Federal Health Plans May Soon Cover IVF, Egg Freezing Under New Fertility Bill

This proposal, the "Family Building FEHB Fairness Act," aims to add fertility treatments to the list of benefits covered by the Federal Employees Health Benefits (FEHB) program. If passed, it would amend existing law (specifically Title 5, Section 8904 of the U.S. Code) to mandate this coverage, with the changes taking effect one year after the bill becomes law.

What's on the Table for Treatment?

The bill casts a wide net for what counts as "fertility treatment." It's not just in vitro fertilization (IVF). The definition laid out in Section 2 includes:

• Preserving eggs, sperm, or embryos for later use (think fertility preservation).
• Artificial insemination procedures.
• Assisted reproductive technologies like IVF.
• Genetic testing of embryos.
• Both prescription and over-the-counter fertility medications.
• Using donated eggs or sperm (gamete donation). It also leaves room for other related services, pending approval from the Office of Personnel Management (OPM) and the Department of Health and Human Services (HHS), giving it flexibility down the road.

The Real-World Impact for Federal Workers

For the millions of federal employees covered by FEHB, this could be a significant change. Fertility treatments like IVF can cost tens of thousands of dollars out-of-pocket, putting them out of reach for many. Mandating coverage could make starting or growing a family more financially feasible for government workers facing infertility. It essentially treats fertility care as a standard health benefit, similar to other medical procedures.

Looking Ahead: Implementation and Details

Keep in mind, these changes wouldn't happen overnight – the bill sets a timeline of one year post-enactment for the coverage to kick in. This gives OPM, HHS, and the insurance carriers time to figure out the specifics. While the bill provides a broad definition of covered treatments, the exact details – like potential limitations, pre-authorization requirements, or how different carriers implement the coverage – will likely be hammered out during that implementation period. The inclusion of OPM and HHS in defining 'appropriate' treatments suggests there will be ongoing oversight.