Illinois Fertility Insurance Coverage
IVF coverage requiredOverview of state insurance mandates and fertility coverage requirements for Illinois. Applies to fully-insured health plans regulated by the state.
Coverage Summary
| Benefit | Required by State |
|---|---|
| Mandate to offer fertility coverage | No |
| Diagnosis coverage | Yes |
| Treatment coverage | Yes |
| IVF included | Yes |
| Fertility preservation included | Yes |
Coverage Details
Illinois is a mandate-to-cover state for many fully insured group plans. 215 ILCS 5/356m requires group accident and health policies providing pregnancy-related benefits to include infertility diagnosis and treatment coverage, including IVF and related ART procedures, with carve-outs for religious employers and self-insured ERISA plans. The prior 25-employee threshold is removed for plans issued or renewed on or after January 1, 2026, and the amended section adds surgical sperm extraction and PGT-A and caps coverage at 4 completed oocyte retrievals lifetime (6 after a live birth). The same section also requires medically necessary standard fertility preservation services for iatrogenic infertility. Medicaid coverage is narrower and should not be read as equivalent to the private-market IVF mandate.
Self-Funded Employer Plans (ERISA)
Source & Dates
- Source:
- State Government
- Data as of:
- 2026-06-10
- Next review:
- 2026-08-09
Disclaimer
This is not legal or insurance advice. Verify coverage directly with your insurer and HR benefits team. Self-funded employer plans (ERISA) are generally exempt from state mandates. Information reflects the reviewed source as of the date noted above and may not reflect recent legislative or regulatory changes.
Browse Fertility Clinics in Illinois
33 clinics listed in Illinois.
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