Does UnitedHealthcare cover IVF?
What UnitedHealthcare publishes about covering IVF and other fertility treatment, in its own words, with the document each statement is in.
- Documents read · checked 16 h ago
Only if your plan includes it. UnitedHealthcare's infertility policy (effective June 1, 2026) says certain plans do not cover infertility services at all and that your own plan document decides. When a plan includes an infertility benefit, IVF is one of the covered procedures, up to the plan's dollar or procedure maximum and with prior authorization. Its pharmacy program puts it more bluntly: infertility is typically excluded from coverage. In California, fully-insured large-group plans new or renewed on or after January 1, 2026 have to cover IVF.
What UnitedHealthcare's own documents say
Read on Oct 12, 2026. The words in quotation marks are the source's own.
Only if your plan includes it
“Certain plans do not cover Infertility services. Legislative mandates and the member specific benefit plan document must be reviewed when determining benefit coverage for Infertility services.”
“Infertility is typically excluded from coverage for UnitedHealthcare. Please refer to member’s specific benefits for coverage determination.”
“When the member’s plan does not include benefits for Infertility, the following services are not covered: • All health care services and related expenses for Infertility treatments, including assisted reproductive technology (see examples listed above), regardless of the reason for the treatment”
Who counts as infertile
The policy counts infertility after 12 months of trying under 35 or 6 months at 35 and over, or when pregnancy is not possible because of a person's medical, sexual or reproductive history. For a woman without a male partner, donor insemination can count toward the definition, up to 12 inseminations under 35 and 6 at 35 and over, depending on the plan's wording.
“Failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse when the female partner is less than 35 years of age.”
“Failure to achieve a pregnancy after 6 months or more of regular unprotected sexual intercourse when the female partner is 35 years or older.”
“The inability to achieve a successful pregnancy due to an individual’s medical, sexual, or reproductive history.”
“Artificial donor insemination may (refer to specific benefit language) be considered diagnostic in terms of meeting the definition of infertility for females without a male partner who do not otherwise have an identified infertility factor. Such artificial insemination is limited to not more than 12 inseminations for females <35 years of age and not more than 6 inseminations for females 35 years of age and older.”
Age and prognosis limits
Optum's guideline, which UnitedHealthcare uses to review fertility treatment, says IVF is not indicated for a recipient 55 or older, or when the chance of pregnancy is under 5% or the outlook is very poor, marked by two or more of: FSH of 15 or more, AMH under 0.2, fewer than 3 antral follicles, or an 85% or higher risk that every embryo is abnormal.
“when using autologous or donor oocytes in female recipients who are ≥55 years of age”
“Prognosis for conception must be ≥ 5%; AND • No evidence of very poor or futile prognosis. Markers of very poor or futile prognosis include but are not limited to two or more of the following: o FSH level ≥ 15 mlU/ml; OR o AMH level < 0.2 ng/ml (La Marca, 2014); OR o Antral follicle count < 3 (ASRM, 2021(a); La Marca, 2014); OR o The risk for aneuploidy for all embryos is ≥85%”
Diagnosis is covered even when treatment is not
Even on a plan that excludes infertility treatment, tests to diagnose infertility and treatment to fix an underlying physical cause are covered health services.
“Even if a plan excludes Infertility services (AI-artificial insemination, ART-assisted reproductive technology, IUI- intrauterine insemination, or ovulation induction), covered health services include procedures to diagnose Infertility and therapeutic (medical or surgical) procedures to correct a physical condition that is the underlying cause of the Infertility”
Fertility Solutions
UnitedHealthcare's fertility program, Fertility Solutions, gives members a dedicated fertility nurse and access to its Centers of Excellence. For self-funded employers, Fertility Solutions Plus adds Maven's digital platform.
“Fertility Solutions includes support from a dedicated fertility nurse and access to Centers of Excellence. For self-insured customers, Fertility Solutions Plus combines the existing fertility support services of UnitedHealthcare with Maven’s digital family health platform.”
Fertility drugs
Fertility drugs given in a clinic, hospital or at home by a provider are part of the infertility benefit. Drugs you inject yourself are not: the policy points to the plan's exclusion for self-injected drugs and to the pharmacy benefit.
“Pharmaceutical products for the treatment of Infertility that are administered on an outpatient basis in a hospital, alternate facility, physician's office, or the home”
“Self-injectable drugs for Infertility (Refer to the exclusion for self-injectable drugs in the member specific benefit plan document; refer to the pharmacy benefit administrator for self-injectable medication benefit information.)”
IUI
Under an infertility benefit, artificial insemination and IUI are covered procedures. Optum's guideline says IUI is not indicated beyond 3 cycles for unexplained infertility, low ovarian reserve and similar diagnoses.
“Insemination procedures: Artificial insemination and intrauterine insemination”
“In the setting of unexplained infertility, diminished ovarian reserve, unilateral tubal factor infertility or mild to moderate male factor infertility or minimal or mild endometriosis in the following situations: • Beyond 3 cycles (ASRM, 2020)”
How much is covered
There is no standard amount: each plan sets its own dollar or procedure maximum, and services beyond it are not covered. Optum's guideline also says IVF is not indicated after two or more cycles with poor egg, fertilization or embryo results.
“Any Infertility services or supplies beyond the benefit maximum [dollars or procedure limit(s)]”
“Numerous ≥ 2 ART cycles without adequate egg quality or production, fertilization and/or embryo quality or development”
Genetic testing of embryos
Testing embryos for a single-gene condition (PGT-M) or an inherited chromosome rearrangement (PGT-SR) can be medically necessary, if your plan covers it. Screening embryos for chromosome counts (PGT-A) is not covered.
“Preimplantation Genetic Testing (PGT) is proven and medically necessary only for monogenic/single-gene defects (PGT-M) or inherited structural chromosome rearrangements (PGT-SR)”
“Benefits are not available for PGT-A”
“Refer to the member specific benefit plan document to determine if the coverage applies.”
Fertility preservation before cancer treatment
Plans that include it cover fertility preservation when chemotherapy, radiation or removal of both ovaries for cancer will cause infertility, limited to one preservation cycle per person for as long as they are enrolled.
“Benefits are available for fertility preservation for medical reasons that cause irreversible Infertility such as chemotherapy, radiation treatment, and bilateral oophorectomy due to cancer; refer to the member specific benefit plan document.”
“Benefits are further limited to one cycle of fertility preservation for Iatrogenic Infertility per covered person during the entire period of time they are enrolled for coverage under the policy”
Elective egg freezing
IVF done to bank eggs or embryos by choice, rather than to treat infertility, is excluded even on plans with an infertility benefit, and Optum's guideline treats planned egg freezing as not indicated unless the plan documents specifically cover it.
“In vitro fertilization that is not an assisted reproductive technology for the treatment of Infertility; this would include but is not limited to elective fertility preservation or embryo accumulation/banking”
“For planned oocyte cryopreservation unless specifically covered in plan documents”
Common exclusions
Infertility from a voluntary sterilization, or a failed reversal of one, does not qualify. The cost of donor eggs, including the donor's stimulation and retrieval, is excluded on every plan, and so is storing eggs, sperm or embryos for more than a year.
“To be eligible for benefits, the member must have Infertility not related to voluntary sterilization or to failed reversal of voluntary sterilization.”
“Donor eggs: The cost of donor eggs, including medical cost related to donor stimulation and egg retrieval, is excluded.”
“Long-term storage (greater than 1 year) of reproductive materials such as sperm, eggs, embryos, ovarian tissue, and testicular tissue”
California: IVF on large-group plans from 2026
Under California's SB 729, UnitedHealthcare covers infertility diagnosis and treatment, IVF included, on fully-insured large-group plans new or renewed on or after January 1, 2026 (it began July 1, 2025 for its own large groups). The law allows up to three completed egg retrievals with unlimited embryo transfers. It does not apply to self-funded plans, and small groups have it only if the employer buys it.
“UnitedHealthcare will offer coverage for infertility treatment, including IVF for fully insured large groups, effective July 1, 2025, prior to CA Senate Bill mandate for Jan. 1, 2026.”
“A large group health care service plan contract, except a specialized health care service plan contract, that is issued, amended, or renewed on or after January 1, 2026, shall provide coverage for the diagnosis and treatment of infertility and fertility services”
“This does not apply to ASO plans, specialized plans, or religious employer’s groups.”
“Coverage for infertility services is only available if purchased by the subscriber’s employer group as a supplemental benefit.”
Whether your UnitedHealthcare plan covers IVF
UnitedHealthcare's 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 UnitedHealthcare 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 UnitedHealthcare cover IVF in your state?
Each state's insurance law applied to a UnitedHealthcare plan issued there. A state law reaches plans issued in that state, usually your employer's state, not where the clinic is.
UnitedHealthcare in Arkansas
Often, on fully-insured plans: Arkansas requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Arkansas unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (lifetime maximum applies). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Arkansas law and clinics
UnitedHealthcare in California
Often, on fully-insured plans: California requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare 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. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. California law and clinics
UnitedHealthcare in Colorado
Often, on fully-insured plans: Colorado requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Colorado unless one of the law's limits or exemptions applies. Fully-insured large-group plans must cover fertility, including IVF. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Colorado law and clinics
UnitedHealthcare in Connecticut
Often, on fully-insured plans: Connecticut requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Connecticut unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Connecticut law and clinics
UnitedHealthcare in Delaware
Often, on fully-insured plans: Delaware requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Delaware unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Delaware law and clinics
UnitedHealthcare in District of Columbia
Often, on fully-insured plans: District of Columbia requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in District of Columbia unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. District of Columbia law and clinics
UnitedHealthcare in Hawaii
Often, on fully-insured plans: Hawaii requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Hawaii unless one of the law's limits or exemptions applies. Fully-insured plans must cover a round of IVF under set conditions. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Hawaii law and clinics
UnitedHealthcare in Illinois
Often, on fully-insured plans: Illinois requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Illinois unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Illinois law and clinics
UnitedHealthcare in Maine
Often, on fully-insured plans: Maine requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Maine unless one of the law's limits or exemptions applies. Fully-insured plans must cover fertility care, including IVF. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Maine law and clinics
UnitedHealthcare in Maryland
Often, on fully-insured plans: Maryland requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Maryland unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (conditions apply). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Maryland law and clinics
UnitedHealthcare in Massachusetts
Often, on fully-insured plans: Massachusetts requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Massachusetts unless one of the law's limits or exemptions applies. One of the broadest IVF mandates; fully-insured plans must cover it. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Massachusetts law and clinics
UnitedHealthcare in New Hampshire
Often, on fully-insured plans: New Hampshire requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in New Hampshire unless one of the law's limits or exemptions applies. Fully-insured plans must cover fertility care, including IVF. A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. New Hampshire law and clinics
UnitedHealthcare in New Jersey
Often, on fully-insured plans: New Jersey requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in New Jersey unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (cycle limits apply). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. New Jersey law and clinics
UnitedHealthcare in New York
Often, on fully-insured plans: New York requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in New York unless one of the law's limits or exemptions applies. Large-group fully-insured plans must cover IVF (up to 3 cycles). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. New York law and clinics
UnitedHealthcare in Rhode Island
Often, on fully-insured plans: Rhode Island requires some fully-insured health plans to cover IVF, and that includes UnitedHealthcare plans issued in Rhode Island unless one of the law's limits or exemptions applies. Fully-insured plans must cover IVF (lifetime cap applies). A self-funded employer plan that UnitedHealthcare only administers is not bound by state law and covers IVF only if the employer chose to. Rhode Island law and clinics
UnitedHealthcare in Texas
Only if your employer bought it: Texas requires insurers to offer IVF coverage to employers, but a plan does not have to include it, so a UnitedHealthcare plan issued in Texas covers IVF only when the employer chose the benefit. Texas law and clinics
UnitedHealthcare in Louisiana
Not because of state law: Louisiana requires some infertility coverage but not IVF, so IVF under a UnitedHealthcare plan there depends on what the employer chose. Louisiana law and clinics
UnitedHealthcare in Montana
Not because of state law: Montana requires some infertility coverage but not IVF, so IVF under a UnitedHealthcare plan there depends on what the employer chose. Montana law and clinics
UnitedHealthcare in Ohio
Not because of state law: Ohio requires some infertility coverage but not IVF, so IVF under a UnitedHealthcare plan there depends on what the employer chose. Ohio law and clinics
UnitedHealthcare in West Virginia
Not because of state law: West Virginia requires some infertility coverage but not IVF, so IVF under a UnitedHealthcare plan there depends on what the employer chose. West Virginia law and clinics
UnitedHealthcare 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 UnitedHealthcare plan there depends on what the employer chose. Georgia law and clinics
UnitedHealthcare 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 UnitedHealthcare plan there depends on what the employer chose. Kentucky law and clinics
UnitedHealthcare in Nevada
Not because of state law: Nevada does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under a UnitedHealthcare plan there depends on what the employer chose. Nevada law and clinics
UnitedHealthcare in Oklahoma
Not because of state law: Oklahoma does not require insurers to cover IVF, only fertility preservation for some patients, so IVF under a UnitedHealthcare plan there depends on what the employer chose. Oklahoma law and clinics
UnitedHealthcare in Florida
Not because of state law: Florida has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Florida law and clinics
UnitedHealthcare in Utah
Not because of state law: Utah has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Utah law and clinics
UnitedHealthcare in Alabama
Not because of state law: Alabama has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Alabama law and clinics
UnitedHealthcare in Alaska
Not because of state law: Alaska has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare 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
UnitedHealthcare in Arizona
Not because of state law: Arizona has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Arizona law and clinics
UnitedHealthcare in Idaho
Not because of state law: Idaho has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Idaho law and clinics
UnitedHealthcare in Indiana
Not because of state law: Indiana has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare 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
UnitedHealthcare in Iowa
Not because of state law: Iowa has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Iowa law and clinics
UnitedHealthcare in Kansas
Not because of state law: Kansas has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Kansas law and clinics
UnitedHealthcare in Michigan
Not because of state law: Michigan has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Michigan law and clinics
UnitedHealthcare in Minnesota
Not because of state law: Minnesota has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Minnesota law and clinics
UnitedHealthcare in Mississippi
Not because of state law: Mississippi has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Mississippi law and clinics
UnitedHealthcare in Missouri
Not because of state law: Missouri has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Missouri law and clinics
UnitedHealthcare in Nebraska
Not because of state law: Nebraska has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Nebraska law and clinics
UnitedHealthcare in New Mexico
Not because of state law: New Mexico has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). New Mexico law and clinics
UnitedHealthcare in North Carolina
Not because of state law: North Carolina has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). North Carolina law and clinics
UnitedHealthcare in North Dakota
Not because of state law: North Dakota has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). North Dakota law and clinics
UnitedHealthcare in Oregon
Not because of state law: Oregon has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Oregon law and clinics
UnitedHealthcare in Pennsylvania
Not because of state law: Pennsylvania has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Pennsylvania law and clinics
UnitedHealthcare in South Carolina
Not because of state law: South Carolina has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare 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
UnitedHealthcare in South Dakota
Not because of state law: South Dakota has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). South Dakota law and clinics
UnitedHealthcare in Tennessee
Not because of state law: Tennessee has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Tennessee law and clinics
UnitedHealthcare in Vermont
Not because of state law: Vermont has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Vermont law and clinics
UnitedHealthcare in Virginia
Not because of state law: Virginia has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Virginia law and clinics
UnitedHealthcare in Washington
Not because of state law: Washington has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare 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
UnitedHealthcare in Wisconsin
Not because of state law: Wisconsin has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare 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
UnitedHealthcare in Wyoming
Not because of state law: Wyoming has no law requiring private plans to cover IVF, so IVF under a UnitedHealthcare plan there depends entirely on what the employer chose (or, for a plan you buy yourself, on the plan's own terms). Wyoming law and clinics
State laws as summarized by RESOLVE Insurance Coverage by State, read Oct 1, 2026.
How to see what your UnitedHealthcare plan covers
A policy or program page is a summary. Your own plan's documents are what it pays by.
- 1Sign in to your UnitedHealthcare member account to see what family-building benefits your plan offers.
- 2Read the infertility section and the exclusions in your own plan document (your employer's summary plan description or certificate of coverage): UnitedHealthcare's policy says that document governs when it differs from the standard plan.
- 3Call the member number on your ID card and ask whether your plan includes an infertility benefit, what its dollar or procedure maximum is, and whether fertility drugs are covered under the medical or the pharmacy benefit.
- 4Ask about Fertility Solutions: UnitedHealthcare's provider news gives Optum Fertility Solutions' number, 866-774-4626, for clinical support and its Centers of Excellence.
- 5Ask HR whether your plan is fully insured or self-funded: a state law reaches only fully-insured plans (California's 2026 IVF law does not apply to self-funded ones).
- 6Before treatment, make sure your clinic has prior authorization.
UnitedHealthcare and IVF: common questions
Does UnitedHealthcare cover IVF?
Only if your plan includes it. UnitedHealthcare's infertility policy, effective June 1, 2026, says certain plans do not cover infertility services and that your own plan document decides; when a plan includes an infertility benefit, IVF is covered up to the plan's dollar or procedure maximum, with prior authorization. Its pharmacy program says infertility is typically excluded from coverage.
Does UnitedHealthcare cover IVF in California?
On fully-insured large-group plans, yes: under California's SB 729, plans new or renewed on or after January 1, 2026 cover infertility diagnosis and treatment including IVF, up to three completed egg retrievals with unlimited embryo transfers. It does not apply to self-funded plans, and small-group plans include it only if the employer buys it.
Does UnitedHealthcare cover IVF in my state?
A fully-insured UnitedHealthcare plan issued in a state that requires IVF coverage follows that law, within its limits and exemptions. A self-funded employer plan that UnitedHealthcare only administers does not, and most states require nothing, so there the employer's choice decides. The By state section of this page gives the answer for every state.
Does UnitedHealthcare cover IVF medications?
Drugs a provider gives you in a clinic, hospital or at home are part of the infertility benefit. Drugs you inject yourself, which is most IVF stimulation drugs, fall under the plan's self-injectable exclusion and the pharmacy benefit, so ask your pharmacy benefit administrator.
Does UnitedHealthcare cover egg freezing?
For medical reasons on plans that include it: fertility preservation before chemotherapy, radiation or removal of both ovaries for cancer is covered, one cycle per person. Elective egg or embryo banking is excluded even on plans with an infertility benefit.
Does UnitedHealthcare cover PGT testing?
Testing embryos for a single-gene condition (PGT-M) or an inherited chromosome rearrangement (PGT-SR) can be medically necessary if your plan covers it. Screening embryos for chromosome counts (PGT-A) is not covered.
- Infertility Diagnosis, Treatment, and Fertility Preservation (UnitedHealthcare Commercial and Individual Exchange Medical Policy 2026T0270NN) (UnitedHealthcare, Effective Date: June 1, 2026)
- UnitedHealthcare Pharmacy Prior Authorization/Notification: Follistim AQ, Gonal-f, Gonal-f RFF (Program 2026 P 1038-16) (UnitedHealthcare, Effective Date 9/1/2026)
- Fertility Solutions Medical Necessity Clinical Guideline: Infertility (Optum, referenced by the UHC policy for medical necessity reviews) (Optum, for UnitedHealthcare, Effective 09/09/2026)
- Prior authorization requirements for UnitedHealthcare commercial plans (UnitedHealthcare, Effective October 1, 2026)
- IVF and related services coverage updates (UHCprovider.com Network News) (UnitedHealthcare, July 17, 2025; last modified Sept. 26, 2025)
- Maternity health benefits (uhc.com employer page) (UnitedHealthcare)
- Preimplantation Genetic Testing and Related Services (UnitedHealthcare Commercial and Individual Exchange Medical Policy 2026T0597Q) (UnitedHealthcare, Effective Date: May 1, 2026)
- UnitedHealthcare to expand infertility coverage for California fully insured plans (uhc.com agents and brokers) (UnitedHealthcare, July 24, 2025)
- Family Planning: Infertility Services (UnitedHealthcare West Benefit Interpretation Policy BIP067.S, UnitedHealthcare of California HMO / Benefits Plan of California EPO/POS) (UnitedHealthcare, Effective Date: June 1, 2026)