Last updated October 2025. Coverage depends on your insurance plan and may change over time.
New York requires insurance coverage for essential infertility services across individual, small-group, and large-group fully insured plans, as long as you meet the clinical definition of infertility.
Large-group plans (typically employers with over 100 employees) must also include benefits for up to three IVF cycles, along with medications associated with each cycle.
Important: Self-funded (ERISA) employer plans and government-sponsored programs follow different rules. After your first consultation at ConceptionIVF, our financial team will review your benefits and confirm exactly what your plan covers.
Start by scheduling a consultation. You’ll then be assigned a Financial Coordinator who will verify your coverage, check authorizations, and prepare a cost estimate tailored to your treatment plan.
Need assistance? Call our Patient Support Team at (212) 661-7673.
Below are the typical requirements included in the New York state mandate:
Fully insured individual, small-group, and large-group plans must provide medically necessary infertility care, including:
1. Diagnostic testing and evaluation
2. Treatment for correctable reproductive issues
3. Basic fertility treatments, such as intrauterine insemination (IUI)
IVF coverage applies only to large-group fully insured plans.
Large-group plans are required to cover:
1. Up to 3 IVF cycles per insured individual over their lifetime
2. No annual dollar caps
3. No age-based limits
Plans may still require preauthorization and standard copays, coinsurance, or deductibles.
A single IVF cycle includes:
1.Monitoring visits
2. Blood work and ultrasound testing
3. All cycle-specific medications
4. Egg retrieval with anesthesia
5. Laboratory fertilization services
6. Embryo culture and development
7. Either a fresh transfer or frozen embryo
8. transfer (FET) with uterine preparation
All market segments—individual, small-group, and large-group—must cover medically necessary fertility preservation, including:
1. Collection, free
zing, and storage of eggs or sperm:
2. When undergoing medical treatment that may result in infertility
Age-based restrictions are not allowed, though medical necessity review and preauthorization may be required.
1. HMO/EPO plans may restrict coverage to in-network providers.
2. PPO/POS plans must offer the same out-of-network infertility benefits that are available for other services, subject to standard cost-sharing and prior authorization.
The mandate applies to fully insured New York health plans.
It does not apply to:
1. Self-funded (ERISA) plans
2. Medicaid managed care
3. Medicare, Essential Plan, or other government programs
We recommend checking plan details with your employer or plan administrator during enrollment.
Living in a state with an infertility coverage mandate can significantly reduce out-of-pocket expenses and make fertility care far more accessible.
After your initial consultation at ConceptionIVF:
Throughout treatment, our team is here to:
Explore more helpful resources in our Fertility Finance Center:
Find organizations offering IVF and fertility preservation grants.
Planning for the cost of treatment can feel overwhelming. Our specialists have created a detailed Financial Planning for Fertility Treatment eBook that covers:
Download your free copy by filling out the form below.
Check with your employer’s HR department or review your Summary of Benefits and Coverage (SBC). If your plan is self-funded, New York’s IVF mandate does not apply. We verify your benefits after your first visit.
Yes. For large-group fully insured plans, cycle-related medications and anesthesia for egg retrieval are typically covered, though prior authorization or use of a specialty pharmacy may be required.
Storage directly related to your mandated IVF cycles is included until all three eligible cycles are completed. Additional long-term storage varies by insurer.
Yes. New York prohibits discrimination based on marital status, gender identity, sex, or sexual orientation. Coverage still depends on medical necessity and your specific insurance plan.
At ConceptionIVF, our experienced fertility specialists and support staff provide compassionate, individualized care for patients across New York and nearby Connecticut.
After your consultation, your Financial Coordinator will:
You’ll find everything you need here: a full spectrum of services, our award-winning laboratory, and heartfelt support for your mind and body.
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