California IVF Coverage Expands Ahead of 2026 Mandate

UnitedHealthcare has stated, it will provide coverage for in vitro fertilization (IVF) and infertility and fertility services on some of its California commercial plans before a requirement outlined in Senate Bill 729 (SB 729) takes effect on January 1, 2026.

Effective as of July 1, 2025, SB 729 has been delayed and will resume on Jan. 1, 2026. Nonetheless, UnitedHealthcare will continue to provide coverage on such services to the exclusion of their waiting period in California as a standard benefit to its new and renewed insured large employer groups’ policies between July 1 and Dec. 31, 2025.

Starting on Jan. 1, 2026, infertility and fertility services coverage will be required in all large-group health plans and those issued outside of California, as well as in all small-group health plans and disability policies that choose to cover the services. Covered services apply to diagnosis and treatment of infertility, artificial insemination, and assisted reproductive technologies, including but not limited to IVF. The number of oocyte retrievals is up to three; there are no limits to the number of transfers to embryos per plan year.

Notably, it also covers the services of an egg and sperm donor, surrogates, and does not have limitations in coverage for medical and disability plans, ending the exclusion of LGBTQ+ people in fertility coverage.

Although prior authorization is still obligatory, providers may use the UnitedHealthcare Provider Portal to make requests. To get clinical assistance and medical guidance, members have access to contacting Optum Fertility Solutions at 866-774-4626. Claims will be met even when Optum Fertility Solutions is not utilized.

In case of questions or further help, you can chat on UnitedHealthcare Provider Portal.