Does Health Net cover IVF?
What Health Net of California (commercial plans) publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 21 h ago
On its California large group plans, yes. Health Net says its large group plans include infertility benefits under California's SB 729: diagnosis and treatment, IVF, GIFT and ZIFT, up to three completed egg retrievals per lifetime with unlimited embryo transfers, at the same cost sharing as other benefits. Small group plans must offer the coverage, and other plans cover it only if they include it. Health Net is ending its commercial group plans in California, many on February 28, 2027.
What Health Net's documents say
Read on Oct 26, 2026. The words in quotation marks are the source's own.
Large group plans: yes, 3 egg retrievals (California SB 729)
“Health Net’s large group plans include infertility benefits.”
“In vitro fertilization (IVF), zygote intrafallopian transfer (ZIFT), or any process that involves harvesting, transplanting or manipulating a human ovum.”
“Small group health plans are required to offer coverage for the diagnosis and treatment of infertility, including medically necessary fertility services. For all other plan types, coverage for diagnostic infertility services and treatment is provided only if explicitly included in the terms of the member’s or enrollee’s benefit plan.”
California's SB 729
Health Net's notice says SB 729 requires large group plans to cover GIFT, IVF and ZIFT with up to three completed egg retrieval cycles per lifetime and unlimited embryo transfers, with no benefit maximum; retrievals after the third are excluded.
“California Senate Bill 729 requires large group health care service plans to cover infertility treatments, including GIFT, IVF, and ZIFT, with up to three (3) completed oocyte retrieval cycles per lifetime, unlimited embryo transfers, and all covered services that prepare members for these procedures.”
“There will be no benefit maximum for these services.”
“Oocyte retrievals after the lifetime maximum of 3 completed oocyte retrieval cycles has been met.”
Cost sharing
Infertility treatment has the same cost sharing as other covered services, with your usual deductible or copayments.
“The cost-sharing for infertility treatment is the same as for any other covered benefits or services.”
Who qualifies
A person unable to reproduce alone or with a partner without medical help, or after 12 months of unprotected intercourse under 35 (6 months at 35 or older). IVF is not considered medically necessary over 55, and from 40 the doctor documents ovarian reserve and prior response.
“A person’s inability to reproduce either as an individual or with their partner without medical intervention.”
“F. Those with a female reproductive system who are > 55 years of age;”
“For those with female reproductive systems ≥ age 40 attempting conception using their own oocytes, documentation that the treating provider has evaluated age, infertility risk factors, measure of ovarian reserve, prior treatment and response, and considers use of the member/enrollee’s own oocytes a viable strategy for attempting conception;”
Who treats you
IVF must be done by a board-certified or board-eligible reproductive endocrinologist, and frozen embryos must be used before more IVF cycles in some cases.
“ART is performed by a physician board-certified or board eligible in reproductive endocrinology for those with a female reproductive system and by a board-certified or board eligible urologist or reproductive endocrinologist for those with a male reproductive system;”
“Frozen embryos must be used prior to authorization of additional IVF cycles in one of the following circumstances:”
Drugs and insemination
Oral drugs and the injectable drugs that prepare you for treatment are covered on large group plans, as are IUI and intracervical insemination.
“Prescription drugs (oral).”
“Services or supplies (including injections and injectable medications) which prepare the member to receive these services.”
“Intrauterine insemination (IUI) and intracervical insemination (ICI);”
Fertility preservation
Preservation before a treatment that causes infertility is covered on all plans; large group plans cover freezing and storing sperm, eggs and embryos for five years.
“Medically necessary services and supplies for established fertility preservation treatments in connection with iatrogenic infertility are covered.”
“Coverage is provided on all plans. See your EOC for additional information.”
“Large Group: Cryopreservation and storage of sperm, oocytes, and embryos for a period of five years from the time the genetic material is first cryopreserved.”
Leaving commercial group coverage
Health Net is closing all its California small business and large group medical plans, many ending February 28, 2027; Medi-Cal, Ambetter/Covered California and Medicare members are not affected.
“After careful consideration, Health Net has decided to discontinue offering commercial group health plans in California.”
“Many commercial group policies are expected to end February 28, 2027, or as otherwise permitted by the applicable contract and regulatory requirements.”
“Note: Medi-Cal, Ambetter/Covered California and Medicare Members are NOT impacted by this transition.”
Not covered
Buying donor eggs, sperm or embryos, reversing a voluntary sterilization, and experimental procedures.
“Excluded services:”
“Purchase of donor eggs, sperm or embryos.”
“B. Reversal of voluntary sterilization;”
Whether your Health Net plan covers IVF
The Health Net 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 Health Net 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 Health Net cover IVF in California?
California's insurance law applied to a Health Net plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
Health Net in California
Often, on fully-insured plans: California requires some fully-insured health plans to cover IVF, and that includes Health Net 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. California law and clinics
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your Health Net plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Read your Evidence of Coverage for infertility coverage and exclusions, as Health Net advises.
- 2Ask HR whether your employer's plan is large group (SB 729 applies) or small group (the coverage is an option), and when it ends as Health Net leaves the group market.
- 3Have a reproductive endocrinologist request authorization before IVF.
Health Net and IVF: common questions
Does Health Net cover IVF?
On its California large group plans, yes, under SB 729: IVF, GIFT and ZIFT with up to three completed egg retrievals per lifetime and unlimited embryo transfers, at normal cost sharing. Other plan types cover it only if included.
Is Health Net leaving the group market in California?
Yes. Health Net says it is closing all its California small business and large group medical plans, many ending February 28, 2027. Medi-Cal, Covered California and Medicare members are not affected.
Does Health Net cover egg freezing?
Before a treatment that causes infertility, on all plans. Large group plans cover freezing and storage of sperm, eggs and embryos for five years.
- Health Net of California, Inc. Large Employer Group: Infertility Benefits (FLY066136EP00) (Health Net of California, 9/25)
- Clinical Policy: Assisted Reproductive Technology (HNCA.CP.MP.55) (Health Net of California, Date of Last Revision: 4/26)
- Notice of Changes to Coverage Terms for Groups Effective on and after July 1, 2025 (Commercial Large Group and Grandfathered Small Group Plans) (Health Net of California, Effective on and after July 1, 2025)
- Commercial Group Exit and Transition Information (Health Net of California, archive copy of 2026-09-29)