Does BlueCross BlueShield of South Carolina cover IVF?
What BlueCross BlueShield of South Carolina (BCBSSC) publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 22 h ago
Only if your contract includes it. BCBSSC's reproductive techniques policy (reviewed April 2026) says coverage of assisted reproduction is a contract-specific benefit, and sets the medical criteria IVF must meet where a contract has the benefit: for example women aged 40 to 45, blocked tubes, or failed rounds of ovarian stimulation with IUI. Assisted reproduction over 45 is not covered, and its drug policy says infertility drugs are not covered unless your contract says otherwise. Freezing eggs or embryos before chemotherapy is covered for one IVF cycle.
What BCBSSC's policy says
Read on Oct 25, 2026. The words in quotation marks are the source's own.
Only if your contract includes it
“Coverage eligibility of ART is a contract-specific benefit issue.”
“Benefits for assisted reproductive techniques may be subject to state mandates and to individual contract exclusions and limitations.”
When IVF meets the medical criteria
For an infertile member who meets one of the policy's criteria, among them a woman aged 40 to 45, blocked fallopian tubes, meeting the criteria for embryo genetic testing, or unexplained infertility after failed ovarian stimulation with IUI: at least four cycles at 34 or younger, fewer at older ages.
“In vitro fertilization may be considered medically necessary for infertile individuals when one of the following criteria are met: Biological female aged 40-45 Biological female with tubal occlusion”
“For patients 34 years or younger: trial of at least 4 cycles of controlled ovarian stimulation and intrauterine insemination”
“Individual who meets criteria for preimplantation genetic testing per the medical policy (CAM 110).”
Who counts as infertile
Not conceiving after twelve months of actively trying under 35, or six months at 35 or older. A woman without a male partner qualifies after twelve inseminations under 35 (six at 35 or older), and the policy calls those inseminations a non-covered benefit.
“An otherwise healthy biological female is younger than age 35 and has not been able to conceive after twelve months or more of actively trying”
“An otherwise healthy biological female is age 35 or older and has not been able to conceive after a period of six months of actively trying”
“An otherwise healthy biological female younger than age 35 without a biological male partner, who has completed twelve (12) cycles total of a combination of intrauterine inseminations (IUIs) in-office or in-home intravaginal inseminations as a non-covered benefit and has not been able to conceive”
Age and ovarian reserve
Assisted reproduction over 45 is not covered. At 40 and older, coverage needs an AMH above 1.0 ng/ml or an antral follicle count above 6.
“Assisted reproductive technologies for individuals over the age of 45 years.”
“Lab values required for infertility services coverage for members age 40 and older AMH > 1.0 ng/ml, OR AFC > 6”
Frozen embryos first, and dollar caps
Every frozen egg or embryo must be used before another fresh cycle is approved, and some contracts cap infertility benefits in dollars.
“For all treatment cycles, all frozen eggs and/or embryos must be used before another fresh cycle may be approved.”
“Some contracts or certificates of coverage may impose a dollar cap on infertility benefits.”
Fertility drugs
Its drug coverage policy says drugs prescribed for infertility are not a covered benefit unless your specific contract says otherwise, and the same goes for injections given to treat infertility.
“Drugs prescribed for non-covered conditions, such as obesity or infertility, are not a covered benefit unless otherwise specified by the specific contract.”
“Drug injections given for the treatment of a non-covered medical condition (e.g., obesity, infertility, impotence) are not a covered benefit.”
Freezing before cancer treatment
For a member facing chemotherapy or another treatment expected to cause permanent infertility: one IVF cycle with egg or embryo freezing, at 45 or younger, with storage for up to 12 months and no infertility workup needed. Freezing for other reasons is not covered.
“One cycle of IVF with egg or embryo cryopreservation and storage* (if the member is ≤ 45 years of age). No infertility workup is required for coverage.”
“Storage is covered for up to 12 months.”
“Cryopreservation of embryos or eggs for fertility preservation purposes other than chemotherapy or other approved medically necessary treatments that may render an individual infertile.”
Not covered
Reversing a sterilization or infertility treatment needed because of one; ICSI without male factor infertility; embryo co-culture.
“Sterilization reversal is not covered. Infertility treatment needed as a result of prior voluntary sterilization or unsuccessful sterilization reversal procedure is not covered.”
“Co-culture of embryos. Intracytoplasmic sperm injection in the absence of male factor infertility.”
Whether your BlueCross BlueShield of South Carolina plan covers IVF
The BlueCross BlueShield of South Carolina 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 BlueCross BlueShield of South Carolina 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 BlueCross BlueShield of South Carolina cover IVF in South Carolina?
South Carolina's insurance law applied to a BlueCross BlueShield of South Carolina plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
BlueCross BlueShield of South Carolina in South Carolina
Not because of state law: South Carolina has no law requiring private plans to cover IVF, so IVF under a BlueCross BlueShield of South Carolina 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
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your BlueCross BlueShield of South Carolina plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Read your contract or certificate of coverage for infertility benefits: BCBSSC says assisted reproduction coverage is contract-specific and some contracts cap it in dollars.
- 2Check whether your contract covers fertility drugs: the drug policy excludes them unless the contract says otherwise.
- 3Verify eligibility and benefits with BCBSSC before treatment, as its policy pages advise.
BlueCross BlueShield of South Carolina and IVF: common questions
Does BlueCross BlueShield of South Carolina cover IVF?
Only if your contract includes it. Its reproductive techniques policy (reviewed April 2026) says coverage of assisted reproduction is a contract-specific benefit, and where a contract has it, IVF must meet medical criteria such as age 40 to 45, blocked tubes, or failed ovarian stimulation with IUI.
What is BCBSSC's age limit for IVF?
Assisted reproduction for people over 45 is not covered, and members 40 and older need an AMH above 1.0 ng/ml or an antral follicle count above 6.
Does BCBSSC cover egg freezing before cancer treatment?
Yes: one IVF cycle with egg or embryo freezing for a member aged 45 or younger facing treatment expected to cause permanent infertility, with storage for up to 12 months.
Does South Carolina require insurance to cover IVF?
No South Carolina law requires private plans to cover IVF, so a BCBSSC plan covers it only if the contract includes it.
- BlueCross BlueShield of South Carolina Medical Policy: Reproductive Techniques (CAM 40204) (BlueCross BlueShield of South Carolina, Live policy page; annual review 04/01/2026, coverage criteria updated 12/09/2025)
- BlueCross BlueShield of South Carolina Medical Policy: Drug Coverage (CAM 468) (BlueCross BlueShield of South Carolina, Live policy page; annual review 07/17/2025)