The HOPE with Fertility Services Act requires group health plans and health insurance issuers to cover infertility and iatrogenic infertility treatments if they already cover obstetrical services. Infertility is defined as the inability to achieve pregnancy after 12 months of unprotected intercourse or through standard medical treatment, while iatrogenic infertility refers to fertility damage caused by surgical procedures, radiation therapy, chemotherapy, or other medical treatments. The bill mandates coverage for a wide range of fertility treatments, from in vitro fertilization to ovulation induction, with cost-sharing rules that are no more restrictive than other medical benefits. Plans cannot offer incentives to discourage fertility treatments, penalize providers for offering them, or prevent discussions about these options. The requirements take effect for plan years beginning January 1, 2026, with a five-year transition period during which plans must submit annual analyses of how they manage utilization of fertility benefits, and the bill authorizes civil penalties of up to $100 per day for plans that deny required coverage or fail to submit required analyses.
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