Does CareSource cover IVF?
What CareSource (Marketplace plans) 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
No, not on the CareSource Marketplace plans we read. Its agreements for Ohio and Indiana (2026), Wisconsin (2026 and 2027), Georgia (2027) and Kentucky (2025) cover only diagnosing and treating the underlying causes of infertility, and exclude assisted reproduction: IVF, artificial insemination, GIFT and ZIFT, with the related drugs and donor costs. Georgia's 2027 plans add one egg or sperm preservation procedure before a treatment that may cause infertility. CareSource's other plans are Medicaid and Medicare, which follow those programs' rules.
What CareSource's agreements say
Read on Oct 25, 2026. The words in quotation marks are the source's own.
Not on its Marketplace plans
“The services, treatments, items, or supplies listed in this section are not Covered Services unless they are listed as a Covered Service”
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including but not limited to artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) procedures, zygote intrafallopian transfer (ZIFT) procedures or any other treatment or procedure designed to create a Pregnancy. This includes any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation.”
“The Benefit Plan covers services for the diagnosis and treatment of the underlying causes of infertility when provided by or under the direction of a Network Provider.”
Only the causes of infertility
The plans cover diagnosing and treating the conditions behind infertility, with a network provider, and exclude fertility drugs unless they treat that condition.
“The Benefit Plan covers services for the diagnosis and treatment of the underlying causes of infertility when provided by or under the direction of a Network Provider.”
“Fertility drugs unless used to treat the medical condition that results in infertility.”
Freezing eggs or sperm
Freezing and long-term storage of eggs, sperm or embryos are excluded, except in Georgia from 2027: oocyte and sperm preservation when a medically necessary treatment may cause infertility, one procedure per lifetime, with storage beyond a year not covered.
“For cryo-preservation and other forms of preservation of reproductive materials.”
“The Plan provides Benefits for oocyte and sperm preservation services when a Medically Necessary treatment may directly or indirectly cause impairment of fertility (iatrogenic infertility) caused by surgery, radiation, chemotherapy, or any other medical treatment affecting reproductive organs or processes, as required by law.”
“Benefits are not available for long-term storage costs (greater than one year). Lifetime limit of one (1) oocyte or cryopreservation procedure per eligible insured/Member.”
Also excluded
Reversing a surgical sterilization, and surrogacy services for someone who is not the member.
“For the reversal of surgical sterilization.”
“For Health Care Services related to surrogacy if the Covered Person is not the surrogate.”
What CareSource sells
Medicaid, a Dual Eligible Special Needs Plan, Marketplace plans for people without employer coverage, and a TRICARE Prime demonstration.
“CareSource is dedicated to transforming health care for those served by government-sponsored health care programs and offers a variety of health insurance plans including: Medicaid Dual Eligible Special Needs Plan Marketplace TRICARE Prime ® Demo by CareSource Military & Veterans™”
“Individual and family health insurance coverage for those who do not have employer insurance and do not qualify for other programs like Medicare or Medicaid.”
CareSource Marketplace agreements we read
The same exclusion in every state read; Georgia's 2027 agreement adds fertility preservation.
Ohio (2026)
IVF excludedAssisted reproduction, IVF and insemination included, is excluded with its drugs; freezing reproductive material is excluded.
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including but not limited to artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) procedures, zygote intrafallopian transfer (ZIFT) procedures or any other treatment or procedure designed to create a Pregnancy. This includes any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation.”
Indiana (2026)
IVF excludedThe same exclusion of assisted reproduction, IVF and insemination included.
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) procedures, zygote intrafallopian transfer (ZIFT) procedures or any other treatment or procedure designed to create a Pregnancy. This includes any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation.”
Wisconsin (2026 and 2027)
IVF excludedIVF, GIFT, ZIFT, ICSI, embryo transfer and insemination are excluded whatever the reason, as are infertility drugs such as clomiphene and storing reproductive material; the 2027 agreement keeps the exclusion.
“In-vitro fertilization regardless of the reason for treatment.”
“Medication prescribed to treat infertility, including but not limited to drugs for hyperstimulation of the ovaries (such as Clomiphene Citrate) and drugs for treating low sperm count or motility.”
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including: o Any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation. o Artificial insemination o Gamete intrafallopian transfer (GIFT) procedures o In vitro fertilization o Medical ovulation induction o Zygote intrafallopian transfer (ZIFT) procedures”
Georgia (2027)
IVF excluded; preservation coveredAssisted reproduction is excluded, but egg and sperm preservation is covered before a treatment that may cause infertility: one procedure per lifetime.
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including but not limited to artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) procedures, zygote intrafallopian transfer (ZIFT) procedures or any other treatment or procedure designed to create a Pregnancy. This includes any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation.”
“The Plan provides Benefits for oocyte and sperm preservation services when a Medically Necessary treatment may directly or indirectly cause impairment of fertility (iatrogenic infertility) caused by surgery, radiation, chemotherapy, or any other medical treatment affecting reproductive organs or processes, as required by law.”
Kentucky (2025)
IVF excludedThe 2025 agreement, the latest posted for Kentucky, excludes assisted reproduction, IVF and insemination included.
“For Health Care Services and associated expenses for Assisted Reproductive Technology (ART) including artificial insemination, in vitro fertilization, gamete intrafallopian transfer (GIFT) procedures, zygote intrafallopian transfer (ZIFT) procedures or any other treatment or procedure designed to create a Pregnancy. This includes any related prescription medication treatment; embryo transport; donor ovum and semen and related costs, including collection and preparation.”
Whether your CareSource plan covers IVF
The CareSource 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 CareSource 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 CareSource cover IVF in your state?
Each state's insurance law applied to a CareSource plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
CareSource in Ohio
Not because of state law: Ohio requires some infertility coverage but not IVF, so IVF under a CareSource plan there depends on what the employer chose. Ohio law and clinics
CareSource in Georgia
Not because of state law: Georgia does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under a CareSource plan there depends on what the employer chose. Georgia law and clinics
CareSource in Kentucky
Not because of state law: Kentucky does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under a CareSource plan there depends on what the employer chose. Kentucky law and clinics
CareSource in Indiana
Not because of state law: Indiana has no law requiring private plans to cover IVF, so IVF under a CareSource 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
CareSource in Wisconsin
Not because of state law: Wisconsin has no law requiring private plans to cover IVF, so IVF under a CareSource 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
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your CareSource plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Download your state's Evidence of Coverage or Certificate of Coverage from CareSource's Marketplace plan documents page and read the infertility exclusions.
- 2Ask your doctor which tests and treatments for the cause of infertility are covered: those are the services the plans include.
- 3If you face cancer treatment in Georgia on a 2027 plan, ask CareSource about the egg and sperm preservation benefit.
CareSource and IVF: common questions
Does CareSource cover IVF?
Not on its Marketplace plans: the agreements for Ohio, Indiana, Wisconsin, Georgia and Kentucky exclude assisted reproduction, including IVF and artificial insemination, and cover only diagnosing and treating the causes of infertility.
Does CareSource cover IUI?
No. Artificial insemination is excluded with the rest of assisted reproduction on the Marketplace plans read.
Does CareSource Medicaid cover IVF?
CareSource's Medicaid plans follow each state's Medicaid program, so the state's Medicaid rules decide: the Medicaid page here shows each state's rule.
- CareSource Marketplace 2026 Evidence of Coverage (Ohio), Exclusions (CareSource, Plan year 2026)
- CareSource Indiana Marketplace Plan Evidence of Coverage, Plan Year 2026 (POLMP-IN(2026)) (CareSource, Plan year 2026)
- CareSource Georgia Marketplace Plan Evidence of Coverage, Plan Year 2027 (POLMP-GA(2027)) (CareSource, Plan year 2027)
- About Us: The CareSource Difference (CareSource)
- CareSource home page (CareSource)
- CareSource (Common Ground Healthcare) Wisconsin Marketplace 2026 Certificate of Coverage (CareSource, Effective January 1, 2026)
- CareSource Wisconsin Marketplace Evidence of Coverage, PY 2027 (POLMP-WI(2027)) (CareSource, Plan year 2027)
- CareSource Kentucky Marketplace 2025 Evidence of Coverage (POLMP-KY(2025)) (CareSource, Plan year 2025)