Home Insurance, Claims, Denials Infertility and IVF in New Jersey – Know Your Insurance Law

Infertility and IVF in New Jersey – Know Your Insurance Law



New Jersey is one of only fifteen states with an infertility insurance mandate. If you work for an employer headquartered in the state of NJ, you may be one of the lucky few whose health insurance will cover some of your infertility treatments. Beware the New Jersey Family Building Act does not apply equally to all NJ citizens. Understand how the law works, and how it applies to your insurance plan before beginning your infertility treatments.

NJ Family Building Act

The New Jersey Family Building Act is one of fifteen state laws mandating some form of infertility treatment coverage for people who work for employer groups subject to the regulation. The key to unlocking how this law applies to you is to understand who is subject to the regulation, what it covers, where the holes lie, and how to fill the gaps.

Where are the Holes?

The New Jersey law applies to employer groups of fifty employees or more, for employer groups headquartered in the state. If you work for an employer with less than fifty employees, or for a branch location that happens to be in NJ but headquartered elsewhere, then you may be out of luck. Also, employers who self insure are not subject to the mandate. Many larger employers take the self insure route, and are therefore not subject to the mandate either.

The NJ law is unique in that is specifically describes a variety of infertility treatments that must be covered. But don’t assume that there is no limit to the coverage. Infertility treatments don’t come with guarantees of success. Most insurance plans will cap the number of cycles you can try in your lifetime.

How to Fill the Gaps

Remember that your unreimbursed infertility medical expenses may be tax deductible and you may get a bigger tax benefit by using your flexible spending account. Also, supplemental insurance is a great way to create maternity leave income, and provide extra protection in case of complications.


Source by Kevin Haney


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