IVF Coverage in California: What You Need to Know
- ACRC Global
- Jul 24
- 6 min read
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A Big Win for Reproductive Equity
In September 2024, Governor Gavin Newsom made a landmark move: he signed Senate Bill 729 (SB 729), ushering California toward a more just and inclusive fertility landscape. This law mandates that fully insured large-group health plans cover infertility treatment—including in‑vitro fertilization (IVF). It also broadens the definition of infertility to include LGBTQ+ individuals, single people, and other non‑traditional families
Under SB 729, health plans covering 100+ employees must provide coverage for infertility diagnosis and treatment—including up to three egg retrievals and unlimited embryo transfers, as long as those retrievals are medically appropriate.
For small-group plans (up to 100 employees), insurers are required to offer at least one plan option with similar infertility coverage—though it’s not mandatory by default.
Coverage can’t be limited or burdensome: that means no fertility-specific copays, higher deductibles, or discriminatory restrictions that differ from other medical services.
This law puts California among the more progressive states—already the 15th to mandate IVF coverage—aiming to eliminate financial barriers that leave many aspiring parents in debt or despair when pursuing assisted reproductive technologies.
IVF Coverage in California
Understanding IVF coverage in California requires a clear breakdown of exactly what’s included under the new mandate. With the passage of SB 729, California sets specific standards for infertility coverage to ensure broader access and fairness. Coverage under this mandate explicitly includes the following:
Diagnostic Testing: Comprehensive assessments to determine fertility issues.
Medically Necessary IVF Treatments: This includes up to three cycles of egg retrieval procedures and unlimited embryo transfers, provided they’re deemed medically appropriate by healthcare providers.
Medication and Prescriptions: Coverage for fertility medications associated with IVF procedures.
Storage and Cryopreservation: Although specifics are still being refined, storage and freezing of embryos and eggs related to medically necessary procedures will likely fall under this coverage.
However, certain limitations still apply. Experimental treatments or elective fertility preservation not related to diagnosed infertility (such as social egg freezing) aren't mandated by this policy. Additionally, insurance plans that fall outside California’s jurisdiction, such as self-funded or federal plans, won't be required to comply.
Californians looking to benefit from this policy should closely review their health plan details, as nuances in coverage can vary significantly depending on the insurer and plan type. Engaging proactively with insurance representatives and healthcare providers can help patients maximize their coverage benefits when the law goes into effect.
But Here’s the Catch: Delay to 2026
The implementation of SB 729 has hit a snag. Though originally slated for July 1, 2025, the law’s effective date has been delayed to January 1, 2026
This change was enacted as part of the state budget—specifically AB 116 (trailer bill)—which was signed by Newsom on June 30, 2025.
Why the delay? State regulators and the governor argue they need more time to work out the logistics—such as defining coverage for donor materials, embryo storage, gestational carriers, and aligning the policy with essential health benefit frameworks
It’s important to stress: the delay applies only to plans issued, renewed, or amended on or after January 1, 2026. Plans that renew at other times, such as July 2025 or later, will still fall under the old effective date, meaning coverage could remain in place, or begin earlier depending on renewal timing.
Who’s Impacted—and Who’s Not
Large-group, fully insured plans (100+ employees) are the primary targets. Coverage kicks in for those renewing after the new effective date.
Small-group plans must offer coverage options, but they aren’t mandated unless chosen by the employer.
Self-insured, federal (e.g., ERISA plans), individual exchange (Covered California), Medi-Cal, and Medicare plans are exempt.
CalPERS (public employee) plans face yet another delay to July 2027.
An estimated nine million Californians—including same-sex couples and single prospective parents—will be impacted by the new mandate once it takes effect.
Real-Life Consequences: The Limbo of Delay
The emotional and financial toll of this delay is already being felt.
Take Ana Rios, a Central Valley resident who, along with her wife, has been pursuing fertility care for six years. She told the Chronicle she felt hopeful when the law passed—until the delay was announced. Confusion over eligibility led them to seek treatment in Mexico, which—though cheaper—adds logistical burdens.
Alise Powell, of Resolve: The National Infertility Association, summed it up: patients feel “left in a holding pattern facing more uncertainty, financial strain, and emotional distress” .
For prospective parents in mid‑cycle—especially those who are older—the stakes are high. Fertility windows move; every delay can have lasting consequences.
Why the Delay? What’s at Stake
From policymakers’ perspective, the delay gives essential time to:
Finalize definitions around embryo banking, storage, and donor-related services.
Align insurance systems with the state's essential health benefits catalogue.
Provide more guidance to insurers and employers to ensure a smoother rollout.
Critics argue that these details don’t justify a six‑month delay—and that they compound stress for hopeful families.
Supporters, including Senator Caroline Menjivar—the bill’s author—appeal for patience, stating the pause is necessary for a sound foundation: “a little longer so we can roll this out right”.
Navigating the Gray Area: Tips for Families & Employers
Check your plan type and renewal date. If you're part of a large-group, fully insured plan renewing in early 2026, SB 729 still applies once effective.
Talk to HR or benefits teams now—ask if your plan will be renewed, amended, or issued after January 1, 2026.
Seek interim solutions—employers might consider “mini-flex” or fertility HSA-like options, grants, or fertility benefit add-ons prior to the mandate.
Maintain strong patient advocacy—keep documentation, stay in touch with fertility clinics, and don’t hesitate to appeal for coverage.
Consider medical tourism cautiously. It may offer financial relief, but comes with its own medical, legal, and coordination complexities.
A National Perspective
California isn’t alone—the Golden State joins a wave of progressive IVF policy—18 states mandate coverage, with more debating including fertility services as essential benefits.
Even federally, the 2025 FEHB program allows up to three IVF cycles. President Trump’s 2025 executive order called for broadening IVF access.
Looking Ahead: What to Watch in 2026
January 1, 2026: New effective date for state-regulated, fully insured large-group plan renewals.
Renewal period variance: Plans renewing mid‑year may actually begin coverage earlier or later depending on each employer’s cycle.
Public employees: CalPERS coverage comes later—July 2027.
Reg-finalization: Insurance regulators are expected to issue sub-regulatory guidance on donor, storage and carrier-related coverage details.
Advocacy benchmarks: Resolve, ASRM, and others will push for clarity and monitor insurer compliance.
Final Take: A Groundbreaking Policy—With Nuanced Activation
California’s SB 729 marks historic progress. By mandating IVF coverage—including multiple retrievals and unlimited transfers—it shatters financial and systemic barriers and supports a far broader definition of family.
Yet the six-month delay is a stark reminder: transformative laws require groundwork. Insurers and employers must adapt their systems, regulators need to frame key rules, and patients are left in limbo.
For hopeful parents—especially those mid-cycle or in later reproductive years—every month matters. The delay is frustrating; the mandate remains vital.
The message for 2026? Be prepared. Lean into employer benefits, ask detailed questions, and don’t assume coverage unless confirmed. The policy is coming—it’s just a few months off.
When it finally rolls out, the impact could be profound: less debt, more equitable access, and greater certainty for Californians creating families—however they define them.
ACRC’s Support for Intended Parents
At ACRC Global, we understand that the IVF journey can feel overwhelming, especially when navigating new policies and coverage options. Our team is here to provide personalized guidance, answer your questions, and connect you with trusted fertility clinics and specialists. Whether you are just beginning to explore IVF or are in the midst of your treatment, ACRC Global is committed to ensuring that Intended Parents feel supported, informed, and confident throughout every step of their path to parenthood.
Take Action
If you’re planning IVF: Contact HR now. Clarify renewal dates and plan types.
If you’re an employer: Assess whether to accelerate fertility benefits voluntarily.
If you're an advocate: Share your story with policymakers. Track insurer readiness—and hold them accountable.
California is leading—but it must also deliver. For all Californians, a healthy future means healthy families.
We're here for you if you have any further questions! |
Sources: California Healthline (KFF Health News) – California’s Much-Touted IVF Law May Be Delayed Until 2026, Leaving Many in the Lurch San Francisco Chronicle – Newsom Delays IVF Coverage Law in California Until 2026 National Law Review – California Governor Signs Legislation Expanding Infertility and IVF Coverage Senator Caroline Menjivar – SD20 Website |
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