Requires individual and group health insurance policies that provide pregnancy-related benefits to cover medically necessary expenses for diagnosis and treatment of infertility and standard fertility-preservation services.
Impact
The proposed bill also removes the previous lifetime cap of $100,000 on coverage for infertility-related treatments, which advocates argue will ensure more equitable access to necessary healthcare services. Furthermore, it prohibits insurers from applying arbitrary limitations, such as age restrictions or pre-existing condition exclusions for infertility treatments. These changes are expected to enhance the affordability and availability of fertility treatments across the state, thereby aligning insurance coverage with the actual medical needs of individuals trying to conceive.
Summary
S0691 is a comprehensive bill aimed at mandating that individual and group health insurance policies providing pregnancy-related benefits must cover medically necessary expenses associated with the diagnosis and treatment of infertility. Notably, it specifies that coverage must be available irrespective of the age of the insured individuals, specifically targeting women between the ages of 25 and 42. This inclusion aims to provide broader access to fertility treatments and support for those facing infertility issues, which can significantly impact emotional and physical well-being.
Contention
While there is substantial support for the bill from various advocacy groups focused on reproductive rights, concerns have been raised regarding its fiscal implications on insurance providers and the potential for increased premiums. Some stakeholders fear that these mandates could lead to elevated insurance costs, thereby affecting the overall accessibility of health insurance services. Moreover, discussions have emerged regarding the ethical implications of mandated coverage for certain procedures, such as in vitro fertilization (IVF), particularly when donor gametes or embryos are involved.
Final_notes
As discussions continue around S0691, the balance between ensuring equitable access to infertility treatments and managing healthcare costs remains a central point of debate. As this bill progresses, stakeholders in both health policy and insurance fields will need to assess the long-term impacts it may have on both service providers and the patients they serve.
Mandates all insurance plans provide insurance coverage for diagnosing and treating infertility for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates insurance policies, provides coverage to diagnose & treat infertility for women between 25 & 42 years, including pre-implantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates insurance policies, provides coverage to diagnose & treat infertility for women between 25 & 42 years, including pre-implantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of testing and treating infertility, including preimplantation genetic testing (PGT), in conjunction with in vitro fertilization (IVF).
Outlines the insurance coverage standards, protocols and guidelines for medically necessary treatment of individuals with mental health or substance abuse use disorders.
Requires that any insurance contract issued, amended or renewed on or after January 1, 2025, that provides hospital, medical or surgical coverage shall provide coverage for medically necessary treatment of mental health or substance use disorders.
Amends the current law on health insurance coverage for fertility diagnostic care, standard fertility preservation services, and fertility treatment and requires coverage for any medically necessary ovulation-enhancing drugs and medical services.
Mandates all insurance plans provide insurance coverage for diagnosing and treating infertility for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates insurance policies, provides coverage to diagnose & treat infertility for women between 25 & 42 years, including pre-implantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates insurance policies, provides coverage to diagnose & treat infertility for women between 25 & 42 years, including pre-implantation genetic diagnosis (PGD) in conjunction with in vitro fertilization (IVF).
Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of diagnosing and treating infertility, for women between the ages of 25 and 42 years including preimplantation genetic diagnosis (PGD) in conjunction with IVF.
Mandates all insurance contracts, plans or policies provide insurance coverage for the expense of testing and treating infertility, including preimplantation genetic testing (PGT), in conjunction with in vitro fertilization (IVF).