Maryland Infertilty and IVF Health Insurance Coverage

Maryland infertility and IVF health insurance is mandated by state law. 

The Maryland law mandates the all health insurers that provide pregnancy related benefits to cover the out-patient treatment cost of in vitro fertilization (IVF). The law does not apply to health maintenance organizations (HMO) unless it choose to cover other infertility treatments.

The Maryland infertility and IVF health insurance law has some interesting quirks that couples need to understand and address:

• Coverage does not apply to every resident - see who is covered
  
• There is a two year waiting period for IVF insurance coverage - how do you pay for 2 years of infertility treatment costs before trying IVF?  Can you wait that long to start your family?
• Unique IVF qualifications - male factor infertility couples lose out.  What to do?
  

The Maryland infertility insurance mandate does not automatically cover every resident - even with some unique features.

Unlike other states with infertility coverage mandates the Maryland law goes a step further: it applies to people living and working in Maryland, regardless of whether the policy is issued outside of Maryland.  If you work for an out-of-state employer your health insurance policy was probably issued in another state and must comply with those state insurance mandates - in addition to the MD rule.  Your employer might overlook this rule.  Check your policy carefully for compliance.

Source: Maryland Insurance Article 15-810

In Vitro Fertilization (IVF) is often the last line of treatment for couples trying to conceive.  Many other treatments including fertility drugs, artificial insemination, and more are not subject to this regulation.

In addition the Maryland mandate stipulates that a patient must have two years of unexplained infertility.  That poses a difficult choice for couples trying to conceive:

• Should we pay for other infertility treatments ourselves right away?
• Should we wait two years and go straight for IVF even though other treatments may work?
  

For those who don't want to wait consider this:

• Cut your infertility costs by leveraging the tax code and flexible spending accounts. 
• Use supplemental health insurance to create income from your normal delivery to offset your infertility treatment costs, and get additional security for complications. 

The Maryland IVF insurance law stipulates that the egg must be fertilized by the patient's spouse. This rule may have been included to limit IVF access for same sex couples, but it also impacts a large group of mainstream couples as well: those with male factor infertility.

Male factor infertility is a sole or contributing cause in 40% of infertile couples. The husband may have difficulty generating healthy sperm or sperm capable of fertilizing an egg.

Couples dealing with male infertility have no relief from the Maryland IVF insurance mandate - even after trying for two years. Make the most of tax breaks and supplemental insurance.