Louisiana Law Mandating Coverage for Infertility

Louisiana law mandates that health insurance plans may not exclude coverage for "diagnosis and treatment of correctable medical conditions". Health policies, contracts, and plans may not deny coverage for treatment of a correctable medical condition only because the condition results in infertility.

The law specifically excludes specified assisted reproductive techniques, but does not rule out care that helps you become pregnant - if the care corrects your medical condition.

• So what does this all mean?
• Who does the law apply to?
• What treatments or conditions might be covered?

Below are the leading causes of infertility in men and women. If your doctor has identified a way to treat the underlying condition, your insurance plan may be required to provide coverage.

The Louisiana mandate is vague about what conditions and treatment options are required, but does effectively rule out almost every type of common infertility procedure, including:

• Fertility drugs
• In Vitro Fertilization or any other artificial reproductive technique
• Reversal of any method of sterilization
• Tubal ligation reversal
• Vasectomy reversal

The inclusion of the term “any other artificial reproductive technique is extremely broad, and confines treatment to the correction of the underlying medical condition. Notice the use of the term “any” several times in the language.

One area where the law extends further than other mandates is the definition of a health insurance policy, contract, or plan. Only a handful of states have infertility mandates, and most leave a loophole for employers who self-insure. The Louisiana mandate specifically includes any self-insurance plans in the requirements.

The leading causes of male infertility are listed below.  Your doctor would need to correct the underlying problem in order for the Louisiana infertility insurance law to apply:

• Impaired shape and movement of sperm
• Low sperm concentration
• Varicocele
• Undescended testicle
• Testosterone deficiency
• Infections
• Sexual issues
• Retrograde ejaculation
• Blockage of epididymis
• Misplaced urinary opening
• Cystic fibrosis

Louisiana law holds any traditional surrogacy contract void and unenforceable as against public policy, but does not address uncompensated agreements or gestational surrogacy arrangements.

Below are the leading causes of female infertility.  As above, your treatment would be needed to correct the underlying condition in order for the mandate to apply.

• Fallopian tube damage or blockage
• Endometriosis
• Ovulation disorders
• Elevated prolactin
• Polycystic ovary syndrome (PCOS)
• Early menopause (premature ovarian failure)
• Uterine fibroids
• Pelvic adhesions