Does Blue Cross Blue Shield of Illinois cover IVF?
What Blue Cross and Blue Shield of Illinois (Health Care Service Corporation) publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 2 wk ago
It depends on your plan, and Illinois law decides it for many fully insured plans. The medical policy Blue Cross and Blue Shield of Illinois shares with its sister plans (effective January 1, 2026) says to check the member's plan first: infertility services are covered only if the plan includes them, and the plan sets what is excluded and capped. Illinois requires many fully insured plans to cover IVF, and the policy applies two more Illinois rules: fertility preservation when a treatment may cause infertility, and a definition of infertility that includes being unable to reproduce as a single person. A self-funded employer plan follows the employer's choice instead of state law.
What the Blue Cross and Blue Shield of Illinois documents say
Read on Oct 12, 2026. The words in quotation marks are the source's own.
Depends on your plan and Illinois law
“NOTE 1: Carefully check the member’s benefit plan, summary plan description or contract for language specific to infertility services. IF infertility services are determined to be eligible for member benefits, then the following services that are listed as medically necessary should be considered for benefit coverage.”
“Each benefit plan, summary plan description or contract defines which services are covered, which services are excluded, and which services are subject to dollar caps or other limitations, conditions or exclusions. Members and their providers have the responsibility for consulting the member's benefit plan, summary plan description or contract to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If there is a discrepancy between a Medical Policy and a member's benefit plan, summary plan description or contract, the benefit plan, summary plan description or contract will govern.”
Illinois's definition of infertility
On policies issued from January 1, 2022, Illinois law defines infertility as failing to get pregnant or carry a pregnancy to live birth after 12 months of unprotected intercourse at 35 or younger, or 6 months over 35 (a miscarriage does not restart the clock), or being unable to reproduce as a single person or with a partner without medical help.
“EXCEPTION: For policies issued on or after January 1, 2022, Illinois law (215 ILCS 5/356m; Public Act 102- 0170) states infertility means a disease, condition, or status characterized by: 1) a failure to establish”
“to carry a pregnancy to live birth after 12 months of regular, unprotected sexual intercourse if the woman is 35 years of age or younger, or after 6 months of regular, unprotected sexual intercourse if the woman is over 35 years of age; conceiving but having a miscarriage does not restart the 12-month or 6-month term for determining infertility; 2) a person’s inability to reproduce either as a single individual or with a partner without medical intervention;”
Fertility preservation
On policies issued after January 1, 2019, Illinois law requires coverage of standard fertility preservation when a necessary medical treatment may cause infertility.
“EXCEPTION: Effective for policies issued after January 1, 2019, Illinois law (215 ILCS 5/356z.29) requires coverage and reimbursement for standard fertility preservation services when a necessary medical treatment may directly or indirectly cause iatrogenic infertility to a member.”
What your contract may leave out
The policy tells members to check their contract for reversal of sterilization, a surrogate's care, freezing and storing sperm, eggs and embryos, donor sperm, eggs and embryos, and travel and living costs.
“NOTE: Member contract benefits may vary. CHECK CONTRACTS FOR COVERAGE ELIGIBILITY of services related to reproductive technologies/techniques, including but not limited to the following: • Reversal of voluntary sterilization; • Payment for medical services or supplies rendered to a surrogate for purposes of childbirth; • Costs associated with cryopreservation and storage of sperm, oocytes, and embryos; • Costs associated with the procurement of sperm, or harvesting of oocytes and embryos from a donor; and • Living and/or travel expenses.”
Treated as experimental
Assisted hatching, embryo co-culture, freezing ovarian tissue, immature eggs or testicular tissue, and ICSI without male-factor infertility, among others.
“The following reproductive techniques for diagnosing or treating infertility are considered experimental, investigational, and/or unproven: • Assisted hatching; • Co-culture of embryos; • Computer-assisted sperm analysis (CASA); • Cryopreservation, storage, thawing and re-transplantation of ovarian tissue or immature oocytes and associated in vitro maturation; • Cryopreservation, storage, thawing and re-transplantation of testicular tissue; • Hemizona assay (HZA); • Hyaluronan binding assay (HBA); • Intracytoplasmic sperm injection (ICSI) in the absence of male factor infertility;”
Blue Distinction Centers for Fertility Care
Blue Cross and Blue Shield of Illinois lists Blue Distinction Centers for Fertility Care, which focus on IVF, and tells members to call the number on their ID card to find out which services their policy covers there.
“Blue Distinction Centers for Fertility Care focus on in vitro fertilization (IVF), which is the most common assisted reproductive technology (ART) treatment and is widely becoming the preferred option for fertility treatment.”
“To find out which services are covered under your policy at any facility, please call the customer service number listed on your Blue Cross and Blue Shield of Illinois member ID card.”
Whether your Blue Cross Blue Shield of Illinois plan covers IVF
The Blue Cross Blue Shield of Illinois 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 Blue Cross Blue Shield of Illinois 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 Blue Cross Blue Shield of Illinois cover IVF in Illinois?
Illinois's insurance law applied to a Blue Cross Blue Shield of Illinois plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
Blue Cross Blue Shield of Illinois in Illinois
Often, on fully-insured plans: Illinois requires some fully-insured health plans to cover IVF, and that includes Blue Cross Blue Shield of Illinois 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 Blue Cross Blue Shield of Illinois only administers is not bound by state law and covers IVF only if the employer chose to. Illinois law and clinics
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your Blue Cross Blue Shield of Illinois plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Ask HR whether your plan is fully insured or self-funded: Illinois's IVF law reaches fully insured plans issued in Illinois, and a self-funded plan covers what the employer chose.
- 2Read your benefit plan, summary plan description or contract for infertility services: the policy says it decides what is covered, excluded and capped.
- 3Call the customer service number on your Blue Cross and Blue Shield of Illinois card and ask whether IVF is covered, how many retrievals, and whether it needs approval first.
- 4If you want a Blue Distinction Center for Fertility Care, confirm the clinic is in network for your plan.
Blue Cross Blue Shield of Illinois and IVF: common questions
Does Blue Cross Blue Shield of Illinois cover IVF?
It depends on your plan, and Illinois law requires IVF coverage on many fully insured plans. The medical policy Blue Cross and Blue Shield of Illinois uses says infertility services are covered only if the member's plan includes them, so check your plan document or call the number on your card. A self-funded employer plan follows the employer's choice.
Does Blue Cross Blue Shield of Illinois cover IVF for single people?
Illinois's definition of infertility, which the policy applies to policies issued from January 1, 2022, includes a person's inability to reproduce as a single individual or with a partner without medical intervention. Whether IVF is then covered depends on your plan.
Does Blue Cross Blue Shield of Illinois cover egg freezing?
Before a medical treatment that may cause infertility, yes on policies issued after January 1, 2019: Illinois law requires coverage of standard fertility preservation, the policy says. Freezing and storing eggs, sperm or embryos otherwise depends on your contract.
- OB402.023 Reproductive Techniques and Immunotherapy for Recurrent Fetal Loss (HCSC medical policy, BCBSIL site) (Blue Cross and Blue Shield of Illinois, Policy Effective Date 01/01/2026)
- Fertility and Reproductive Care Centers (bcbsil.com) (Blue Cross and Blue Shield of Illinois)