Understanding The New Maine Fertility Insurance Law
As the provider of the only fertility center in Maine with a full-service IVF center, Boston IVF is thrilled to spread awareness of Maine’s new fertility treatment insurance mandate, L.D. 1539 “An Act to Provide Access, to Fertility Care. This legislation paves the way for many deserving individuals and couples in Maine who can now seek the high-quality family building treatments they deserve.
This is a great first step in addressing equitable fertility coverage, and we hope it progresses to improve accessibility for all.
Boston IVF is proud to be Maine’s sole provider of IVF for over 15 years. Located in South Portland and Bangor, our fertility centers and IVF laboratory are dedicated to anyone who wishes to build a family. Since joining the Maine community in 2008, Boston IVF has strived to provide patients with convenient, local access to reproductive care and our doors are open wide to those benefited by this new legislation.
Importance of Comprehensive Insurance Coverage
Numerous situations lead individuals to seek assisted reproductive technology in order to expand their families. Regrettably, in many cases, this necessity isn't accompanied by adequate medical insurance coverage, placing these families under significant financial strain. Prior to this law, individuals and couples in Maine and Vermont were most likely to feel this financial strain, as these were the only state in New England without required fertility coverage.
Now, thanks to the inclusive and comprehensive language of the law, individuals and couples in Maine with a myriad of backgrounds will now be able to seek the family building care they have long deserved.
Coverage Explained
*This legislation is evolving and so conditions may change.
The law outlines that insurance policies must cover three separate elements of fertility care, including:
- Fertility diagnosis
- Fertility treatment for fertility patients
- Medically necessary fertility preservation: In cases where an individual’s treatment for a medical or genetic condition would result in impaired fertility, including but not limited to certain cancer treatments.
It is important to note that in Maine, the definition of infertility is: “presence of a demonstrated condition recognized by a provider as a cause of loss or impairment of fertility or a couple's inability to achieve pregnancy after 12 months of unprotected intercourse when the couple has the necessary gametes for conception, including the loss of a pregnancy occurring within that 12-month period, or after a period of less than 12 months due to a person's age or other factors.”
The definition of a fertility patient is further clarified as, “an individual or couple with infertility, an individual or couple who is at increased risk of transmitting a serious inheritable genetic or chromosomal abnormality to a child or an individual unable to conceive as an individual or with a partner because the individual or couple does not have the necessary gametes for conception.”
These definitions help to ensure coverage for a myriad of individuals and couples, including those who have traditionally been left out of mandated insurance coverage such as LGBTQ+ individuals and couples, single parents by choice, and people with cancer who need fertility preservation.
FAQ
When did the law go into effect?
The legislation took effect on January 1, 2024, however, due to the variable nature of enrollment dates and enrollment periods, some individuals may have a different coverage start date.
Who is eligible for the mandate?
This is dependent on a few factors:
- Does their health insurance policy already cover infertility treatments?
- Is their health insurance policy subject to state law?
- Do they have a diagnosis of infertility from a medical professional?
In order to clarify these factors, it is important for each individual to communicate with their employer’s human resources department, their insurance provider, and/or a healthcare provider who specializes in reproductive health.
Are single parents by choice covered by the law?
Yes, if diagnosed with infertility.
Are LGBTQ+ individuals and couples covered by the law?
Yes, if diagnosed with infertility.
Is egg or sperm freezing covered for individuals with cancer?
Yes, fertility preservation is covered for those facing loss of future fertility due to medical treatments.
Starting Treatment
To schedule an appointment, please visit https://www.bostonivf.com/Appointments/
