Infertility Coverage Changes for 2021

The Maryland Legislature enacted SB988 on May 8, 2020. Effective for policies issued or renewed on or after January 1, 2021, SB 988 requires the following changes to infertility coverage:

  • Infertility coverage is available to all subscribers, not just those that are married. Thus, unmarried subscribers will be eligible for infertility coverage where they could have previously been excluded from such.
  • An insured that is married to the opposite sex must have a demonstrated one-year history of intercourse failing to result in pregnancy (previously two years).
  • If the insured and the spouse are of the same sex, they must demonstrate three attempts of artificial insemination over a one-year period that failed to result in pregnancy; OR the insured or spouse has one of four medical conditions (endometriosis, exposure in utero to diethylstilbestrol, blockage of surgical removal of at least one fallopian tube, or abnormal male factors). The requirement was previously six attempts in two years. This same requirement applies to unmarried subscribers.

Employers should work with carriers to revise plan documents and communicate changes to participants.

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