What tips should I keep in mind?

States with strong fertility mandates: MA, CT, IL, MD, NJ, NY, RI. Self-insured employer plans (ERISA) are exempt from state mandates. Ask your HR department specifically about fertility benefits — they are often hidden.

Fertility Insurance Coverage Calculator

Estimate fertility treatment insurance coverage and out-of-pocket costs based on your plan type and state mandates.

Total Treatment Cost ($)(Estimated total for all cycles/procedures)

State Fertility Mandate?(Does your state require fertility coverage?)

Insurance Plan Type(Your insurance plan structure)

Lifetime Fertility Maximum ($)(Maximum your plan will pay for fertility (0 = no limit))

Annual Deductible ($)(Amount you pay before coverage kicks in)

Coinsurance (your %)(Your share after deductible (e.g., 20%))

Out-of-Pocket Maximum ($)(Most you will pay in a year)

Results

Visualization

How It Works

Fertility insurance coverage varies dramatically by state and employer. 20 states have some form of fertility mandate, but coverage details differ significantly.

The Formula

Insurance Pays = min(Eligible Amount, Lifetime Max) - Deductible - Your Coinsurance

Your Cost = Deductible + Coinsurance + Uncovered Amounts

Variables

Mandate — State law requiring insurers to offer or cover fertility treatments
Lifetime Max — Total amount plan will ever pay for fertility treatments

Worked Example

$25,000 treatment, full coverage plan, $2,000 deductible, 20% coinsurance: Insurance pays ~$16,400, you pay ~$8,600.

Practical Tips

States with strong fertility mandates: MA, CT, IL, MD, NJ, NY, RI.
Self-insured employer plans (ERISA) are exempt from state mandates.
Ask your HR department specifically about fertility benefits — they are often hidden.
Some employers add fertility benefits even without state mandates (especially tech companies).
HSA/FSA funds can be used for fertility treatments to save on taxes.

Last updated: March 15, 2026 · Reviewed by the FertilityCalcs Editorial Team