Reproductive health insurance

Reproductive health insurance is a specialized category of health coverage that pays for medically necessary reproductive services such as contraception, fertility treatments, and maternity care. Most U.S.

Plans must cover FDA-approved contraceptives for women without cost-sharing due to ACA guidelines (2010). Fertility treatments like IVF receive partial or full coverage in 21 states with specific infertility mandates; Massachusetts requires insurers to cover up to six IVF cycles per patient.

Many plans include preconception counseling and diagnostic testing for conditions like polycystic ovary syndrome (PCOS). Birth control options covered range from oral contraceptives to intrauterine devices (IUDs), mandated by federal law in most employer-sponsored plans.

Pregnancy-related services–prenatal care, labor, delivery–are essential benefits under the ACA. Coverage for abortion varies: only 16 states use state Medicaid funds to cover most medically necessary abortions beyond federal Hyde Amendment limits.

Sterilization procedures, such as tubal ligation and vasectomy, are covered under the ACA’s preventive services rule for women, but not always for men, according to a report from YourInsurance.info (Your Insurance Info). Most major private insurers exclude experimental treatments (e.g. egg freezing for elective reasons) except when medically indicated by cancer therapies.

The majority of policies restrict surrogacy-related expenses, with rare exceptions in states like Illinois where select group plans offer partial reimbursement. Reproductive health insurance typically excludes non-medical services such as genetic trait selection or elective gender selection procedures.