New Brief Highlights Disparities in Fertility Services Driven by Cost and Gaps in Coverage

A new KFF brief provides a comprehensive overview of the coverage and use of fertility services in the United States, highlighting cost and insurance coverage gaps as key barriers faced by low-income people, Black and Hispanic people, LGBTQ individuals, infertile couples and single individuals seeking these services.

The coronavirus pandemic has worsened the availability of medical services and the financial situations of many Americans. Utilization of fertility services has declined, and medical professional societies issued guidelines earlier this year to stop new fertility treatment cycles, non-urgent diagnostic procedures and the criteria to resume such care. However, even before the pandemic several populations experienced disparities in access to such services.

Most patients pay out of pocket for fertility services which typically range in costs based on treatment and duration from the low thousands to tens of thousands of dollars. There is limited coverage of such services by private insurance plans and Medicaid. Fifteen states have laws requiring certain private insurers to cover some infertility treatments and these laws vary widely in the populations eligible and services covered. Only one state, New York, requires its Medicaid program to cover fertility treatment and eight states cover some diagnostic services. Additionally, surveys indicate that about 1 in 5 employers cover some form of infertility treatments.

Read the full brief, Coverage and Use of Fertility Services in the U.S., for a comprehensive examination of the issue and state specific information on coverage of fertility benefits.