New Jersey Fertility Insurance Coverage

Partial coverage required

Overview of state insurance mandates and fertility coverage requirements for New Jersey. 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

New Jersey is a mandate-to-cover state for qualifying large-group coverage. N.J.S.A. 17B:27-46.1x requires group policies with more than 50 covered persons that include pregnancy-related benefits to cover medically necessary infertility diagnosis and treatment, including IVF-related services, and related provisions extend to HMOs and the State Health Benefits and School Employees Health Benefits programs. The rule is not a blanket individual-market mandate, religious-employer exclusions may apply for specific services, Medicaid coverage remains limited, and self-funded ERISA employer plans generally are exempt from state insurance mandates.

Self-Funded Employer Plans (ERISA)

Self-funded employer health plans are generally governed by ERISA and may be exempt from state insurance mandates; verify benefits with the clinic and insurer.

Source & Dates

Source:: KFF State Health Facts
Data as of:: 2025-11-30
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.

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22 clinics listed in New Jersey.

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