Texas Fertility Insurance Coverage
Mandate to offer coverageOverview of state insurance mandates and fertility coverage requirements for Texas. Applies to fully-insured health plans regulated by the state.
Coverage Summary
| Benefit | Required by State |
|---|---|
| Mandate to offer fertility coverage | Yes |
| Diagnosis coverage | Yes |
| Treatment coverage | Yes |
| IVF included | Yes |
| Fertility preservation included | Yes |
Coverage Details
Texas is primarily a mandate-to-offer state for IVF rather than a broad mandate-to-cover state. Insurance Code Chapter 1366 requires certain insurers to offer infertility/IVF coverage to group policyholders, but the employer generally has to elect that coverage, and § 1366.005 imposes eligibility conditions when the IVF benefit is purchased: a continuous infertility history of at least five years or infertility associated with listed medical causes (such as endometriosis, in utero DES exposure, blocked or surgically removed fallopian tubes, or oligospermia), and fertilization using the spouse's sperm. Insurance Code § 1366.104 separately requires coverage for standard fertility preservation services when cancer treatment may impair fertility. Texas does not create a general Medicaid IVF benefit, religious and issuer exceptions exist in Chapter 1366, and self-funded ERISA plans are generally outside state insurance mandates.
Self-Funded Employer Plans (ERISA)
Source & Dates
- Source:
- KFF State Health Facts
- 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.
Pricing and insurance details are compiled from public sources and change frequently — confirm directly with the clinic. Full disclaimer