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Texas Infertility Mandate
Texas Infertility & IVF Insurance Law Mandating Coverage
Texas state law mandates the group health insurance plans that provide pregnancy related benefits must offer coverage for expenses that arise out of In Vitro Fertilization (IVF). Benefits must be provided to the same extent as any pregnancy related procedures under the plan. The mandate requires 5 years of continuous infertility, or an inability to conceive due to specific conditions which are listed below. So what does this mean for TX couples trying to conceive? It depends upon your situation. Find some strategies to cope below.
Many couples simply don’t want to wait five years to have a baby, and must use alternative infertility treatments in order to get pregnant. So they must pay out of pocket. These expenses are tax deductible, but you must know the rules to preserve your assets for what could be ongoing attempts to conceive.
TX Maternity Insurance  If you are seeking coverage for infertility or IVF in Texas, make sure you also understand how the market works for maternity coverage. Options are very limited. Once you are already pregnant it will be too late to get the assistance some of these plans might provide.
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Tax Deductible Infertility & IVF Expenses How do you preserve your resources while trying to conceive for five years? And what if after waiting your Texas health insurance plan does not cover In Vitro Fertilization? The mandate only requires insurance companies to offer the option. Your out of pocket expenses are tax deductible, which can result in significant savings if you know the rules and plan ahead.
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Texas 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.
Texas Infertility Insurance Mandate - What it Means to You?
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.
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
- Allow the IRS cut infertility costs by 1/3 or more
- Purchase supplemental maternity insurance before getting pregnant
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.
