HB588: HB588 Insurance; coverage for fertility diagnostic care, treatment, and preservation services; provide

Georgia insurance law currently does not require health insurers to cover fertility care. This bill would add a new section to Georgia's insurance code (O.C.G.A. § 33-24-59.30) requiring insurers offering health benefit policies in the state to cover fertility diagnostic care, fertility treatment, and fertility preservation services for people defined as fertility patients, including those with infertility, those lacking necessary reproductive cells for conception, and couples at increased risk of passing on a serious inherited genetic condition. The coverage must include at least three complete egg retrievals with unlimited embryo transfers, following guidelines from the American Society for Reproductive Medicine. Insurers could not impose waiting periods, use prior fertility history to deny coverage, restrict coverage based on use of donor eggs, sperm, embryos, or surrogacy, or apply different rules based on race, sex, sexual orientation, or disability. The Insurance Commissioner would write implementing rules. The requirements would apply to policies issued or renewed on or after January 1, 2026.

• Requires all Georgia health benefit policies to cover fertility diagnostic care, fertility treatment, and fertility preservation services starting January 1, 2026.
• Sets a minimum coverage floor of at least three complete egg retrievals with unlimited embryo transfers from those retrievals.
• Bars insurers from imposing waiting periods or using a person's prior fertility diagnosis or treatment history to limit coverage.
• Prohibits insurers from limiting coverage based on use of donor gametes, donor embryos, or surrogacy arrangements.
• Bans differing coverage limits or benefits based on race, color, religion, national origin, sex, sexual orientation, gender, or disability.
• Directs the Insurance Commissioner to adopt rules on cost-sharing, benefit design, and clinical guidelines, informed by American Society for Reproductive Medicine standards.

People and couples seeking fertility diagnosis, treatment, or preservation, including those with infertility, those lacking necessary reproductive cells, and couples at risk of passing on serious genetic conditions; health insurers offering policies in Georgia; and the Georgia Insurance Commissioner, who would write implementing rules.

Georgians with infertility or facing medical treatments that threaten fertility could gain guaranteed insurance coverage for diagnostic testing, treatment such as egg retrieval and embryo transfer, and fertility preservation, potentially reducing the out-of-pocket cost of care that is currently often uncovered.

• Subsection (a) defines key terms including 'infertility,' 'fertility patient,' 'fertility treatment,' and 'experimental fertility procedure,' tying several definitions to American Society for Reproductive Medicine standards.
• Subsection (b) requires insurers to cover fertility diagnostic care, fertility treatment, and fertility preservation services beginning January 1, 2026.
• Subsection (c) sets a minimum benefit of at least three complete egg retrievals with unlimited embryo transfers, using single embryo transfer when medically appropriate.
• Subsection (e) prohibits waiting periods, exclusions based on prior diagnosis or treatment, limits based on donor gametes or surrogacy, and discriminatory limits based on protected characteristics.
• Subsection (f) requires any insurer limitations to be based on medical history and requires clinical guidelines to be documented and shared with a covered person within three business days of a request.
• Subsection (g) allows insurers to exclude experimental fertility procedures and nonmedical costs tied to donor gametes, donor embryos, or surrogacy.
• Subsection (h) directs the Insurance Commissioner to adopt implementing rules covering cost-sharing, benefit design, and clinical guidelines.
• Subsection (i) applies the requirements to policies, contracts, and certificates issued, delivered, or renewed on or after January 1, 2026.

1. 2025-02-26House Second Readers (House)
2. 2025-02-24House First Readers (House)
3. 2025-02-21House Hopper (House)

• Karla Drenner (D, HD-085)Primary sponsor
• Park Cannon (D, HD-058)
• Michelle Au (D, HD-050)
• Samuel Park (D, HD-107)

• health insurance
• fertility treatment
• infertility coverage
• reproductive health
• insurance regulation