Requiring insurance coverage of the diagnosis and treatment of infertility. (FE)

The bill requires that certain conditions be satisfied for coverage of procedures in connection with in vitro fertilization and specifies that, if those conditions are satisfied, the procedures that must be covered in connection with in vitro fertilization are up to three egg retrievals performed on an insured under age 42; all single embryo transfers that result from covered retrievals and that are performed on an insured under age 35; all double embryo transfers that result from covered retrievals and that are performed on an insured between ages 35 and 42; and up to five embryo transfers to an insured of embryos not resulting from covered retrievals. The bill provides that an egg retrieval is required to be covered only if all high quality embryos resulting from any previous covered egg retrieval have been used in embryo transfers performed on the insured. In addition, if the eggs retrieved under a covered retrieval are of poor quality, a health care plan must cover all double embryo transfers to an insured under age 35 and all triple embryo transfers to an insured between ages 35 and 42.

The coverage requirement applies to all health care plans that provide maternity coverage, including individual health insurance policies and group health plans, health maintenance organizations, preferred provider plans, plans of cooperative sickness care associations, plans offered by the state to its employees, and self-insured plans of counties, cities, towns, villages, and school districts.

Excluded from the requirement is health care provided to Medical Assistance recipients.

The bill provides that copayments and deductibles for the infertility coverage may not be greater than any copayments or deductibles for the maternity coverage under the health care plan. The bill also provides that the coverage required for procedures in connection with in vitro fertilization is the lifetime maximum coverage for any insured under all health care plans covering that insured during her lifetime.