IVF Insurance Coverage in California: What Patients Need to Know
California passed a new law (SB 729) expanding infertility insurance coverage and removing the IVF exclusion for certain health plans. While this is an important step forward, IVF is not automatically covered for everyone.
Coverage still depends on your specific insurance plan, employer, and renewal timing.
Is IVF Automatically Covered in California?
No. IVF coverage depends on several factors, including:
Whether your plan is fully insured or self-funded
Employer size
Your plan’s renewal date
Whether the plan is subject to state insurance laws
Insurance benefits do not change mid-year, even when a new law passes.
When Does the Law Take Effect?
SB 729 applies only to plans that are issued, amended, or renewed on or after January 1, 2026.
If your plan renews later in the year, required changes would not apply until that renewal date.
Why Does My Insurance Cover Infertility but Not IVF?
Many plans cover parts of fertility care, such as:
Consultations
Diagnostic testing
Bloodwork and ultrasounds
However, partial fertility coverage does not always include IVF. Some plans still exclude IVF procedures, medications, or laboratory services.
Why IVF Can Still Be Expensive — Even With Insurance
IVF involves two separate components:
Physician services (consults, monitoring, procedures)
IVF laboratory services (fertilization, embryo development, freezing, genetic testing)
Even when physician services are covered, most IVF laboratories are not contracted with insurance, and lab services often represent the largest portion of IVF costs.
Will the Clinic Tell Me What My Insurance Covers?
We can help explain how IVF services are structured and review general benefit information. However, coverage decisions are made by your insurance plan, not the clinic.
Patients should always confirm coverage directly with their insurance provider and request details in writing.
What If IVF Is Not Covered?
If IVF is not covered under your plan, we will review:
Self-pay options
Package pricing
Financing options
Whether waiting until plan renewal makes sense
Our goal is clarity, transparency, and no surprises.
If you have questions about IVF coverage or want help understanding how treatment costs are structured, our team is here to help.
Frequently Asked Questions
Is IVF covered by insurance in California?
IVF may be covered for certain health plans under California law, but coverage depends on plan type, employer, and renewal date.
When does IVF insurance coverage start in California?
The law applies to plans issued, amended, or renewed on or after January 1, 2026. Benefits do not change mid-year.
Does infertility coverage mean IVF is covered?
Not always. Many plans cover fertility testing and monitoring but still exclude IVF procedures or laboratory services.
Are HMO plans required to cover IVF?
Some HMO plans may cover fertility evaluations but not IVF. Coverage depends on whether the plan is fully insured and subject to state law.
Do self-funded employer plans have to cover IVF?
No. Self-funded plans are not required to follow state insurance mandates, even if they use a major insurance carrier.
Why are IVF laboratory services often not covered?
IVF labs are highly specialized and often operate outside standard insurance networks, resulting in out-of-pocket costs for laboratory services.
How can I confirm what my insurance covers for IVF?
Contact your insurance company directly and ask which physician services and IVF laboratory services are covered. Request confirmation in writing.