33-24-59.34. Required medical coverage for standard fertility preservation services.

As used in this Code section, the term:#

1. (1)

   “Health benefit policy” means any individual or group plan, policy, or contract for healthcare services issued, delivered, issued for delivery, or renewed in this state by an insurer that provides major medical benefits. Such term shall not include any plans, policies, or contracts executed by the state. Such term shall not include self-funded, employer sponsored health insurance plans subject to the exclusive jurisdiction of the federal Employee Retirement Income Security Act of 1974, as codified and amended at 29 U.S.C. Section 1001, et seq.#

2. (2)

   “Iatrogenic infertility” means an impairment of fertility caused directly or indirectly by a medically necessary treatment for cancer, sickle cell disease, or lupus.#

3. (3)

   “Insurer” means any person, corporation, or other entity authorized to provide health benefit policies under this title, including a healthcare corporation, health maintenance organization, preferred provider organization, accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, or any similar entity.#

4. (4)

   “Medically necessary treatment” means a medically necessary treatment for cancer, sickle cell disease, or lupus that has a potential side effect of iatrogenic infertility. Such treatment includes but is not limited to the surgical removal of the primary or secondary reproductive organs, chemotherapy, radiation therapy, and bone marrow transplantation.#

5. (5)

   “Standard fertility preservation services” means procedures to preserve fertility that are consistent with established medical practices or professional guidelines. Such services include but are not limited to egg, sperm, embryo, and ovarian tissue cryopreservation.#

Every health benefit policy renewed or issued after January 1, 2026, shall include coverage for expenses for standard fertility preservation services when a medically necessary treatment may directly or indirectly cause iatrogenic infertility in any covered person. Such coverage shall include evaluation expenses, laboratory assessments, medications, and treatments associated with standard fertility preservation services, including storage of gametes for up to one year.#

The coverage provided for in subsection (b) of this Code section may:#

1. (1)

   Exclude costs associated with storage of gametes for more than one year;#

2. (2)

   Include age restrictions;#

3. (3)

   Include a lifetime limit per procedure per eligible insured; and#

4. (4)

   Be limited to nonexperimental procedures.#

The benefits in a health benefit policy as provided in subsection (b) of this Code section shall be subject to the same deductibles, coinsurance, and copayment provisions established for all covered benefits within such health benefit policy. Special deductibles, coinsurance, copayment, or other limitations that are not generally applicable to other hospital, medical, or surgical services covered by a health benefit policy shall not be imposed on coverage for standard fertility preservation services.#

The Commissioner shall promulgate rules and regulations necessary to implement the provisions of this Code section in accordance with current guidelines established by professional medical organizations such as the American Society of Clinical Oncology or the American Society for Reproductive Medicine.#