Updated September 26, 2025
Does Insurance Cover IVF in California? New 2025 Law Changes Everything
Does insurance cover IVF in California? Until now, the answer has been complicated and often disappointing for thousands of hopeful parents facing fertility challenges. The average cost of a single IVF cycle can exceed $20,000, putting this essential medical treatment out of reach for many families without insurance support.
However, everything is about to change with California's groundbreaking new law. Senate Bill 729 (SB 729), signed in 2023, will transform fertility coverage across the state beginning in 2025, making California one of the most progressive states for reproductive healthcare access.
As a result of this legislation, many Californians will finally have access to comprehensive fertility treatments through their insurance for the first time. This isn't just a minor policy adjustment—it represents a fundamental shift in how the state approaches reproductive healthcare and family building.
First, we'll examine exactly what SB 729 includes, who qualifies for coverage, when these benefits take effect, and what specific fertility services will be covered. Then we'll guide you through practical steps to prepare for these changes and maximize your benefits under this new law.
What is California’s new IVF insurance law (SB 729)?
California's Senate Bill 729 represents a major breakthrough for fertility healthcare access. Signed into law by Governor Gavin Newsom in October 2023, this legislation fundamentally changes how fertility treatments are covered by insurance throughout the state.
Why this law was introduced
For decades, most Californians struggled with the enormous financial burden of fertility treatments. Before SB 729, insurance companies typically classified IVF as an "elective" procedure rather than a necessary medical treatment. This classification left countless individuals and couples facing impossible choices between starting a family and financial stability.
The push for this legislation came after years of advocacy from patient groups, medical professionals, and fertility justice organizations. These groups highlighted how the lack of insurance coverage created significant inequities in who could access fertility care. Without coverage, a single IVF cycle could cost upwards of $20,000 out of pocket, with many patients requiring multiple cycles.
Additionally, the law acknowledges that fertility challenges are legitimate medical conditions deserving the same insurance consideration as other health issues. Supporters pointed out that fifteen other states already had some form of IVF coverage mandate, leaving California behind despite its otherwise progressive healthcare policies.
How it changes previous insurance rules
Prior to SB 729, California only required insurance plans to offer coverage for some infertility treatments—but explicitly excluded IVF. Furthermore, these limited requirements only applied to certain types of health plans, creating a patchwork system where coverage varied dramatically depending on employer size and plan type.
The new law makes several critical changes:
- It requires rather than merely offers coverage for fertility treatments
- It explicitly includes IVF in the mandated coverage
- It expands the definition of infertility to be more inclusive
- It prohibits lifetime caps or unreasonable limits on treatment cycles
Perhaps most significantly, SB 729 moves away from the traditional medical definition of infertility that required 12 months of unsuccessful attempts to conceive. The updated definition recognizes the needs of LGBTQ+ individuals and single parents by including a "functional" definition that acknowledges when pregnancy is impossible without medical intervention.
What IVF services are now included
Under the new law, qualifying insurance plans must cover a comprehensive range of fertility services. The coverage extends beyond just the IVF procedure itself to include:
- Initial fertility evaluations and diagnostic testing
- Ovarian stimulation medications and monitoring
- Egg retrieval procedures
- Laboratory services including fertilization and embryo culture
- Embryo transfer procedures
- Cryopreservation (freezing) and storage of eggs, sperm, and embryos
- Genetic testing of embryos when medically indicated
Notably, the law requires coverage for multiple IVF cycles if medically necessary—a crucial provision since many patients require more than one cycle to achieve a successful pregnancy.
While the law doesn't set specific dollar limits on coverage, it does allow for "reasonable medical management techniques," meaning insurance companies may still implement some cost-control measures like requiring patients to try less expensive fertility treatments before approving IVF.
The question "does insurance cover IVF" in California now has a much more positive answer for many residents, though as we'll explore in subsequent sections, important exceptions and implementation timelines still apply.
Who qualifies for IVF coverage under the new law?
Not everyone in California will have access to fertility treatment coverage under SB 729. Understanding exactly who qualifies—and who doesn't—is crucial for anyone considering fertility treatments in the state.
Large group plans vs. small group and self-funded plans
The coverage mandate primarily applies to fully insured large group health plans—specifically those covering 101 or more employees [1][2]. These plans must provide comprehensive coverage for infertility diagnosis and treatment, including IVF [3].
Conversely, the requirements differ significantly for smaller employers:
Small group plans (those with up to 100 employees) are not required to include fertility coverage by default [1][2]. Instead, insurance carriers must simply offer at least one plan with comparable infertility coverage in the small group market [4][5]. Importantly, small employers have no obligation to select or provide these plans to their employees.
Self-funded or level-funded plans fall outside the mandate entirely [3][2]. Since these plans are governed by federal ERISA law rather than state insurance regulations, they remain exempt from California's new requirements [6][5]. If you're unsure about your plan type, contact your HR department with this simple question: "Do we have a fully insured or self-insured health plan, and is our health insurance regulated by California law?" [3]
Additionally, the mandate excludes individual market plans, Medicaid, Medicare, and plans offered on the California Exchange (Covered California) [3].
LGBTQ+ individuals and single parents
One groundbreaking aspect of SB 729 is its inclusivity. The law explicitly extends coverage to LGBTQ+ individuals, single parents by choice, and others historically excluded from fertility benefits [7][8].
Essentially, the law broadens the traditional definition of infertility beyond the typical medical diagnosis that required 12 months of unsuccessful conception attempts. Under SB 729, coverage must be provided without discrimination based on:
- Age
- Gender identity or expression
- Sexual orientation
- Marital status
- Domestic partner status [9]
This inclusive approach ensures that same-sex couples and single individuals seeking to start families have equal access to fertility services that were previously unavailable to them under traditional infertility definitions [10][11].
Exemptions: religious employers and others
Several categories of employers and plans remain exempt from the new coverage requirements:
Religious employers that meet all four of these criteria:
- The organization's primary purpose is the "inculcation of religious values"
- The entity primarily employs persons who share its religious tenets
- The entity primarily serves persons who share its religious tenets
- The entity is a qualified nonprofit organization as described in Section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code [1][9]
California Public Employees' Retirement System (CalPERS) initially received an exemption but will eventually need to comply with the law starting July 1, 2027—a full year after most other plans [4][6]
Government programs including Medi-Cal (California's Medicaid program) and Medicare [10][6]
Specialized plans such as dental-only or vision-only coverage [9]
For the approximately 9 million Californians enrolled in large group, state-regulated health plans, the answer to "does insurance cover IVF" will soon be yes [10]. Nevertheless, the many exceptions mean millions of others will still lack mandatory coverage.
When does the new IVF coverage take effect?
The implementation timeline for California's new IVF mandate has undergone significant changes. If you're wondering exactly when insurance will cover IVF under this groundbreaking law, the answer depends on several factors including your employer's plan renewal date.
Original vs. updated implementation dates
When first signed into law in September 2024, SB 729 was originally scheduled to take effect on July 1, 2025 [2]. Yet subsequent legislative action has pushed this date back. Upon signing the bill, Governor Newsom immediately requested that the California Legislature delay implementation by six months [12].
This delay became official on June 30, 2025, when Governor Newsom signed Assembly Bill 116 (AB 116) as part of the 2025-2026 state budget [2]. As a result, SB 729 will now be implemented on January 1, 2026 [3]. This six-month extension gives insurance carriers, employers, and healthcare providers additional time to prepare for the sweeping changes.
How plan renewal dates affect your coverage
An important detail many prospective parents miss: the mandate only takes effect when your employer's health insurance plan is renewed or newly issued on or after January 1, 2026 [3].
For instance:
- If your employer's plan renews on January 1, 2026, you'll gain IVF coverage immediately
- If your plan renews in March 2026, your coverage begins in March
- If your plan renewed in December 2025, you might wait until December 2026 for coverage
According to the California Department of Managed Health Care, most employers subject to the law renew their contracts in January [12], consequently most eligible employees will gain coverage at the start of 2026. Nonetheless, for those whose employers renew later in the year, access to covered fertility treatments might not begin until mid-to-late 2026.
Not sure when your plan renews? Contact your human resources department to ask specifically about your health insurance renewal date [3]. This information is crucial for planning fertility treatments and budgeting accordingly.
Special timeline for CalPERS and state employees
State employees covered under CalPERS health plans face an even longer wait. The law explicitly exempts CalPERS from the initial implementation requirements, giving this large system additional time to integrate the new benefits [6].
For CalPERS members—primarily California state employees—coverage for fertility treatments and IVF will not begin until July 1, 2027 [13], a full 18 months after the general implementation date.
Moreover, some sources indicate that certain CalPERS plans may actually implement coverage on January 1, 2027 [8], creating potential confusion. State employees should directly contact CalPERS or their HR representatives to confirm their specific coverage start date.
In the meantime, for everyone affected by these implementation timelines, consulting with both fertility specialists and insurance representatives remains crucial for understanding exactly when you can answer "yes" to the question: "does insurance cover IVF for me?"
What fertility services are covered and what’s excluded?
Understanding exactly what fertility treatments your insurance will cover under SB 729 is crucial for financial planning. The new mandate establishes clear guidelines about which services are included and which remain out-of-pocket expenses.
Egg retrievals and embryo transfers
Under the new law, covered plans must include comprehensive IVF services. This primarily encompasses:
- Complete diagnostic testing to determine fertility status
- Medications for ovarian stimulation and egg development
- Monitoring appointments including bloodwork and ultrasounds
- The egg retrieval procedure itself
- Laboratory services for fertilization and embryo culture
- Fresh and frozen embryo transfer procedures
Importantly, the law requires coverage for multiple IVF cycles when medically necessary, recognizing that many patients require more than one attempt to achieve pregnancy. Although insurance companies can implement "reasonable medical management techniques," they cannot impose arbitrary limits that would effectively deny necessary care.
Medically necessary fertility preservation
Beyond traditional infertility treatment, the law mandates coverage for fertility preservation when medically necessary. This specifically applies to patients facing medical treatments that might cause infertility, such as:
- Cancer treatments including chemotherapy and radiation
- Gender-affirming care that could affect fertility
- Autoimmune conditions requiring treatments that might damage reproductive organs
Covered preservation services typically include egg or sperm freezing prior to these medical interventions. The mandate also includes ongoing storage costs for preserved reproductive materials for patients who meet these medical necessity criteria.
What is not covered: elective preservation, surrogacy, etc.
Although comprehensive, certain fertility-related services remain excluded from the coverage mandate:
- Elective egg freezing without medical necessity (such as age-related preservation)
- Surrogacy-related expenses including compensation for surrogates
- Long-term storage costs for eggs, sperm, or embryos beyond what's medically necessary
- Reversal of voluntary sterilization procedures (such as tubal ligation or vasectomy reversals)
- Non-medical costs related to donor eggs or sperm
Certain genetic testing procedures may fall into a gray area—preimplantation genetic testing for aneuploidy (abnormal chromosome numbers) might be covered when medically indicated, while testing for non-medical sex selection or other non-medical preferences typically remains uncovered.
For services not included in the mandate, patients should expect to pay out-of-pocket or seek supplemental coverage options. Many fertility clinics offer financial counseling to help patients navigate these complex coverage decisions and identify potential financial assistance programs for excluded services.
What should you do now to prepare?
With the new law taking effect in 2026, taking action now can help you maximize your future benefits and make informed decisions about your fertility journey.
How to check if your plan is fully insured
First, determine if SB 729 will apply to your coverage. The mandate only affects fully insured large group health plans regulated by California law. Self-funded plans are exempt. To confirm your plan type, contact your human resources department and ask directly: "Do we have a fully insured or self-insured health plan? And is our health insurance regulated by California law?" [3]
Talking to your HR department
Once you've confirmed your plan type, request additional details from HR about your current and future coverage. Ask specifically about your plan's renewal date, which determines when new benefits take effect [3]. Request your Summary Plan Description (SPD) and evidence of coverage documents to review all details in writing [14]. Document all communications for your records.
Meeting with a fertility specialist
Even before coverage begins, consulting with a fertility specialist is valuable. Your doctor can assess your fertility status, complete necessary diagnostic testing, and create a personalized treatment plan [15]. Importantly, age remains the biggest factor affecting fertility outcomes—delaying treatment while waiting for insurance coverage might not be medically advisable for everyone [8].
Understanding your current out-of-pocket costs
Meanwhile, work with a financial counselor at your fertility clinic to understand existing benefits and costs. Many clinics offer financial educators who can help verify your insurance coverage and create a financial plan [16]. Track all expenses using FSA/HSA accounts where applicable, and maintain detailed receipts for future claim submissions [14]. Some clinics extend cash-pay discounts for services not covered by insurance [17].
By preparing thoroughly now, you'll be ready to make the most of your coverage when it becomes available.
Conclusion
California's groundbreaking fertility insurance mandate represents a significant shift in reproductive healthcare access. After years of prohibitive out-of-pocket costs, thousands of Californians will finally have insurance coverage for IVF treatments starting in 2026. This change eliminates a major financial barrier that has prevented many individuals and couples from building their families.
Nevertheless, important limitations remain. The law primarily benefits those with large group fully-insured plans while leaving others without mandated coverage. Additionally, the delayed implementation timeline means patients must carefully consider whether waiting for coverage aligns with their personal fertility timeline and medical needs.
Undoubtedly, SB 729 places California among the most progressive states for fertility coverage. The inclusive definition of infertility particularly benefits LGBTQ+ individuals and single parents who were previously excluded from traditional coverage frameworks. Though certain services like surrogacy and elective egg freezing remain excluded, the core treatments essential for many fertility journeys will become accessible.
For those hoping to benefit from these changes, preparation starts now. First, confirm your plan type with your employer. Then, understand your renewal date to pinpoint when coverage begins. Meanwhile, consider consulting with fertility specialists to assess your situation and create a treatment plan. Finally, explore existing financial options while waiting for the new law to take effect.
Despite its limitations, this legislation marks a transformative step forward in recognizing fertility treatments as essential healthcare rather than elective procedures. As January 2026 approaches, thousands of Californians previously priced out of parenthood will gain new pathways to building their families.
References
[1] – https://ogletree.com/insights-resources/blog-posts/california-governor-signs-legislation-expanding-infertility-and-ivf-coverage/
[2] – https://www.sequoia.com/2025/07/california-mandates-infertility-ivf-coverage-updated/
[3] – https://resolve.org/learn/financial-resources/insurance-coverage/understanding-californias-ivf-insurance-law/
[4] – https://www.azaleahealth.com/blog/california-ivf-bill/
[5] – https://www.wordandbrown.com/NewsPost/California-Law-Fertility-and-IVF-Coverage
[6] – https://wordandbrown.com/NewsPost/California-Law-Fertility-and-IVF-Coverage
[7] – https://www.ccrmivf.com/blog/california-sb729-fertility-coverage/
[8] – https://kindbody.com/sb-729-explained-what-it-means-for-fertility-patients-in-california/
[9] – https://www.keenan.com/knowledge-center/news-and-insights/briefings/new-infertility-coverage-mandate-for-california-health-plans/
[10] – https://calmatters.org/health/2024/09/ivf-health-insurance-coverage-law/
[11] – https://ncfmc.com/post/california-senate-bill-729-faq
[12] – https://californiahealthline.org/news/article/california-ivf-law-delay-2026-newsom/
[13] – https://www.mybenefitadvisor.com/siteassets/documents/2025/q3/california-delays-implementing-mandated-fertility-benefits—072325m.pdf?v=20f06bf3
[14] – https://www.laborlawpc.com/blog/your-right-to-fertility-and-ivf-benefits-what-california-employees-should-know/
[15] – https://www.shadygrovefertility.com/article/california-senate-bill-729/
[16] – https://www.fertilityassociates.com/using-insurance/
[17] – https://crh.ucsf.edu/fertility-insurance-coverage/
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