Texas Infertility & IVF Insurance Coverage

The Texas IVF Insurance law defines who is eligible for coverage as:

• You must be the policyholder or spouse of the policyholder
• Your eggs must be fertilized with your spouse's sperm
• You and your spouse have a history of infertility of at least five continuous years or associated with endometriosis, DES, blockage of or surgical removal of one or both fallopian tubes or oligospermia
• You have been unable to attain a pregnancy through less costly treatment covered under your policy
• The IVF procedures must be performed at medical facilities that conform to ACOG and ASRM guideline

The Texas law does not require employers that are religious organizations to offer coverage for treatment that conflict with the organization's religious values. Self insured employers are exempt from the Texas infertility insurance law.

Source: Texas Insurance Code: Title 8 Section 1366

Texas infertility health insurance laws address IVF specifically and require that your try other less costly procedures for at least five years. Since the law does not mandate coverage for these other procedures, it is unlikely that your health plan will cover them.

Also Infertility health insurance mandates raise the costs of insurance for all plan participants. Insurers competing for business are unlikely to include the coverage unless specifically requested by an employer. Employers looking to cut cost are unlikely to make the option available unless the employee population demands the option.

So what do you do? Discover three ways to cut your infertility costs for a variety of treatments: find coverage from employers based in mandate states with better laws, let the IRS cut infertility costs by 1/3 or more, and purchase supplemental maternity insurance before getting pregnant.