New York has expanded insurance coverage for in vitro fertilization ("IVF") and fertility preservation services, effective January 1, 2020.
To help to explain the new law, the New York State Department of Financial Services ("DFS") has issued FAQs to clarify the changes to IVF coverage and fertility preservation services, including mandatory coverage of prescription drugs by large group health insurers provided in connection with IVF services.
The FAQs provide information to help understand eligibility and coverage details and instruct insurers on compliance with legal requirements under the expanded reproductive coverage.
"New York is leading the fight to expand reproductive health access for all New Yorkers, no matter who they love or how much money they have," Governor Cuomo said in a statement. "This new law will help break down economic barriers that have prevented too many individuals and families from having a child of their own and give New Yorkers more control over their reproductive health and family planning decisions."
Linda A. Lacewell, the DFS superintendent, added, "DFS and New York State is on the side of families and we are reminding New Yorkers of their rights and insurers of their obligations under the state's new IVF and fertility preservation law. As Washington rolls back critical reproductive health rights, New York will continue to fight to ensure New Yorkers receive the care they deserve."
New mandated benefits under the law include:
- Mandatory coverage of prescription drugs in connection with IVF services by large group health insurance policies.
- Access to fertility preservation services for insured New Yorkers who are about to undergo gender-affirming care.
- Health insurance policies that provide comprehensive care must cover fertility preservation services, which include egg and/or embryo storage if medically necessary until the three required IVF cycles are provided.
- Coverage for three cycles of IVF, including all treatment that starts when preparatory medications are administered for ovarian stimulation with the intent of undergoing IVF using a fresh or frozen embryo, by large group health insurance policies.
The law also prohibits age restrictions on IVF coverage and prohibits insurers from imposing lifetime limitations on fertility preservation services.
Learn more: DFS Guidance.
Victoria Spears
Victoria Prussen Spears is senior vice president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. A graduate of Sarah Lawrence College and Brooklyn Law School, Ms. Spears was an attorney at a leading New York City law firm before joining Meyerowitz Communications. She may be contacted at [email protected].