ACA Coverage for Infertility Treatment: What You Need to Know
Infertility is a common issue, and the cost of treatment can be daunting. Many people wonder if the Affordable Care Act (ACA) covers infertility treatment. Here are some things to keep in mind.
Does the ACA Cover Infertility Treatment?
The ACA does not specifically mandate coverage for infertility treatment. However, the ACA does require all health insurance plans to cover certain essential health benefits (EHBs), including the following:
Pregnancy, childbirth, and newborn care
Mental health and substance use disorder services
Pediatric services
Preventive and wellness services
Chronic disease management
Infertility treatment is not specifically included in the EHBs. However, some states have laws that require health insurance plans to cover infertility treatment. For example, New York has a law that requires all health insurance plans to cover infertility treatment, including IVF.
What If I Live in a State That Does Not Mandate Infertility Coverage?
If you live in a state that does not mandate infertility coverage, you may still be able to get coverage through your health insurance plan. Some health insurance plans offer infertility coverage as a rider or add-on. You can also purchase a separate insurance policy that covers infertility treatment.
What to Do If You Are Denied Coverage for Infertility Treatment
If you are denied coverage for infertility treatment, you have the right to file an appeal. You can also contact your state insurance commissioner for assistance.
Getting Help with Infertility Treatment
If you are struggling with infertility, there are many resources available to help you. You can find information and support from the following organizations:
Resolve: The National Infertility Association (https://resolve.org/)
American Society for Reproductive Medicine (https://www.asrm.org/)
Society for Assisted Reproductive Technology (https://www.sart.org/)
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