Exclusions & Limitations
Unfortunately, due to the current definition of infertility (which is 12 months of unprotected sex without achieving a pregnancy), the New York State mandate does not cover same-sex male couples. Visit Gay Parents To Be for resources and support for LGBTQ+ families.
Additionally, the mandate leaves out providers in fully-insured small group plans (companies with less than 100 employees), employers with self-insured plans, Obamacare and Medicaid. People enrolled in so-called “self-insured” group health insurance plans (primarily used by large corporations and unions) are governed by federal law, so the New York State mandate does not apply to them.
Ask your employer’s HR or benefits team if your employer is fully-insured or self-insured. If your employer is self-insured, they can choose to cover IVF and fertility preservation.