Ohio Infertility Mandate
Ohio Infertility & IVF Health Insurance Laws
Ohio is one of only a handful of states with a law requiring certain insurance plans to cover infertility treatments. Some of the wording is vague and difficult to interpret. You will find below some of the important definitions and key points summarized below in simplified language.
The Ohio mandate is not the most comprehensive or specific state law we have seen. Chances are not high that your plan will be required to cover all your costs when trying to conceive. You may need to pay out of pocket. Make sure you leverage the tax code to it’s fullest advantage, and use supplemental insurance to offset your costs when you become pregnant and deliver your baby.
Interpreting Ohio Infertility Law
Ohio insurance law mandates that a Health Insuring Corporation must provide basic health care services when medically necessary. In order to understand and apply this applies to OH couples trying to conceive, we must interpret each of these terms from some dense legal language.
Ohio Infertility Treatments Eligible for Coverage
Basic health care services are defined in part as preventive services including fertility procedures. The Ohio Department of Insurance issued Bulletin 2009-07 clarifying the meaning of infertility services, and the phrase "medically necessary". Infertility services are defined as diagnostic and exploratory procedures to correct medically diagnosed diseases of the reproductive organs including but not limited to:
Certain infertility procedures are specifically excluded from the mandated requirements:
Ohio Revised Code - 1751.01