Does Obamacare cover IVF?
What HealthCare.gov, each state's benchmark plan on file with CMS and the state laws that reach individual plans say about IVF in marketplace (Obamacare) plans for 2027, each in its own words, with the document each statement is in.
Only in 9 states and DC. A marketplace plan has to cover what its state's benchmark plan and the state's own insurance laws require, and IVF is required in Arkansas (not on HMO plans), Connecticut, Delaware, Hawaii (one cycle), Illinois, Maine, Maryland, Massachusetts and Rhode Island, and in the District of Columbia, each with its own limits. In 15 more states plans must cover some infertility care, such as tests, treating the cause or insemination, but not IVF. In the other 26 the benchmark plan lists infertility treatment as not covered. Open enrollment for 2027 plans runs November 1, 2026 to January 15, 2027 on HealthCare.gov.
What HealthCare.gov and CMS say
Read on Oct 21, 2026. The words in quotation marks are the source's own.
Only in 9 states and DC
“HHS regulations (45 CFR 156.100, et seq.) define EHB based on State-specific EHB-benchmark plans.”
“Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements.”
Open enrollment for 2027 plans
On HealthCare.gov, open enrollment for 2027 plans starts November 1, 2026. Choose a plan by December 15 for coverage from January 1, 2027; open enrollment ends January 15, 2027, and a plan chosen after December 15 starts February 1. If your state runs its own marketplace, you apply there instead.
“Starting November 1, you can apply for 2027 coverage”
“December 15: Last day to enroll in or change plans for coverage to start January 1.”
“January 15: Open Enrollment ends”
“February 1: Coverage starts for those who enroll in or change plans December 16 through January 15 and pay their first premium.”
“How you apply depends on if your state has its own Marketplace.”
IVF is not one of the 10 required benefits
Every marketplace plan must cover 10 categories of essential health benefits, from doctor visits to pregnancy care and prescription drugs. Infertility treatment is not one of them, so whether a plan covers IVF turns on what the state's benchmark plan includes and what the state's own laws add.
“The Affordable Care Act requires non-grandfathered health insurance coverage in the individual and small group markets to cover essential health benefits (EHB), which include items and services in at least the following ten benefit categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care.”
State laws can add IVF
A state's insurance law can require more than the benchmark. In Arkansas, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts and Rhode Island, and in DC, a law or the benchmark plan itself requires individual plans to cover IVF; Illinois is the state where it is the benchmark that does it.
“Generally, yes. But some states require insurers to cover additional services and procedures.”
Ask the plan before you enroll
HealthCare.gov's own advice for a service that is not on the required list, like IVF, is to call the plan. A plan can cover more than its state requires.
“If you want to find out if a particular service is covered, call the plan.”
“Plans may cover other services.”
Where marketplace plans must cover IVF
Nine states and the District of Columbia, where a state law that reaches individual plans, or the state's benchmark plan, requires IVF. Each sets its own limits.
Arkansas
Required, except HMOsArkansas law requires individual and group policies to cover IVF, with HMOs left out. The state's benchmark plan comes from an HMO company and lists infertility treatment as not covered, so an HMO marketplace plan does not have to include IVF; other plan types do, within the limits the law sets.
“In vitro fertilization Individual, Small Group, Large Group (N/A HMOs) Before 2012 §23-85-137”
“Infertility Treatment No Not Covered No”
“Issuer Name HMO Partners, Inc.”
Connecticut
Required, 2 cyclesConnecticut's infertility law reaches individual and group plans, and the state's benchmark plan covers IVF, GIFT, ZIFT and related procedures, with ovulation drugs, up to two cycles in all.
“Infertility diagnosis and treatment Individual, group Before 2012 § 38a-536”
“Uterine embryo lavage, in-vitro fertilization (IVF), gamete intra-fallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) or low tubal ovum transfer, including the use of gonadotropins and other medicines designed to stimulate ovulation (to a maximum of two cycles combined for all procedures”
Delaware
Required, 6 retrievalsDelaware law requires every individual health policy to cover fertility care, IVF included: six completed egg retrievals in a lifetime with unlimited embryo transfers, with retrievals before age 45. The state's benchmark plan lists infertility treatment as not covered, but the law applies to individual plans on its own terms.
“All individual health insurance policies, contracts, or certificates that are delivered, issued for delivery, renewed, extended, or modified in this State by any health insurer, health service corporation, or health maintenance organization and that provide for medical or hospital expenses shall include coverage for fertility care services, including in vitro fertilization services”
“Six completed egg retrievals per lifetime, with unlimited embryo transfers”
“For IVF services, retrievals are completed before the individual is 45 years old”
“Infertility Treatment No Not Covered No”
District of Columbia
Required, 3 retrievalsSince January 1, 2025, DC law requires individual and small-group plans to cover infertility diagnosis and treatment, IVF included: at least three complete egg retrievals with unlimited embryo transfers. DC's benchmark plan for 2026 onward lists infertility treatment as covered.
“Beginning January 1, 2025, a health insurer offering an individual health benefit plan or small group health plan shall provide coverage for the diagnosis and treatment of infertility, including in vitro fertilization”
“At least 3 complete oocyte retrievals with unlimited embryo transfers”
“Infertility Treatment Yes Covered No”
Hawaii
One IVF cycleHawaii law requires individual, group and HMO plans to cover an IVF procedure. The state's benchmark plan covers IVF as its only infertility treatment, once, when set criteria are met.
“In-vitro fertilization procedure Individual, small group, large group, HMO Before 2012 431:10A-116.5”
“In vitro fertilization is the only infertility treatment covered given that certain criteria are met.”
“1 Treatment per Issuer.”
Illinois
Required, up to 6 retrievalsIllinois's benchmark plan, which sets what every individual and small-group plan in the state must cover, covers infertility treatment including IVF: up to four completed egg retrievals, and two more after a live birth. Illinois's own infertility law reaches only employer groups of more than 25, so for a marketplace plan it is the benchmark that brings IVF in.
“Infertility Treatment Yes Covered No Limitations vary based on procedures.”
“Covered Services rendered in connection with the diagnosis and/or treatment of infertility, including, but not limited to, in-vitro fertilization”
“You have not undergone four completed oocyte retrievals, except that if a live birth followed a completed oocyte retrieval, two more completed oocyte retrievals shall be covered.”
“HHS regulations (45 CFR 156.100) define EHB based on state-specific EHB benchmark plans, which apply to individual and small group ACA compliant plants.”
“Infertility Group and group HMO contracts that provide coverage for more than 25 employees”
Maine
Required since 2024Since January 1, 2024, Maine law requires every health plan the state regulates to cover fertility diagnostic care, fertility treatment and fertility preservation, and the state's rule lists IVF among the required benefits. The rule also sets how the state reimburses insurers for these benefits on plans bought through the Maine marketplace.
“all health plans subject to the Maine Health Plan Improvement Act, and issued or renewed on or after January 1, 2024, must provide coverage for fertility diagnostic care, fertility treatment, and fertility preservation service.”
“For fertility treatment if the enrollee is a fertility patient”
“In vitro fertilization, including in vitro fertilization using donor eggs and in vitro fertilization where the embryo is transferred to a gestational carrier or surrogate”
“Are provided by a health plan purchased on the Maine Health Insurance Marketplace”
Maryland
Required, conditions applyMaryland's IVF law reaches individual and large-group plans; small-group plans fall under its infertility services rule instead. The state's benchmark plan, a small-group plan, covers counseling, testing and insemination.
“1. In vitro fertilization; 2. Infertility services 1. Applies to individual and large group”
“Benefits are limited to: a) Infertility counseling; b) Testing; and c) Artificial Insemination and Intrauterine Insemination.”
Massachusetts
RequiredMassachusetts's infertility law reaches individual, small-group and large-group plans, and the state's benchmark plan covers infertility technologies including IVF for someone unable to conceive within a year, or six months at 35 or older.
“Infertility treatment Individual, Small Group, Large Group Before 2012 M.G.L. c. 175 § 47H”
“Infertility technologies, such as: in vitro fertilization and embryo placement”
“Only covers services to diagnose and treat infertility if unable to conceive during one year, or has been diagnosed with cancer and is expected to become infertile after treatment, or is age 35 or older and has not been able to conceive for 6 months.”
Rhode Island
Required, ages 25 to 42Rhode Island law requires plans with pregnancy benefits, which every marketplace plan has, to cover diagnosis and treatment of infertility for women aged 25 to 42, with a copayment of up to 20%. The state's benchmark plan covers three treatment cycles a plan year and eight in a lifetime.
“that includes pregnancy-related benefits, shall provide coverage for medically necessary expenses of diagnosis and treatment of infertility for women between the ages of twenty-five (25) and forty-two (42) years”
“Infertility Services Any nonprofit medical service contract, plan, or insurance”
“Three (3) infertility treatment cycles will be covered per plan year with a total of eight (8) infertility treatment cycles covered in a member’s lifetime.”
Where plans must cover some infertility care, but not IVF
Fifteen states whose benchmark plan, or an infertility law that reaches plans you buy yourself, covers tests, treating the cause or insemination, and leaves IVF out.
Colorado
Some care, not IVFColorado's benchmark plan for 2027 onward covers infertility treatment but excludes IVF, egg transplants, GIFT and ZIFT. Colorado's IVF law reaches large-group employer plans, not plans you buy yourself.
“This EHB-benchmark plan will be the basis for determining EHB for non-grandfathered individual and small group health insurance coverage in Colorado for plan years beginning on or after January 1, 2027.”
“Infertility Treatment Yes Covered No”
“such as, but not limited to in vitro fertilization, ovum transplants, gamete intra fallopian transfer and zygote intra fallopian transfer are not covered.”
Iowa
Some care, not IVFIowa's benchmark plan covers infertility care but lists artificial insemination and IVF among its limits and exclusions.
“Artificial insemination, in vitro fertilization and other limitations and exclusions apply.”
Kansas
Some care, not IVFKansas's benchmark plan covers tests to find the cause of infertility and treatment of the condition, including fertility drugs such as Clomid, Gonal-f and Follistim when medically necessary, and excludes IVF and insemination.
“Excludes In vitro fertilization, in vivo fertilization or any”
“Benefits are available for covered services such as office visits, laboratory tests, and radiological studies to diagnose the cause of infertility.”
“drug therapy regimens (Pregnyl, Clomid, Clomiphene, Ovidrel, Gonal, Follistim and Cetrotide) are all covered services when medically necessary.”
Michigan
Underlying causes onlyMichigan's benchmark plan covers treatment of the underlying causes of infertility only.
“Infertility Treatment Yes Covered No Pages 27-28; Underlying causes only.”
Montana
Tests and inseminationMontana's benchmark plan pays for diagnosing infertility and for artificial insemination, and excludes IVF and fertility drugs.
“Infertility Treatment Yes Covered No Exclude Invitro and prescription drugs for the treatment We pay for the diagnosis of infertility & Artificial”
Nevada
Tests and inseminationNevada's benchmark plan covers office visits, lab studies, diagnostic procedures and up to six artificial insemination cycles in a lifetime, and excludes IVF, GIFT and ZIFT.
“Advanced reproductive techniques such as embryo transplants, in vitro fertilization, GIFT and ZIFT procedures.”
“1. Laboratory studies; 2. Diagnostic procedures; and 3. Artificial insemination services, up to six (6) cycles per Member per lifetime.”
New Hampshire
Tests and causes onlyNew Hampshire's benchmark plan covers tests to find the cause of infertility and treatment of the underlying condition, and excludes insemination and assisted reproduction such as IVF. New Hampshire's IVF law reaches group plans.
“Benefits do not include artificial insemination (AI) services or assisted reproductive technologies (ART) services”
“Covered Services include diagnostic tests to find the cause of infertility, such as diagnostic laparoscopy,”
New Jersey
Insemination and drugsNew Jersey's IVF law reaches group plans of more than 50 employees. The state's benchmark plan covers artificial insemination and ovulation drugs, with pre-approval, and excludes IVF, embryo transfer and embryo freezing.
“Infertility treatment Group plans with more than 50 employees”
“procedures: invitro fertilization; embryo transfer; embryo freezing”
“Horizon BCBSNJ covers charges for: artificial insemination; and standard dosages, lengths of treatment and cycles of therapy of Prescription Drugs used to stimulate ovulation for artificial insemination or for unassisted conception.”
New Mexico
Diagnosis and causesNew Mexico's benchmark plan covers diagnosis and medically indicated treatment of physical conditions that cause infertility.
“Pages 23-24; Diagnosis and medically indicated treatments for physical conditions causing infertility”
New York
Treatment, not IVFNew York requires individual plans to cover infertility, and its benchmark plan covers diagnosis and treatment of infertility for members aged 21 to 44 but not IVF, GIFT or ZIFT. New York's IVF law reaches large-group plans.
“Infertility coverage Individual, group Before 2012 §3221(k)(6)”
“Infertility Treatment Yes Covered No Does not cover In vitro, GIFT and ZIFT procedures.”
“Members must be between the ages of 21 and 44 (inclusive) in order to be considered a candidate for these services.”
North Carolina
3 ovulation cyclesNorth Carolina's benchmark plan covers diagnosis and correction of underlying causes of infertility and up to three medical ovulation induction cycles in a lifetime.
“Benefits are provided for certain services related to the diagnosis, treatment and correction of any underlying causes of infertility for all members. Benefits are limited to three medical ovulation induction cycles per lifetime per member.”
Ohio
HMO plans onlyOhio requires HMO plans, and only HMO plans, to cover infertility services; the state's benchmark plan excludes infertility treatment beyond that.
“Infertility treatment HMOs only Before 2012”
“Infertility treatment is excluded except as required under state law for HMO plans.”
Pennsylvania
Insemination onlyPennsylvania's benchmark plan covers artificial insemination and excludes IVF, embryo transfer, egg retrieval, GIFT and ZIFT.
“For In vitro fertilization, embryo transplant, ovum retrieval including, but not limited to, gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) and any services required in connection with these procedures are Not Covered.”
“Artificial Insemination is covered”
Washington
Tests and inseminationWashington's benchmark plan for 2026 onward covers only evaluations to find out whether and why a member is infertile, and artificial insemination.
“Infertility Treatment Yes Covered No Only evaluations to determine if and why a covered”
“member is infertile and artificial insemination are covered.”
West Virginia
Some care, not IVFWest Virginia's benchmark plan covers correcting a physical or medical problem tied to infertility, and lists IVF and other egg transfer procedures among its exclusions.
“Infertility Treatment Yes Covered No”
“Treatment includes coverage for the correction of a physical or medical problem associated with infertility.”
“In-vitro fertilization, gamete intra-fallopian transfer and other ova transfer procedures.”
Where the benchmark plan leaves infertility treatment out
Twenty-six states whose benchmark plan lists infertility treatment as not covered and whose laws do not require IVF on plans you buy yourself. Some of these benchmark plans still cover tests to find the cause.
Alabama
Not coveredAlabama's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Alabama law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Alaska
Not coveredAlaska's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Alaska law requires plans you buy yourself to cover IVF. This is the benchmark plan for 2026 onward. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Arizona
Testing onlyArizona's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Arizona law requires plans you buy yourself to cover IVF. The benchmark plan covers tests to diagnose infertility and excludes treatment once infertility is diagnosed. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“Diagnostic services rendered for infertility evaluation are covered. Any medical treatment and/or prescription related to infertility once diagnosed are excluded by the Plan.”
California
Not coveredCalifornia's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no California law requires plans you buy yourself to cover IVF. California's 2026 IVF law reaches large-group employer plans, not plans you buy yourself. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Florida
Not coveredFlorida's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Florida law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Georgia
Not coveredGeorgia's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Georgia law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Idaho
Not coveredIdaho's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Idaho law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Indiana
Not coveredIndiana's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Indiana law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Kentucky
Not coveredKentucky's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Kentucky law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Louisiana
Not coveredLouisiana's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Louisiana law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Minnesota
Not coveredMinnesota's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Minnesota law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Mississippi
Not coveredMississippi's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Mississippi law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Missouri
Testing onlyMissouri's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Missouri law requires plans you buy yourself to cover IVF. The benchmark plan covers tests to find the cause of infertility and treatment of the underlying condition, and excludes insemination and IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“Fertility treatments such as artificial insemination and in-vitro fertilization are not a Covered Service.”
“Covered Services include diagnostic tests to find the cause of infertility and services to treat the underlying medical conditions that cause infertility.”
Nebraska
Not coveredNebraska's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Nebraska law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
North Dakota
Not coveredNorth Dakota's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no North Dakota law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not No Exclusions: Pgs. 40-46”
Oklahoma
Not coveredOklahoma's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Oklahoma law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Oregon
Not coveredOregon's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Oregon law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
South Carolina
Not coveredSouth Carolina's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no South Carolina law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
South Dakota
Not coveredSouth Dakota's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no South Dakota law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Tennessee
Testing onlyTennessee's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Tennessee law requires plans you buy yourself to cover IVF. The benchmark plan covers evaluating infertility and excludes insemination and IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“including but not limited to: artificial insemination, in vitro fertilization.”
Texas
Offered as an add-onTexas law requires insurers to offer IVF coverage, and the state's benchmark plan covers diagnosis only, with IVF covered just when a rider is bought. Whether an individual plan can add that rider is the insurer's to say, so ask before you enroll.
“Women's Health - In Vitro Fertilization Must be offered to individual, small group, large group”
“Infertility Treatment No Not Covered No”
“Diagnosis covered but treatment not covered unless a rider is purchased to cover In-vitro ONLY.”
Utah
Not coveredUtah's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Utah law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Vermont
Testing onlyVermont's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Vermont law requires plans you buy yourself to cover IVF. The benchmark plan covers evaluations to find out whether and why a member is infertile, and excludes insemination, IVF, GIFT and ZIFT. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“artificial insemination; in vitro fertilization, embryo transplantation and gamete intrafallopian transfer (GIFT); zygote intrafallopian transfer (ZIFT)”
Virginia
Testing onlyVirginia's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Virginia law requires plans you buy yourself to cover IVF. The benchmark plan covers tests to find the cause of infertility and treatment of the underlying condition, and excludes insemination and IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“Fertility treatments such as artificial insemination and in- vitro fertilization are not a Covered Service.”
“Diagnostic tests to find the cause of infertility, such as diagnostic laparoscopy, endometrial biopsy, and semen analysis.”
Wisconsin
Not coveredWisconsin's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Wisconsin law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
Wyoming
Not coveredWyoming's benchmark plan, which sets what every individual and small-group plan there must cover, lists infertility treatment as not covered, and no Wyoming law requires plans you buy yourself to cover IVF. A plan may still cover more than the minimum.
“Infertility Treatment No Not Covered No”
“Benefits will not be provided for artificial insemination, in vitro ("test tube") fertilization, or other artificial methods of conception.”
How to check a plan before you enroll
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Find your state above: its line says what every marketplace plan there has to cover, and what it leaves to each plan.
- 2Start on HealthCare.gov and pick your state: if your state runs its own marketplace, you apply there instead.
- 3When you compare plans, open each plan's Summary of Benefits and Coverage and look for infertility treatment, both among the services the plan does not cover and among its other covered services.
- 4Before you enroll, call the plan and ask whether it covers IVF, how many egg retrievals or cycles, and whether fertility drugs are covered. Get the answer in writing if you can.
- 5If no plan in your state covers IVF, look at an employer plan you or a partner can join, then at IVF grants and clinic refund programs.
Obamacare and IVF: common questions
Does Obamacare cover IVF?
Only in 9 states and DC. Marketplace plans must cover IVF in Arkansas (not on HMO plans), Connecticut, Delaware, Hawaii (one cycle), Illinois, Maine, Maryland, Massachusetts, Rhode Island and the District of Columbia, each with its own limits. In 15 more states they must cover some infertility care, such as tests or insemination, but not IVF, and in 26 states the benchmark plan lists infertility treatment as not covered.
Which states require marketplace plans to cover IVF?
Arkansas (except HMO plans), Connecticut (up to two cycles), Delaware (six egg retrievals, before age 45), the District of Columbia (at least three egg retrievals), Hawaii (one IVF cycle), Illinois (up to four egg retrievals, two more after a live birth), Maine, Maryland, Massachusetts and Rhode Island (women aged 25 to 42). In Illinois the requirement comes from the state's benchmark plan; elsewhere from the state's insurance law.
Does Obamacare cover IVF in Illinois?
Yes. Illinois's benchmark plan, which sets what every individual and small-group plan in the state must cover, includes infertility treatment with IVF: up to four completed egg retrievals, and two more after a live birth.
Does Obamacare cover IVF in California, Texas or Florida?
No. In all three the state's benchmark plan lists infertility treatment as not covered. California's 2026 IVF law reaches large-group employer plans, not plans you buy yourself. Texas law requires insurers to offer IVF coverage, and its benchmark plan covers IVF only when a rider is bought, so ask an insurer whether its individual plans offer one.
Does Obamacare cover IVF in New York?
No. New York's individual plans must cover diagnosis and treatment of infertility for members aged 21 to 44, but the state's benchmark plan does not cover IVF, GIFT or ZIFT. New York's IVF law reaches large-group plans.
When is open enrollment for 2027 marketplace plans?
On HealthCare.gov it runs from November 1, 2026 to January 15, 2027. Choose a plan by December 15 for coverage that starts January 1; a plan chosen from December 16 to January 15 starts February 1. If your state runs its own marketplace, apply there.
Does a marketplace plan cover fertility testing?
Often, but not everywhere. Many states' benchmark plans cover tests to find the cause of infertility even where they leave treatment out, Arizona, Missouri, Tennessee, Texas, Vermont and Virginia among them, and the laws of Delaware, DC and Maine cover diagnostic care. Look for infertility in a plan's Summary of Benefits and Coverage, or ask the plan.
- Information on Essential Health Benefits (EHB) Benchmark Plans (Centers for Medicare & Medicaid Services)
- What Marketplace health insurance plans cover (HealthCare.gov (Centers for Medicare & Medicaid Services))
- When can you get health insurance? (dates and deadlines) (HealthCare.gov (Centers for Medicare & Medicaid Services))
- Health Insurance Marketplaces in your state (HealthCare.gov (Centers for Medicare & Medicaid Services))
- Arkansas State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Arkansas EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Connecticut State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Connecticut EHB benchmark plan document (ConnectiCare), in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services)
- Delaware Code, Title 18, Chapter 33 (Health Insurance Contracts), § 3342 (State of Delaware)
- Delaware EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- D.C. Code § 31-3834.06, Coverage of fertility treatments (Council of the District of Columbia)
- District of Columbia EHB Benchmark Plan (2026-2028) Summary Information, in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services, Plan years 2026-2028)
- Hawaii State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Hawaii EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Illinois EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Illinois EHB benchmark plan document (Blue Cross Blue Shield of Illinois), in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services)
- Illinois State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Bulletin 467: Interim Guidance for Mandated Fertility Coverage (Maine Bureau of Insurance, May 23, 2023)
- Maine Revised Statutes, Title 24-A, § 4320-U (Maine Legislature)
- Rule Chapter 865, Standards for Fertility Coverage (Maine Bureau of Insurance, Effective May 11, 2024)
- Maryland State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Maryland EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Massachusetts State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Massachusetts EHB benchmark plan document (Blue Cross Blue Shield HMO Blue), in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services)
- Massachusetts EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Rhode Island General Laws § 27-18-30 (State of Rhode Island General Assembly)
- Rhode Island State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Rhode Island EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Colorado EHB Benchmark Plan (2026-2028) Summary Information, in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services, Plan years 2026-2028)
- Iowa EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Kansas EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Michigan EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Montana EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Nevada EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- New Hampshire EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- New Jersey State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- New Jersey EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- New Mexico EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- New York State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- New York EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- North Carolina EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Ohio State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Ohio EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Pennsylvania EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Washington EHB Benchmark Plan (2026-2028) Summary Information, in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services, Plan years 2026-2028)
- West Virginia EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- West Virginia EHB benchmark plan document (Highmark Blue Cross Blue Shield West Virginia), in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services)
- Alabama EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Alaska EHB Benchmark Plan (2026-2028) Summary Information, in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services, Plan years 2026-2028)
- Arizona EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- California EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Florida EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Georgia EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Idaho EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Indiana EHB Benchmark Plan (2025-2027) Summary Information, in CMS's benchmark plan file (ZIP) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Kentucky EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Louisiana EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Minnesota EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Mississippi EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Missouri EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Nebraska EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- North Dakota EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Oklahoma EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Oregon EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- South Carolina EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- South Dakota EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Tennessee EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Texas State Required Benefits (CMS) (Centers for Medicare & Medicaid Services)
- Texas EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Utah EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Vermont EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Virginia EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Wisconsin EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)
- Wyoming EHB Benchmark Plan (2025-2027) Summary Information (CMS) (Centers for Medicare & Medicaid Services, Plan years 2025-2027)