Does Your California Health Plan Have to Cover IVF? A 2026 Guide

As of January 1, 2026, fully insured large employer groups with 101+ employees are required to cover infertility diagnosis and treatment, including in vitro fertilization (IVF). 

While the new law, Senate Bill 729, eliminates some significant barriers to fertility care access, Medi-Cal (California Medicaid) plans, small group employers, religious organizations, and self-funded employers are exempt.

Here is your guide for navigating IVF coverage in California in 2026 and beyond.

Why This Matters for Patients in California

Health insurance coverage is ever-changing, and can vary depending on your insurance provider, plan type, and the state you live in. The passage of Senate Bill 729 is a big win for fertility coverage and equity in California. The new law increases access to insurance coverage for fertility care inclusive of IVF—and it redefines “infertility” in such a way that makes care more accessible for individuals conceiving on their own and LGBTQ+ couples and families.

The California law expands the definition of an infertility diagnosis to be more inclusive of different paths to parenthood than other state’s definitions. In California, infertility is defined in the law as:

• A licensed physician’s determination that a patient is a good candidate for infertility treatment and diagnosis, based on their medical, sexual, and reproductive history, their age, any physical findings or diagnostic testing, or a combination of those factors.
• A patient’s inability to conceive, either or with or without a partner, without the help of medical intervention.
• A patient’s inability to become pregnant or carry a pregnancy to term with a live birth after six months of regular, unprotected sex for patients over 35 years old or 12 months for patients under 35. (If a pregnancy ends in miscarriage, the six- or 12-month clock doesn’t restart.)

The Factors Affecting Changes to Your Coverage

There are two main factors that affect whether or not your California insurance plan now covers IVF:

• Health plan type: If you have Medi-Cal or certain types of employer plans, the new law does not affect your insurance coverage. If you are covered by CalPERS health insurance, your benefits will not go into effect until 2027.
• Employer: If your health plan is under a small group employer (100 or fewer employees), a religious organization, or a self-funded employer, the new law does not affect your insurance coverage. 

If you aren’t sure what kind of health plan you have, you can always reach out to your employer’s HR department or your insurance provider. 

FAQs

When does new IVF coverage begin?

The California law went into effect on January 1, 2026. If you enrolled in or renewed your plan on January 1, 2026, your coverage should now be available.

Are there any limits on IVF coverage in the new California law?

Yes. The new law requires most plans to cover up to three egg retrievals. If you need more than three egg retrievals, health plans will not be required to cover the additional retrievals.

Thankfully, there is no limit on single embryo transfers (in alignment with single embryo transfer guidelines). It is unclear at this time if there will be other clinical requirements for covered IVF cycles, such as needing to complete an embryo transfer between egg retrievals. We will keep you updated along the way.

What are my options for help paying for IVF if I don’t have coverage under this new law?

If your health plan continues not to cover IVF, our financial counselors can guide you through available payment options, including fertility grants, scholarships, and loans. We’re here to help make sure that your fertility care is as affordable as possible for you.

Care and Coverage at Northern California Fertility Medical Center

At Northern California Fertility Medical Center, we work with most insurance providers:

• Aetna Center of Excellence
• Blue Cross PPO/HMO Blue Distinction Centers for Fertility Care
• Blue Shield PPO/HMO Blue Distinction Centers for Fertility Care
• Cigna PPO/HMO Center of Excellence
• Hill Physicians Medical Group
• Maven
• Optum Fertility Solutions Center of Excellence
• Progyny
• Sutter Medical Groups (Sutter Medical Group, Sutter Independent, Sutter Gould Medical Group)
• Sutter Physicians Alliance
• Sutter Select-Blue Cross EPO Plus/PPO Plus (we are not participating providers for traditional Blue Cross EPO/Select/Narrow Network Plans)
• TriWest Alliance
• UC Davis Medical Group
• United Healthcare
• United Resource Network/Optum Health (Center of Excellence)
• WinPremier

We are currently unable to accept Medi-Cal, and your plan likely does not cover IVF. For Sacramento County residents, Medi-Cal plans include:

• Anthem Blue Cross
• Health Net Community Solutions, Inc.
• Kaiser Permanente
• Molina Healthcare of California Partner Plan, Inc.

Next Steps at San Diego Fertility Center

Our goal is to make fertility treatment as accessible as possible, regardless of your health insurance plan or fertility benefits. Our team is here to help you determine your fertility goals and make the best plan for your growing family.

Schedule a consultation at San Diego Fertility Center today.

Reviewed by Constance Rapson, Ivy Fertility