New York State IVF Mandate

As of January 2020, New York State will finally have a mandate for coverage of In-Vitro Fertilization (IVF). This exciting development will help an estimated 2.4 million people have access to this medical treatment. The new law will cover large size companies with at least 100 employees for up to three treatment cycles of IVF. The law also addresses age and lifestyle discrimination, by removing age restrictions, including expedited access to coverage for women over the age of 35. The mandate would also extend coverage to single women and same sex female couples.

Under the new law, insurance payers for all size employers and all commercial markets must cover fertility preservation, including egg and sperm freezing. This would include any medical condition or treatment that has the potential to affect future fertility, especially cancer treatments such as chemotherapy and/or radiation. Additionally, aggressive surgery for endometriosis, bone marrow transplant, sickle cell anemia, and sexual reassignment surgery would all be indications for covered IVF under the new law.

The IVF mandate does have some limitations. Coverage under the new law would not be available for small and medium- size companies of less than 100 employees. Individuals covered by employer self- funded plans, and federal plans such as Medicaid, Tricare, and Exchanges/Obamacare, would not be covered. Additionally, male same-sex couples, who require both an egg donor and a surrogate, would not be covered.

Current legislation under consideration in the NYS legislature would provide for the legalization of paid surrogacy in New York State. It is hoped that through the passage of this bill, additional access to care would include the use of surrogacy.

Please call us at 845-765-0125, email at inform@hudsonvalleyfertility.com for additional information regarding the mandate and how we can help you achieve your dream of having a child and building a family.

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