Some workplace health plans would have to cover fertility treatment

Covered health plans would have to cover infertility diagnosis and treatment, including in vitro fertilization (IVF), which combines eggs and sperm outside the body. The requirement would cover health benefit plans covering more than 25 employees that provide pregnancy-related benefits. Infertility includes inability to achieve a successful pregnancy based on a patient's medical circumstances, needing medical help to achieve pregnancy, or unsuccessful attempts through regular, unprotected sex for 12 months for women under 35 or six months for women 35 or older. Egg freezing would require coverage when medically necessary for patients receiving treatments known to significantly harm fertility. Plans issued to or by religious institutions, organizations, or their sponsored entities would be exempt if they find the procedures violate their religious and moral beliefs. People eligible for procedures other than IVF would not have to meet other conditions for approval. IVF would have separate requirements. The proposal would apply to plans issued, amended, delivered, or renewed in Missouri on or after August 28, 2026.

Covered health plans would have to cover IVF only when patients meet treatment and egg-retrieval requirements and use facilities meeting specified medical standards. These requirements would apply to plans covering more than 25 employees with pregnancy benefits, except religious plans eligible for the exemption. Patients must have been unable to achieve or sustain a successful pregnancy through less costly, medically appropriate treatments covered by their plan. Patients generally must have undergone fewer than four completed egg retrievals. If a live birth follows a completed retrieval, two additional retrievals would be covered. Facilities must meet clinic guidelines from the American College of Obstetricians and Gynecologists or minimum program standards from the American Society for Reproductive Medicine. These IVF requirements would apply to covered plans issued, amended, delivered, or renewed in Missouri on or after August 28, 2026.