First, ask your employer if your health plan is “self-insured” or “fully insured”. Unfortunately, self-insured employers do not NEED to follow state mandates (some choose to do so voluntarily). If fully insured, you need to confirm with your employer/insurer that it is a Maine-based plan.

When will coverage take effect?

You should check or ask your employer or insurer if you have an individual or group plan. If you have a group plan, the new coverage requirements go into effect when your plan is renewed (this date varies plan-to-plan and may not be January 1st). For individual plans, the new requirement is in effect on January 1, 2024.

What is covered?

In May 2024, the Maine Bureau of Insurance issued its Rule 865 relative to fertility coverage. Fertility coverage includes diagnostic care, laboratory testing, ultrasounds, intrauterine insemination (IUI), in vitro fertilization (IVF), fertility medications, medically necessary fertility preservation, and costs associated with cryopreservation and storage for up to five years. Insurance carriers may impose limits of 3 lifetime IUI cycles intrauterine, 4 completed egg retrievals and 2 fresh or frozen embryo transfer.