HB 94: Insurance; medically necessary expenses for standard fertility preservation services when a medically necessary treatment for cancer, sickle cell disease, or lupus may directly or indirectly cause an impairment of fertility; require coverage

Right now, Georgia insurance plans are not required to cover fertility preservation for patients undergoing treatments like chemotherapy or radiation that can leave them infertile as a side effect. HB 94 changes that by adding a new section to Georgia's insurance code (O.C.G.A. § 33-24-59.34). Starting with policies renewed or issued after January 1, 2026, most individual and group health plans in Georgia would have to cover evaluation, lab work, medications, and procedures like egg, sperm, embryo, or ovarian tissue freezing when a medically necessary cancer, sickle cell disease, or lupus treatment could cause infertility. The coverage can exclude storage costs after one year, include age limits, cap lifetime use per procedure, and be limited to non-experimental methods. Insurers must apply the same deductibles and copays used for other medical benefits, not special extra costs. The law would take effect as soon as the Governor signs it, and the state Insurance Commissioner would write rules to implement it.

• Requires most individual and group health insurance plans issued or renewed after January 1, 2026 to cover standard fertility preservation services for patients facing infertility risk from cancer, sickle cell disease, or lupus treatment.
• Defines covered treatments to include chemotherapy, radiation, bone marrow transplants, and surgical removal of reproductive organs when they may cause 'iatrogenic infertility' (infertility caused by medical treatment).
• Covers evaluation, lab testing, medications, and treatments tied to preserving fertility, including storage of eggs, sperm, or embryos for up to one year.
• Allows insurers to exclude storage costs beyond one year, apply age restrictions, set lifetime limits per procedure, and limit coverage to non-experimental procedures.
• Bars insurers from imposing special deductibles or copays on this coverage beyond what applies to other medical benefits in the same plan.
• Directs the state Insurance Commissioner to write rules implementing the law based on guidelines from groups like the American Society of Clinical Oncology.

Georgians diagnosed with cancer, sickle cell disease, or lupus who face fertility-damaging treatment; health insurers offering individual and group plans in the state; and the Georgia Insurance Commissioner's office, which must write implementing rules. Self-funded employer plans governed by federal ERISA law and state government plans are excluded.

Patients undergoing treatments like chemotherapy that can cause infertility would gain a guaranteed path to freeze eggs, sperm, or embryos without facing extra out-of-pocket costs beyond their normal plan terms, potentially preserving their ability to have children later.

• Section 1 adds new Code section 33-24-59.34, defining 'health benefit policy,' 'iatrogenic infertility,' 'insurer,' 'medically necessary treatment,' and 'standard fertility preservation services.'
• Subsection (b) requires covered plans issued or renewed after January 1, 2026 to pay for evaluation, lab assessments, medications, and fertility preservation treatments, including up to one year of gamete storage.
• Subsection (c) lets insurers exclude storage beyond one year, apply age limits, set a lifetime per-procedure limit, and restrict coverage to non-experimental methods.
• Subsection (d) requires the same deductibles, coinsurance, and copays as other covered benefits, barring special extra cost-sharing for this coverage.
• Subsection (e) directs the Insurance Commissioner to create rules aligned with guidelines from professional medical organizations.
• Section 2 makes the law effective immediately upon the Governor's signature or becoming law without signature.

1. 2025-05-01Effective Date
2. 2025-05-01Act 42
3. 2025-05-01House Date Signed by Governor (House)
4. 2025-04-08House Sent to Governor (House)
5. 2025-04-02House Agreed Senate Amend or Sub (House)
6. 2025-03-31Senate Passed/Adopted By Substitute (Senate)
7. 2025-03-31Senate Third Read (Senate)
8. 2025-03-21Senate Read Second Time (Senate)

• Eddie Lumsden (R, HD-12)Primary sponsor
• Darlene Taylor (R, HD-173)
• Lee Hawkins (R, HD-27)
• Sharon Cooper (R, HD-45)
• Deborah Silcox (R, HD-53)
• Kim Schofield (D, HD-63)
• Chuck Hufstetler (R, SD-52)

1. PassedHouse voteFebruary 27, 2025

   162 yea, 2 nay (4 not voting, 12 excused)

   PASSAGE: House Vote #108

2. PassedSenate voteMarch 31, 2025

   52 yea, 1 nay (0 not voting, 3 excused)

   PASSAGE BY SUBSTITUTE: Senate Vote #353

3. PassedHouse voteApril 2, 2025

   162 yea, 3 nay (6 not voting, 9 excused)

   Agree to Senate Substitute: House Vote #383

• health insurance coverage
• fertility preservation
• cancer treatment
• sickle cell disease
• insurance regulation