New York Fertility Insurance Coverage
Partial coverage requiredOverview of state insurance mandates and fertility coverage requirements for New York. 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 York is a mandate-to-cover state for large-group IVF, not for every market. Insurance Law ?? 3221(k)(6)(C) and 4303(s)(3) require large-group policies or contracts subject to New York law to cover three IVF cycles for infertility treatment, while Insurance Law ?? 3216(i)(13), 3221(k)(6), and 4303(s) also require medically necessary fertility preservation for iatrogenic infertility across individual, small-group, and large-group markets. Individual and small-group coverage does not get the same IVF-cycle mandate, Medicaid coverage is narrower, and self-funded ERISA employer plans, some government plans, and religious exceptions can sit outside the state rule.
Self-Funded Employer Plans (ERISA)
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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