2024 Connecticut Advocacy Efforts
Active Family Building Legislation
An Act Concerning Medicaid Coverage for Infertility Treatment (HB-5240)
Lead Sponsors: Rep. Eleni Kavros DeGraw, Rep. Kate Farrar, and Sen. Saud Anwar
Update May 2024: Unfortunately this bill, which would provide Medicaid coverage for the medically necessary diagnosis and treatment of infertility, did not pass in 2024.
This bill would provide Medicaid coverage for the medically necessary diagnosis and treatment of infertility. The Fertility Access Connecticut (FACT) campaign is continuing to work with legislators to make this legislation as strong and inclusive as possible – and to pass it this session!
Current Connecticut Fertility Insurance Law
Connecticut has a Fertility Insurance Law. It passed in 1989 and has been amended several times.
RNE is an active member of the Fertility Access CT (FACT) Campaign, advocating for improvements to the current statute.
Summary
The Connecticut Fertility Insurance Law provides coverage for:
- Infertility diagnosis and treatment for individuals
- Medically necessary fertility preservation
Legal Definition of Infertility
The Act defines infertility as “the condition of an individual who is unable to conceive or produce conception or sustain a successful pregnancy during a one-year period or such treatment is medically necessary.”
Limits
This mandate does limit lifetime maximum coverage for ovulation induction (4 cycles), intrauterine insemination (3 cycles), and IVF, GIFT, ZIFT or low tubal ovum transfer (2 cycles). Treatment must be performed at fertility clinics that conform to the guidelines developed by the American Society of Reproductive Medicine (ASRM) and the Society of Reproductive Endocrinology and Infertility (SREI).
Exemptions
Religious employers and employers who self-insured are exempt from the Connecticut insurance mandate requirements.
For more information about the Connecticut Insurance Mandate, please consult Chapter 700c-38a-509 and BULLETIN HC-125.