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Fertility Healthcare Coverage

Fertility-related health care is diverse and can include fertility treatment services such as medications to assist in conception, in vitro fertilization (IVF), and others. It may also include fertility preservation services, such as egg retrieval. In the United States, however, fertility-related healthcare is often not covered by insurance. As a result, some states have passed laws that require insurers to cover fertility treatment and/or preservation services. But, even when fertility healthcare is covered by insurance, many states still have definitions of “infertility” or other terms that exclude single people and many LGBTQ people from otherwise covered services. As a result, LGBTQ people may have to spend thousands of dollars in out-of-pocket costs to grow their families, even when these services are covered for other people. These Equality Maps track current laws regarding state-mandated coverage of fertility treatment and fertility preservation by both private insurers and state Medicaid programs.
United States Map
Washington New York U.S. Virgin Islands Puerto Rico Guam Commonwealth of the Northern Mariana Islands American Samoa New Hampshire Vermont Virginia Pennsylvania New York Maine West Virginia Ohio Kentucky Indiana Michigan Illinois Wisconsin North Carolina South Carolina Tennessee Georgia Florida Mississippi Missouri Arkansas Louisiana Iowa Minnesota Oklahoma Kansas Nebraska South Dakota North Dakota Texas 33 Colorado Wyoming Montana Idaho Arizona Utah Nevada Oregon California Hawaii Alaska Massachusetts Rhode Island Connecticut New Jersey Delaware Maryland Washington D.C. New Hampshire Vermont
  • State requires private insurers to cover fertility treatment care and is explicitly inclusive of LGBTQ people (6 states + D.C.)
  • State requires private insurers to cover fertility treatment care (9 states)
  • State requires coverage by at least some private insurers or of at least some fertility care, but requirements differ across states (see citations for more detail) (2 states)
  • State requires private insurers to offer coverage, but employers may still choose not to include that coverage (1 state)
  • State does not require private insurers to cover fertility treatment care (32 states, 5 territories)
  • State requires Medicaid to cover at least some fertility treatment care, though coverage differs across states (see citations for more detail) (4 states + D.C.)
  • State has requirements or language that may exclude some LGBTQ people or couples (3 states)
Please note: These maps are not intended to be legal advice or other advice related to health or insurance. Please consult with lawyers or other professionals as needed.

Thank you to GLAD for their partnership in developing these maps.

Recommended citation:
Movement Advancement Project. [Year of access]. “Equality Maps: Fertility Healthcare Coverage.”
www.mapresearch.org/equality-maps/healthcare/fertility_coverage. Accessed [day of access].

Percent of Adult LGBTQ Population Covered by Laws

*Note: These percentages reflect estimates of the LGBTQ adult population living in the 50 states and the District of Columbia. Estimates of the LGBTQ adult population in the five inhabited U.S. territories are not available, and so cannot be reflected here.

26%

26 % of LGBTQ adults (18+) live in states that require private insurers to cover fertility treatment care and are explicitly inclusive of LGBTQ people

9%

9 % of LGBTQ adults (18+) live in states that require private insurers to cover fertility treatment care

4%

4 % of LGBTQ adults (18+) live in states that require coverage by at least some private insurers or of at least some fertility care, but requirements differ across states (see citations for more detail)

8%

8 % of LGBTQ adults (18+) live in states that require private insurers to offer coverage, but employers may still choose to not include that coverage

53%

53 % of LGBTQ adults (18+) live in states that do not require private insurers to cover fertility treatment care

Fertility-related health care is diverse and can include fertility treatment services such as medications to assist in conception, in vitro fertilization (IVF), and others. It may also include fertility preservation services, such as egg retrieval. In the United States, however, fertility-related healthcare is often not covered by insurance. As a result, some states have passed laws that require insurers to cover fertility treatment and/or preservation services. But, even when fertility healthcare is covered by insurance, many states still have definitions of “infertility” or other terms that exclude single people and many LGBTQ people from otherwise covered services. As a result, LGBTQ people may have to spend thousands of dollars in out-of-pocket costs to grow their families, even when these services are covered for other people. These Equality Maps track current laws regarding state-mandated coverage of fertility treatment and fertility preservation by both private insurers and state Medicaid programs.
United States Map
  • State requires private insurers to cover fertility preservation, including storage (5 states)
  • State requires private insurers to cover fertility preservation, but not storage (8 states + D.C.)
  • State requires private insurers to cover fertility preservation, but only for cancer patients (4 states)
  • State does not require private insurers to cover fertility preservation (33 states, 5 territories)
  • State requires Medicaid to cover at least some fertility preservation services, or for at least some (i.e., cancer) patients (see citations for more details) (4 states)
Please note: These maps are not intended to be legal advice or other advice related to health or insurance. Please consult with lawyers or other professionals as needed.

Thank you to GLAD for their partnership in developing these maps.

Recommended citation:
Movement Advancement Project. [Year of access]. “Equality Maps: Fertility Healthcare Coverage.”
www.mapresearch.org/equality-maps/healthcare/fertility_coverage. Accessed [day of access].

Percent of Adult LGBTQ Population Covered by Laws

*Note: These percentages reflect estimates of the LGBTQ adult population living in the 50 states and the District of Columbia. Estimates of the LGBTQ adult population in the five inhabited U.S. territories are not available, and so cannot be reflected here.

11%

11 % of transgender adults (18+) live in states that require private insurers to cover fertility preservation, including storage

24%

24 % of transgender adults (18+) live in states that require private insurers to cover fertility preservation, but not storage

10%

10 % of transgender adults (18+) live in states that require private insurers to cover fertility preservation, but only for cancer patients

55%

55 % of transgender adults (18+) live in states that do not require private insurers to cover fertility preservation



Data current as of 10/18/2024
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Sexual Orientation Policy Tally

The term “sexual orientation” is loosely defined as a person’s pattern of romantic or sexual attraction to people of the opposite sex or gender, the same sex or gender, or more than one sex or gender. Laws that explicitly mention sexual orientation primarily protect or harm lesbian, gay, and bisexual people. That said, transgender people who are lesbian, gay or bisexual can be affected by laws that explicitly mention sexual orientation.

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“Gender identity” is a person’s deeply-felt inner sense of being male, female, or something else or in-between. “Gender expression” refers to a person’s characteristics and behaviors such as appearance, dress, mannerisms and speech patterns that can be described as masculine, feminine, or something else. Gender identity and expression are independent of sexual orientation, and transgender people may identify as heterosexual, lesbian, gay or bisexual. Laws that explicitly mention “gender identity” or “gender identity and expression” primarily protect or harm transgender people. These laws also can apply to people who are not transgender, but whose sense of gender or manner of dress does not adhere to gender stereotypes.

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