If you reside in California and are facing infertility, you will likely benefit from the IVF laws in California, which are set to undergo major changes on the behest of Governor Gavin Newsom.
With IVF costs in the US touching over $20,000, most people had to wait for months to be able to collect the funds of their IVF or let go of their parenthood dreams. Over the past few years, so many of our US clients travelled to Mexico for IVF, where the entire process can be completed for 1/3rd of the cost.
Now, the state of California is looking to address to your plight. Governor Newsom signed SB 729 into law, requiring medical insurance coverage to include IVF.
So, what does California’s new IVF law entail and how can it benefit you?
Did SB 729 pass in California?
Yes, SB 729 was passed and signed into law by Governor Newsom on September 29, 2024, making it mandatory for large group insurance plans to cover fertility treatments, including IVF.
This will cover all individuals who need IVF, including those in the LGBTQ+ community and single individuals. Up until now, insurers in California were required to cover basic services for infertility treatments such as fertility testing, diagnosis of infertility, and sometimes, artificial insemination. IVF was often excluded from insurance.
Are singles and gays covered in SB 729?
What’s exciting about SB 729 is that not only does it make IVF more accessible, it also expands the definition of infertility to include more people.
Instead of restricting it only to heterosexual couples trying to conceive for a certain time, the new law defines infertility as the inability to reproduce either as an individual or with a partner without medical intervention.
This allows LGBTQ+ individuals and single persons to benefit from insurance coverage for IVF.
The criteria for infertility have also been broadened to consider medical factors such as age, sexual history, and diagnostic testing.
Which insurance covers IVF in California?
With California’s new fertility law, all fully insured large group plans will start covering IVF. If your employer offers a large group health plan—meaning the company has more than 50 employees—will be required to cover IVF and other fertility treatments like IVF.
All private insurers operating in California will have to abide by this.
However, if you have a small group or self-insured plan, which is commonly used by smaller businesses, SB 729 will not be applicable.
There will be an option for the small group employers to add infertility coverage, but it’s not mandated by law. If you’re insured through a small employer, you must check with them to see if your plan includes fertility treatments.
Religious employers (organizations with religious affiliations) are also exempt from this requirement.
How soon can I get IVF insurance in California?
The IVF coverage mandated by SB 729 goes into effect on July 1, 2025. However, depending upon the progress of legislative developments, this date might be pushed back to January 1, 2026.
Governor Newsom has requested for some more time to better align California’s essential health benefits (EHB) benchmark plan with SB729.
So, if you’re considering IVF and worried about the costs, you may want to start looking at your insurance options to prepare for these changes. Fertility declines with age, and if you cannot wait for another 12-16 months for these changes to take effect, you can consider IVF in Asia Europe, or Mexico, where our packages start as low as $4,200 (inclusive of medications). Get in touch for pricing and details.
What does the new IVF law of California cover?
The new IVF law will cover up to three oocyte retrievals and unlimited embryo transfers, giving you a real chance to succeed with multiple tries.
Criticism of California’s new IVF Law
The new law is likely to impact insurance premiums, as the expanded coverage could lead to higher costs for employers. The higher costs will be applicable to everyone, irrespective of their status.
So, if you’re insured through a large employer, there might be changes in your premium or plan costs with the deployment of SB 729.
While the new law doesn’t cover everyone, a lot of individuals and couples, who previously couldn’t afford IVF, stand to benefit from these developments.
Irrespective of small hiccups, SB 729 is a step forward for fertility care in California that will affect thousands of families across California.
Successful implementation of this might also pave the way for more insurance companies across America to consider adding IVF to some of their plans since infertility now affects a large population—almost 15% of the couples in the US (2).
The new IVF laws in California will help thousands of individuals trying to conceive, however it may take some time to implement. In the meantime, find your affordable IVF clinic with Infertility Aide. Get in touch for more information.
References:
- California Mandates Infertility & IVF Coverage: https://www.sequoia.com/2024/10/california-mandates-infertility-ivf-coverage/
- American Society for Reproductive Medicine. (2012). Optimizing natural fertility. Retrieved May 31, 2016, from https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/optimizing-natural-fertility/
Reviewd by: Dr. Meenakshi, PhD