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Does Virginia require IVF coverage?

No general fertility coverage mandate

No. Virginia does not have a general state requirement for health plans to cover IVF. Your plan may still include fertility benefits voluntarily. Virginia SCC 2028 EHB benchmark page

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.

Sources reviewed August 25, 2026. Requirements depend on the plan and the services covered.

Coverage Details

Virginia: private insurance context - Not Covered. Medicaid context - Not Covered. State mandates vary by market and plan type and generally do not control self-funded employer plans.

Coverage Summary

BenefitRequirement for qualifying plans
Insurers must offer IVF coverage (plan may decline)No
Diagnosis coverageNo
Plans must cover infertility treatmentNo
Plans must cover IVFNo
Qualifying fertility preservation coveredNo

How to Verify Your Coverage

  1. Ask your employer or plan administrator whether the plan is fully insured or self-funded.
  2. Request the plan document for infertility diagnosis, treatment, fertility preservation, medication, and laboratory benefits.
  3. Confirm prior authorization, network, age, diagnosis, cycle, and lifetime-limit requirements with the insurer.
  4. Ask the clinic billing team to verify both the clinic and laboratory providers for the services you expect to use.

Pending or Future Changes

Chapter 1048 directed Virginia to seek a 2028 essential health benefits benchmark that includes infertility diagnosis and treatment, up to three completed assisted-reproduction cycles, and fertility preservation for iatrogenic infertility. The Bureau of Insurance submitted the proposed benchmark to CMS on May 6, 2026. The current flags remain false because the proposed 2028 coverage is not yet in force.
Sources and review dates
Sources reviewed:
August 25, 2026

Clinics publishing insurance or employer-benefit information

These Virginia clinic profiles name at least one insurer or employer fertility-benefit program in a reviewed source. Inclusion does not guarantee that your plan, treatment, physician, or laboratory is covered.

Disclaimer

This is not legal or insurance advice. Verify coverage directly with your insurer and HR benefits team. Information reflects the reviewed source as of the date noted above and may not reflect recent legislative or regulatory changes.

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