation in coverage and requirements to receive coverage between insurers. Coupled with inconsistencies in state-level mandates and available choices for employer-sponsored plans, this may limit coverage of IVF services and, therefore, access to infertility treatment.

Keywords: Assisted reproduction; In vitro fertilization; Infertility; Insurance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Coverage of in vitro fertilization services by American insurance companies
See this image and copyright information in PMC

Comment in

References

    1. Kushnir VA, Smith GD, Adashi EY. The future of IVF: the new normal in human reproduction. Reprod Sci. 2022;29(3):849–856. doi: 10.1007/s43032-021-00829-3. - DOI - PMC - PubMed
    1. Eskew AM, Jungheim ES. A history of developments to improve in vitro fertilization. Mo Med. 2017;114(3):156–159. - PMC - PubMed
    1. van de Wiel L. Disrupting the biological clock: fertility benefits, egg freezing and proactive fertility management. Reprod Biomed Soc Online. 2022;14:239–250. doi: 10.1016/j.rbms.2021.11.004. - DOI - PMC - PubMed
    1. Blakemore JK, Maxwell SM, Hodes-Wertz B, Goldman KN. Access to infertility care in a low-resource setting: bridging the gap through resident and fellow education in a New York City public hospital. J Assist Reprod Genet. 2020;37(7):1545–1552. doi: 10.1007/s10815-020-01781-y. - DOI - PMC - PubMed
    1. Schmidt L. Effects of infertility insurance mandates on fertility. J Health Econ. 2007;26(3):431–446. doi: 10.1016/j.jhealeco.2006.10.012. - DOI - PMC - PubMed