Does Premera Blue Cross cover IVF?
What Premera Blue Cross publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 4 d ago
Only if your contract covers it. Premera's infertility guideline (effective June 1, 2026) says tests to diagnose infertility are a medical benefit, but treatment, assisted reproduction included, may be allowed only when the member's contract covers it, and its drug policy (effective July 1, 2026) says the same for fertility drugs. Premera serves Washington, except Clark County, and Alaska; neither state requires private plans to cover IVF.
What Premera Blue Cross' own documents say
Read on Oct 22, 2026. The words in quotation marks are the source's own.
Only if your contract covers it
“Even though an infertility treatment exists, it does not mean it is covered; the member’s contract determines this. (Services to diagnose infertility are covered as a medical benefit.)”
“Once an infertility diagnosis has been established, infertility treatments may be allowed, dependent on the member’s contract.”
Where Premera is the Blue plan
Washington state, except Clark County, and Alaska.
“Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving businesses and residents of Alaska and Washington state, excluding Clark County.”
Fertility drugs
Covered only if your contract covers them; the drug policy then sets when drugs used in assisted reproduction are medically necessary.
“Even though drug treatment exists, it does not mean it is covered; the member’s contract determines this. This policy describes when drugs used in assisted reproduction may be considered medically necessary if covered by the member’s contract.”
Before treatment that may cause infertility
Infertility treatment may also be allowed, depending on the contract, for members facing medical or surgical treatment with a significant likelihood of causing infertility.
“Infertility treatments may also be allowed, dependent on the member’s contract, for members undergoing or scheduled to undergo medical or surgical treatment with a significant likelihood of causing infertility.”
A listed service is not a covered one
The guideline's tables of assisted fertilization services do not mean a service is covered: the member's contract decides, and contracts differ.
“Listing of a service in the Assisted Fertilization Services tables does not imply it is covered. Coverage is determined by the member’s contract. Refer to the member contract language for benefit determination.”
“Member contracts differ in their benefits.”
Whether your Premera Blue Cross plan covers IVF
The Premera Blue Cross 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 Premera Blue Cross 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 Premera Blue Cross cover IVF in your state?
Each state's insurance law applied to a Premera Blue Cross plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
Premera Blue Cross in Alaska
Not because of state law: Alaska has no law requiring private plans to cover IVF, so IVF under a Premera Blue Cross plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Alaska law and clinics
Premera Blue Cross in Washington
Not because of state law: Washington has no law requiring private plans to cover IVF, so IVF under a Premera Blue Cross plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Washington law and clinics
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your Premera Blue Cross plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Read the infertility section of your benefit booklet: Premera's guideline says your contract decides whether treatment is covered.
- 2Call a Premera member service representative and ask whether IVF and fertility drugs are covered on your plan, and what the limits are.
- 3If you face cancer treatment or surgery that may cause infertility, ask specifically about fertility preservation under your contract.
Premera Blue Cross and IVF: common questions
Does Premera Blue Cross cover IVF?
Only if your contract covers it. Premera's infertility guideline, effective June 1, 2026, says tests to diagnose infertility are a medical benefit, but treatment, assisted reproduction included, may be allowed only when the member's contract covers it.
Does Premera cover fertility drugs?
Only if your contract covers them, its drug policy effective July 1, 2026 says; it then sets when drugs used in assisted reproduction are medically necessary.
Does Washington require insurance to cover IVF?
No. Washington has no law requiring private plans to cover IVF, so a Premera plan covers it only when the employer or the plan includes the benefit.
- Premera Benefit Coverage Guideline 4.02.503 Infertility and Assisted Reproduction Services (BCBSA Ref. Policy 4.02.04) (Premera Blue Cross, Effective Date: Jun. 1, 2026; Last Revised: May 11, 2026)
- Premera Blue Cross medical policies page (footer) (Premera Blue Cross)
- Premera Pharmacy / Medical Policy 5.01.610 Pharmacologic Treatment in Assisted Reproduction (Premera Blue Cross, Effective Date: Jul. 1, 2026; Last Revised: Jun. 22, 2026)