Health Coverage for IVF Act of 2025

This bill adds fertility treatment and care to the Affordable Care Act’s list of essential health benefits. It spells out what’s covered, including egg, sperm, or embryo freezing; artificial insemination; in vitro fertilization and similar treatments; embryo genetic testing; fertility medications; and donor eggs or sperm. It guarantees at least three full egg-retrieval cycles and unlimited embryo transfers from those retrievals, following medical guidelines and using single-embryo transfer when recommended. The Secretary of Health and Human Services may add other related services over time .

For plans in the individual and small‑group markets, insurers can’t make fertility care harder to get or more expensive than other medical or surgical care. They can’t set special copays, deductibles, or stricter visit limits just for fertility care, and they can’t deny benefits just because someone doesn’t have an official infertility diagnosis. If a plan uses utilization‑management tools (rules that limit or manage care), it must study and report how it applies them to fertility care for the first five plan years after the law takes effect, and federal watchdogs will publish findings. These changes would start for plan years beginning one year after the law is enacted .

Key points

• Who is affected: People with health plans in the individual and small‑group markets.
• What changes: Fertility care becomes an essential benefit with a clear list of covered services, including at least 3 egg retrievals and unlimited embryo transfers from those retrievals; no extra or stricter cost or visit limits for fertility care; no denial for lack of an infertility diagnosis; oversight of insurer rules for using these benefits .
• When: Applies starting with plan years that begin one year after enactment.