Families

DC law expands IVF insurance coverage. Here's how it works

"Infertility is a medical issue, and therefore your medical insurance should cover the ability for you to seek treatment," said bill cosponsor Christina Henderson, a D.C. Council member

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For years now, D.C. resident Chantil Thomas has dreamed of having a baby. She has endometriosis, which can make it difficult to get pregnant.

Soon, she and others who live or work in D.C. will have more options. Congress just approved a new D.C. law that will require health insurers to cover in vitro fertilization treatment.

D.C. Council Member Christina Henderson cosponsored the DC Expanding Access to Fertility Treatment Amendment Act.

Infertility is a medical issue, and therefore your medical insurance should cover the ability for you to seek treatment.

Council member Henderson

Henderson said she hopes the law will help families.

“When folks learn that it could cost upwards of $100,000, $150,000 in order for you to even be able to begin the process to try to start a family, it's just out of reach for a lot of people,” she said.

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Here’s what DC’s new IVF law will provide

Starting in 2024, people who use DC Healthcare Alliance and Medicaid can have their infertility diagnosis covered, along with three cycles of ovulation-enhancing drugs.

Then, in 2025, people who get insurance through D.C. employers or DC Health Link become eligible too. Their benefits include diagnosis, three rounds of IVF, and if needed, an embryo transfer to a surrogate.

People with private insurance could see a slight increase in their premiums. For Medicaid and District insurance, the funding comes from the government.

Nationally, 22 states have some type of infertility insurance law, with varying levels of coverage. Maryland requires infertility coverage; Virginia does not.

Thomas said the new law will help her to do IVF and, hopefully, have a baby.

“When I heard this news, it was a glimmer of hope that I needed. This is no easy walk for anyone. And so if this can help lessen the burden financially, then I'm all for it,” she said.

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