Does Aetna cover IVF?
What Aetna, a CVS Health company, publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 16 h ago
Only if your plan includes it. Aetna's infertility policy (Clinical Policy Bulletin 0327, last reviewed July 16, 2026) says IVF and other assisted reproduction are covered only on plans with an ART benefit, and that coverage varies with state laws and how each plan is set up. Where a plan includes it, IVF has to be precertified through Aetna's National Infertility Unit and meet the policy's medical criteria, such as a day 3 FSH under 19. Many Aetna plans now cover IUI without an infertility diagnosis, but IVF, fertility drugs and donor eggs or sperm still depend on the plan.
What Aetna's own documents say
Read on Oct 12, 2026. The words in quotation marks are the source's own.
Only if your plan includes it
“Advanced Reproductive Technology Note: Coverage is limited to plans with an ART benefit; please check benefit plan descriptions.”
“For purposes of this entire policy, coverage is subject to the terms and conditions of the member's benefit plan. Coverage may vary due to state mandates and plan customization; please check plan documents.”
“Coverage of other fertility services – such as medication, surgery, in vitro fertilization (IVF) and donor sperm or eggs – hasn’t changed. It’s based on plan benefits.”
Who qualifies under the policy
The policy counts people who need donor eggs, sperm or embryos, alone or with a partner, and says the definition may not be used to deny treatment over relationship status or sexual orientation. Before IVF it generally expects a trial of insemination (12 months or 4 IUI cycles under 35, 6 months or 3 cycles at 35 and over), waived when IVF is the only treatment that would work.
“the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner”
“For women under 35 years of age, an appropriate trial of egg-sperm contact requires 12 months of regular intravaginal inseminations or 4 cycles of timed intrauterine or intracervical inseminations, documented in the medical record. For women 35 years of age and older, an appropriate trial of egg-sperm contact requires 6 months of regular intravaginal inseminations or 3 cycles of timed intrauterine or intracervical insemination, documented in the medical record. This requirement applies to all individuals regardless of sexual orientation or the availability of a reproductive partner.”
“For IVF procedures under the ART benefit, these requirements for a trial of egg-sperm contact are waived for persons for whom intravaginal, intrauterine, or intracervical inseminations would not be expected to be effective and IVF procedures are the only effective treatment”
Age and egg-reserve limits
IVF is not covered for women 40 and older who have gone through natural menopause. Some plans exclude IVF with your own eggs when ovarian reserve is low, judged by a cycle day 3 FSH test: under 40 the latest result must be below 19 mIU/mL, and at 40 and older every earlier result must be. At 37 or younger the policy first expects three cycles of ovulation-inducing drugs; at 38 and older it does not.
“ART services for women 40 years of age and older with natural menopause is not covered because it is not considered medically necessary treatment of disease; natural menopause is not considered a disease.”
“For women who are less than 40 years of age, the day 3 FSH must be less than 19 mIU/mL in their most recent laboratory test to use their own eggs.”
“For women 37 years of age or younger, three cycles of oral or injectable ovulation induction (with or without intravaginal, intrauterine, or intracervical inseminations); or For women 38 years of age or older, no trial of ovulation induction is required;”
Precertification through the National Infertility Unit
IVF, IUI with injectable drugs and other assisted reproduction are precertified through Aetna's National Infertility Unit. An in-network clinic asks for it; with an out-of-network clinic, you are responsible for getting it.
“Once there is a plan for infertility treatment using ovulation induction with injectable fertility medications, artificial insemination, or assisted reproductive technology (ART), your provider will submit precertification to the National Infertility Unit (NIU) using the online Provider Portal: www.availity.com, or by contacting NIU at phone number: 1-800-575-5999.”
“In-Network Infertility providers are responsible for treatment authorizations. If you are doing treatment with an infertility specialist, you may contact Member Services to confirm whether your provider is In-Network for your plan. If you are treating with an Out-of-Network provider, the member would be responsible for obtaining precertification.”
The Institutes of Excellence network
Aetna runs a limited infertility network it calls Institutes of Excellence, and some plans require you to use one of its clinics.
“Aetna has an Institute of Excellence (IOE) infertility network, which is a limited network of providers that offer high-quality, high-value infertility care. Check with your plan to confirm if you need to use an IOE for infertility services.”
Fertility drugs
Many Aetna plans exclude injectable fertility drugs or limit how many cycles of them are covered, and drugs you inject yourself usually fall under the pharmacy benefit rather than the medical one. The injectables used in IVF (Gonal-f, Follistim, Menopur, Cetrotide, ganirelix, Ovidrel and hCG) need precertification on plans that require it.
“Note: Many plans exclude coverage for infertility injectable medications; other plans may limit coverage of ovulation induction cycles with menotropins to a maximum number per lifetime. Please check plan documents for details. Note: Under most Aetna benefit plans, self-administered prescription medications are covered under the pharmacy benefit.”
“Precertification of Cetrotide (cetrorelix acetate), ganirelix acetate, Follistim AQ (follitropin beta), Gonal-F (follitropin alfa), Menopur (menotropins), Novarel (chorionic gonadotropin), Pregnyl (chorionic gonadotropin), Ovidrel (choriogonadotropin alfa), and chorionic gonadotropin is required of all Aetna participating providers and members in applicable plan designs.”
IUI without an infertility diagnosis
Since September 1, 2024 Aetna covers IUI on eligible plans without an infertility diagnosis, whatever a member's sexual orientation or partner status, without precertification or a separate fertility benefit. The change reaches most plans at their renewal.
“Our industry-leading policy change expands coverage of IUI, without an infertility diagnosis and regardless of a member’s sexual orientation or partner status. We cover IUI without precertification or the need for extra fertility benefits on eligible plans.*”
“Our updated coverage policy began nationwide on September 1, 2024 for many plans. It will become effective on a rolling basis for most plans on renewal.”
How a cycle is counted
On a plan that limits IVF cycles, a fresh cycle with a transfer counts as one cycle, and a retrieval without a transfer or a frozen embryo transfer counts as half. The National Infertility Unit can tell you how many you have used; Member Services can tell you what is left of a dollar limit.
“For plans with cycle limits, an ART cycle is defined as: Procedure Cycle One complete fresh IVF cycle with transfer (egg retrieval, fertilization, and transfer of embryo) One full cycle One fresh IVF cycle attempted egg aspiration (with or without egg retrieval) but without transfer of embryo One-half cycle Fertilization of egg and transfer of embryo One-half cycle One cryopreserved (frozen) embryo transfer One-half cycle”
“To find out how many “cycles” have been pre-certified of your cycle count maximum limit, you may contact the National Infertility Unit at 1-800-575-5999.”
Genetic testing of embryos
Testing embryos for a known inherited condition (PGT-M) is covered for members with an ART benefit who meet Aetna's criteria. Screening embryos for chromosome counts (PGT-A) to improve IVF results is on the policy's list of experimental, investigational or unproven uses.
“Note on coverage of advanced reproduction technology (ART) for preimplantation genetic testing for monogenic disorders (PGT-M) (formerly called preimplantation genetic diagnosis [PGD]): embryo biopsy, and testing of the biopsied material, is covered for persons with an ART benefit when medical necessity criteria for PGT-M are met as set forth in CPB 0358 - Invasive Prenatal Diagnosis of Genetic Diseases.”
“Preimplantation genetic testing for aneuploidy (PGT-A) (formerly called preimplantation genetic screening (PGS)) for IVF optimization (see CPB 0358 - Invasive Prenatal Diagnosis of Genetic Diseases)”
Fertility preservation before cancer treatment
Freezing eggs, sperm or embryos is medically necessary for people facing infertility from chemotherapy, pelvic radiation, other treatment that harms fertility, or removal of the ovaries or testicles. Storage is covered when the plan or a state law requires it, and the National Infertility Unit checks whether your plan covers the cycle.
“Retrieval, freezing, and/or storage (when required by the plan or mandate) of oocytes (eggs) or sperm; and creation, freezing, and storage (when required by the plan or mandate) of embryos is considered medically necessary for use in persons facing iatrogenic infertility due to chemotherapy, pelvic radiotherapy, other gonadotoxic therapies, or ovary or testicle removal for treatment of disease.”
“The National Infertility Unit will review your benefits plan to determine if there is coverage for an Iatrogenic Fertility Preservation IVF cycle, review clinical information submitted by your provider, and determine whether applicable medical necessity criteria are met.”
Elective egg freezing
Freezing eggs, sperm or embryos in a healthy person to get ahead of age is listed as experimental, investigational or unproven, so the policy does not count it as medically necessary.
“Retrieval, freezing, and/or storage of oocytes (eggs) or sperm; and creation, freezing, and storage of embryos to circumvent reproductive aging in healthy persons is considered experimental, investigational, or unproven because of insufficient evidence in the peer-reviewed literature.”
Common exclusions
Most plans exclude infertility treatment after a sterilization, reversed or not, or a hysterectomy. Many plans that cover IVF exclude the egg donor's fees, and some exclude freezing and storing embryos or limit gestational surrogacy.
“Most plans exclude coverage of infertility services for persons who have had a previous sterilization procedure, including tubal sterilization and vasectomy, with or without surgical reversal, and for persons who have undergone a hysterectomy.”
“Many Aetna plans that otherwise cover ART exclude coverage of fees associated with oocyte donation, including recruitment and selection of donors, ovarian stimulation of donors, collection of oocytes from donors, and screening and storage of donor oocytes.”
“Note: Some Aetna plans have a specific contractual exclusion of coverage of any charges associated with embryo cryopreservation or storage of cryopreserved embryos. Please check benefit plan descriptions.”
“Note: Some plans limit and/or exclude coverage for gestational surrogacy; please check benefit plan descriptions.”
New York: same-sex couples and single people
Aetna's list of state differences notes a 2021 New York rule: on fully-insured and student plans subject to New York's infertility law, members who cannot conceive because of their sexual orientation or gender identity get immediate coverage of some services, including IUI, when the plan covers them.
“Pursuant to New York Department of Financial Services Insurance Circular Letter #3 issued February 23, 2021: Members covered under New York student health plans and fully-insured plans who are unable to conceive due to their sexual orientation or gender identity, and who also have coverage subject to the infertility mandates located at NY Insurance Law §§ 3221(k)(6)and 4303(s), are entitled to immediate coverage of certain infertility diagnostic and treatment services, including intrauterine insemination procedures, if the member’s plan covers the requested benefit.”
Whether your Aetna plan covers IVF
Aetna's policy says how it pays for IVF when a plan includes it. Three things decide whether yours does.
- 1.Your employer's choice
Most people with Aetna coverage get it through work, and the employer picks the benefits. About 50% of employers with 500 or more workers now cover IVF.
- 2.Your plan type
A fully-insured plan follows the law of the state it is issued in. A self-funded plan, which 67% of covered US workers have, does not: it covers whatever the employer chose.
- 3.Your state's law
Some states require fully-insured plans to cover IVF, some require insurers only to offer it, and most require nothing. Your state's line is below.
What specific employers publish about their fertility benefits, including which insurer or benefit company runs them: companies that cover IVF.
Does Aetna cover IVF in your state?
Each state's insurance law applied to a Aetna plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
Aetna in Arkansas
Often, on fully-insured plans: Arkansas requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Arkansas unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (lifetime maximum applies). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Arkansas law and clinics
Aetna in California
Often, on fully-insured plans: California requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in California unless one of the law's limits or exemptions applies. New for 2026: SB 729 requires large-group fully-insured plans to cover IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. California law and clinics
Aetna in Colorado
Often, on fully-insured plans: Colorado requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Colorado unless one of the law's limits or exemptions applies. Fully-insured large-group plans must cover fertility, including IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Colorado law and clinics
Aetna in Connecticut
Often, on fully-insured plans: Connecticut requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Connecticut unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Connecticut law and clinics
Aetna in Delaware
Often, on fully-insured plans: Delaware requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Delaware unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Delaware law and clinics
Aetna in District of Columbia
Often, on fully-insured plans: District of Columbia requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in District of Columbia unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. District of Columbia law and clinics
Aetna in Hawaii
Often, on fully-insured plans: Hawaii requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Hawaii unless one of the law's limits or exemptions applies. Fully-insured plans must cover a round of IVF under set conditions. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Hawaii law and clinics
Aetna in Illinois
Often, on fully-insured plans: Illinois requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Illinois unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Illinois law and clinics
Aetna in Maine
Often, on fully-insured plans: Maine requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Maine unless one of the law's limits or exemptions applies. Fully-insured plans must cover fertility care, including IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Maine law and clinics
Aetna in Maryland
Often, on fully-insured plans: Maryland requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Maryland unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (conditions apply). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Maryland law and clinics
Aetna in Massachusetts
Often, on fully-insured plans: Massachusetts requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Massachusetts unless one of the law's limits or exemptions applies. One of the broadest IVF mandates; fully-insured plans must cover it. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Massachusetts law and clinics
Aetna in New Hampshire
Often, on fully-insured plans: New Hampshire requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in New Hampshire unless one of the law's limits or exemptions applies. Fully-insured plans must cover fertility care, including IVF. A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. New Hampshire law and clinics
Aetna in New Jersey
Often, on fully-insured plans: New Jersey requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in New Jersey unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. New Jersey law and clinics
Aetna in New York
Often, on fully-insured plans: New York requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in New York unless one of the law's limits or exemptions applies. Large-group fully-insured plans must cover IVF (up to 3 cycles). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. New York law and clinics
Aetna in Rhode Island
Often, on fully-insured plans: Rhode Island requires some fully-insured health plans to cover IVF, and that includes Aetna plans issued in Rhode Island unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (lifetime cap applies). A self-funded employer plan that Aetna only administers is not bound by state law and covers IVF only if the employer chose to. Rhode Island law and clinics
Aetna in Texas
Only if your employer bought it: Texas requires insurers to offer IVF coverage to employers, but a plan does not have to include it, so an Aetna plan issued in Texas covers IVF only when the employer chose the benefit. Texas law and clinics
Aetna in Louisiana
Not because of state law: Louisiana requires some infertility coverage but not IVF, so IVF under an Aetna plan there depends on what the employer chose. Louisiana law and clinics
Aetna in Montana
Not because of state law: Montana requires some infertility coverage but not IVF, so IVF under an Aetna plan there depends on what the employer chose. Montana law and clinics
Aetna in Ohio
Not because of state law: Ohio requires some infertility coverage but not IVF, so IVF under an Aetna plan there depends on what the employer chose. Ohio law and clinics
Aetna in West Virginia
Not because of state law: West Virginia requires some infertility coverage but not IVF, so IVF under an Aetna plan there depends on what the employer chose. West Virginia law and clinics
Aetna in Georgia
Not because of state law: Georgia does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under an Aetna plan there depends on what the employer chose. Georgia law and clinics
Aetna in Kentucky
Not because of state law: Kentucky does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under an Aetna plan there depends on what the employer chose. Kentucky law and clinics
Aetna in Nevada
Not because of state law: Nevada does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under an Aetna plan there depends on what the employer chose. Nevada law and clinics
Aetna in Oklahoma
Not because of state law: Oklahoma does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under an Aetna plan there depends on what the employer chose. Oklahoma law and clinics
Aetna in Florida
Not because of state law: Florida has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Florida law and clinics
Aetna in Utah
Not because of state law: Utah has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Utah law and clinics
Aetna in Alabama
Not because of state law: Alabama has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Alabama law and clinics
Aetna in Alaska
Not because of state law: Alaska has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Alaska law and clinics
Aetna in Arizona
Not because of state law: Arizona has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Arizona law and clinics
Aetna in Idaho
Not because of state law: Idaho has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Idaho law and clinics
Aetna in Indiana
Not because of state law: Indiana has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Indiana law and clinics
Aetna in Iowa
Not because of state law: Iowa has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Iowa law and clinics
Aetna in Kansas
Not because of state law: Kansas has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Kansas law and clinics
Aetna in Michigan
Not because of state law: Michigan has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Michigan law and clinics
Aetna in Minnesota
Not because of state law: Minnesota has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Minnesota law and clinics
Aetna in Mississippi
Not because of state law: Mississippi has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Mississippi law and clinics
Aetna in Missouri
Not because of state law: Missouri has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Missouri law and clinics
Aetna in Nebraska
Not because of state law: Nebraska has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Nebraska law and clinics
Aetna in New Mexico
Not because of state law: New Mexico has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). New Mexico law and clinics
Aetna in North Carolina
Not because of state law: North Carolina has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). North Carolina law and clinics
Aetna in North Dakota
Not because of state law: North Dakota has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). North Dakota law and clinics
Aetna in Oregon
Not because of state law: Oregon has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Oregon law and clinics
Aetna in Pennsylvania
Not because of state law: Pennsylvania has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Pennsylvania law and clinics
Aetna in South Carolina
Not because of state law: South Carolina has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). South Carolina law and clinics
Aetna in South Dakota
Not because of state law: South Dakota has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). South Dakota law and clinics
Aetna in Tennessee
Not because of state law: Tennessee has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Tennessee law and clinics
Aetna in Vermont
Not because of state law: Vermont has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Vermont law and clinics
Aetna in Virginia
Not because of state law: Virginia has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Virginia law and clinics
Aetna in Washington
Not because of state law: Washington has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Washington law and clinics
Aetna in Wisconsin
Not because of state law: Wisconsin has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Wisconsin law and clinics
Aetna in Wyoming
Not because of state law: Wyoming has no law requiring private plans to cover IVF, so IVF under an Aetna plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Wyoming law and clinics
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your Aetna plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Open your plan's benefit document in the Aetna member portal at aetna.com (your employer's plan document) and look for "infertility" or "advanced reproductive technology": that is where an ART benefit, and any cycle or dollar limit, is written.
- 2Call Member Services on the back of your card and ask three things: does my plan have an ART benefit, do I have to use an Institutes of Excellence clinic, and how much of any dollar limit is left.
- 3If your pharmacy benefit is through Aetna, call Aetna Pharmacy Management at 1-888-792-3862 to ask which fertility drugs are covered and at what cost.
- 4Ask HR whether your plan is fully insured or self-funded: that decides whether your state's insurance law applies (see your state below).
- 5Before treatment, make sure your clinic has precertification from the National Infertility Unit (1-800-575-5999); with an out-of-network clinic that is your job.
Aetna and IVF: common questions
Does Aetna cover IVF?
Only if your plan includes it. Aetna's infertility policy, last reviewed July 16, 2026, says IVF and other assisted reproduction are covered only on plans with an ART benefit, and that coverage varies with state laws and how each plan is set up. Where it is covered, IVF must be precertified through Aetna's National Infertility Unit and meet the policy's criteria.
Does Aetna cover IVF in my state?
A fully-insured Aetna plan issued in a state that requires IVF coverage has to follow that law, within its limits and exemptions. A self-funded employer plan that Aetna only administers does not, and most states require nothing, so there the employer's choice decides. The By state section of this page gives the answer for every state.
Does Aetna cover IUI?
On eligible plans, yes: since September 1, 2024 Aetna covers IUI without an infertility diagnosis, whatever a member's sexual orientation or partner status, and without precertification or a separate fertility benefit. The change reaches most plans at their renewal, and some plans still exclude or limit artificial insemination.
Does Aetna cover IVF medications?
It depends on the plan. Aetna's policy says many plans exclude injectable fertility drugs or limit them, and that drugs you inject yourself usually fall under the pharmacy benefit. If your pharmacy benefit is through Aetna, Aetna Pharmacy Management (1-888-792-3862) can tell you what your plan covers.
Does Aetna cover egg freezing?
For medical reasons, yes: freezing eggs, sperm or embryos before chemotherapy, pelvic radiation or other treatment that harms fertility is medically necessary under the policy, with storage covered when the plan or a state law requires it. Elective egg freezing in a healthy person is listed as experimental, investigational or unproven.
Does Aetna require prior authorization for IVF?
Yes. IVF, IUI with injectable drugs and other assisted reproduction are precertified through Aetna's National Infertility Unit. An in-network clinic requests it; with an out-of-network clinic, the member is responsible for getting it.
- Infertility, Clinical Policy Bulletin Number 0327 (Aetna, Last Review 07/16/2026; Next Review 05/25/2027)
- Expanding Access to Intrauterine Insemination (IUI) (Aetna)
- Fertility treatment FAQs (Aetna)
- Top 6 questions to ask about infertility services (Aetna)
- Clinical policy bulletin state deviations (Aetna)