New Jersey Law Improves and Expands Infertility Coverage
May 01, 2017
Published in: ASRM Bulletin Volume 19, Number 14
Today, New Jersey Governor Chris Christie signed into law legislation (A1447/S1398) improving the existing insurance requirements regarding infertility coverage and expanding who is eligible to receive coverage.
The existing statute required insurance providers that cover at least 50 people and provide pregnancy-related benefits to pay for infertility diagnosis and treatment. It defined infertility as a disease or condition that results in the abnormal function of the reproductive system such that: a male is unable to impregnate a female; a female under 35 years of age is unable to conceive after two years of unprotected sexual intercourse; a female 35 years of age and over is unable to conceive after one year of unprotected sexual intercourse; the male or female is medically sterile; or the female is unable to carry a pregnancy to live birth.
The new statute updates the definition of infertility to “a disease or condition that results in the abnormal function of the reproductive system, as determined pursuant to American Society for Reproductive Medicine practice guidelines or by a physician who is Board Certified or Board Eligible in Reproductive Endocrinology and Infertility or in Obstetrics and Gynecology; or that the patient has met one of the following conditions:
- a male is unable to impregnate a female;
- a female with a male partner and under 35 years of age is unable to conceive after 12 months of unprotected sexual intercourse;
- a female with a male partner and 35 years of age and over is unable to conceive after six months of unprotected sexual intercourse;
- a female without a male partner and under 35 years of age who is unable to conceive after 12 failed attempts of intrauterine insemination under medical supervision;
- a female without a male partner and over 35 years of age who is unable to conceive after six failed attempts of intrauterine insemination under medical supervision;
- partners are unable to conceive as a result of involuntary medical sterility;
- a person is unable to carry a pregnancy to live birth; or
- a previous determination of infertility pursuant to the law.”
These provisions of the new law are effective 90 days after enactment.
Additionally, the new law requires health plans contracting to cover state employees and teachers to include the same infertility coverage, effective immediately, and applies its provisions to contracts that are in force or that are issued or renewed after today’s date.
These important changes mean not only that the new law comports with the medical definition of infertility, but that women with same sex partners and women without partners can now qualify for infertility coverage.
For more information on these press releases, contact:
J. Benjamin Younger Office of Public Affairs
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