H.R. 4648 requires health insurance plans—including private insurance, federal employee benefits, TRICARE, Veterans Affairs, Medicare, and state Medicaid programs—to cover fertility treatments such as in vitro fertilization, egg and sperm preservation, artificial insemination, genetic testing of embryos, and fertility medications without imposing higher out-of-pocket costs than other medical services. The bill applies to all plans that cover obstetrical services and prohibits insurers from denying coverage, penalizing providers, or discouraging patients from pursuing fertility treatment. Implementation varies by program, with private plans and federal employee benefits required to notify patients of coverage by January 1, 2027, Medicare coverage beginning January 1, 2026, and Medicaid coverage effective October 1, 2026. Under Medicare, the federal government will cover 100 percent of fertility treatment costs, waiving deductibles and coinsurance. The legislation aims to expand access to fertility care across all major health insurance programs serving Americans.
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