An Act To Mandate Insurance Coverage for Infertility Treatment
Maine Legislature, Session 125, LD 0720
Committee: Insurance and Financial Services
Sponsors: KNIGHT, BEAUDOIN, BECK, CUSHING, DILL, GRAHAM, WALSH INNES, RUSSELL, SHAW
Amends: 24 MRSA §2320-H, 24-A MRSA §2745-H, 24-A MRSA §2837-I, 24-A MRSA §4234-F

Legislative Document 
No. 720 
H.P. 534 
House of Representatives, February 23, 2011 
An Act To Mandate Insurance Coverage for Infertility Treatment 
Received by the Clerk of the House on February 18, 2011.  Referred to the Committee on 
Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered printed pursuant to 
Joint Rule 401. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative KNIGHT of Livermore Falls.  (BY REQUEST) 
Cosponsored by Representatives: BEAUDOIN of Biddeford, BECK of Waterville, CUSHING 
of Hampden, DILL of Cape Elizabeth, GRAHAM of North Yarmouth, WALSH INNES of 
Yarmouth, RUSSELL of Portland, SHAW of Standish. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24 MRSA §2320-H is enacted to read: 
§2320-H.  Infertility 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual and group nonprofit hospital and medical 
services plan policies, contracts and certificates and all nonprofit health care plan 
policies, contracts and certificates must provide coverage for the treatment of infertility.  
A contract, policy or certificate that provides coverage for the services required by this 
section may contain provisions requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in 
standards adopted by the American Society for Reproductive Medicine or successor 
organization as outlined by the Society of Assisted Reproductive Technology or 
successor organization; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined by the American Society for Reproductive Medicine or successor 
organization as experimental or investigational. 
Sec. 2.  24-A MRSA §2745-H is enacted to read: 
§2745-H.  Infertility 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual insurance policies, contracts and certificates 
must provide coverage for the treatment of infertility.  A contract, policy or certificate 
that provides coverage for the services required by this section may contain provisions 
requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in 
standards adopted by the American Society for Reproductive Medicine or successor 
organization as outlined by the Society of Assisted Reproductive Technology or 
successor organization; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined by the American Society for Reproductive Medicine or successor 
organization as experimental or investigational. 
Sec. 3.  24-A MRSA §2837-I is enacted to read: 
§2837-I.  Infertility 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All group insurance policies, contracts and certificates must 
provide coverage for the treatment of infertility.  A contract, policy or certificate that 
provides coverage for the services required by this section may contain provisions 
requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in 
standards adopted by the American Society for Reproductive Medicine or successor 
organization as outlined by the Society of Assisted Reproductive Technology or 
successor organization; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined by the American Society for Reproductive Medicine or successor 
organization as experimental or investigational. 
Sec. 4.  24-A MRSA §4234-F is enacted to read: 
§4234-F.  Infertility 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Infertility" means the inability to become pregnant after one year of unprotected 
sex or the inability to carry a pregnancy to term. 
B.  "Treatment of infertility" means the following procedures provided for the 
purpose of the treatment of infertility: 
(1)  In vitro fertilization; 
(2)  Uterine embryo lavage; 
(3)  Embryo transfer; 
(4)  Artificial insemination; 
(5)  Gamete intrafallopian transfer; 
(6)  Zygote intrafallopian transfer; 
(7)  Intracytoplasmic sperm injection; 
(8)  Four completed egg retrievals per lifetime; and 
(9)  Low tubal ovum transfer. 
2.  Required coverage.  All individual and group health maintenance organization 
contracts, policies and certificates must provide coverage for the treatment of infertility.  
A contract, policy or certificate that provides coverage for the services required by this 
section may contain provisions requiring a 50% or lower copayment by the insured. 
3.  Limits.  The coverage required by this section is subject to the following 
conditions: 
A.  The covered individual must be married; 
B.  The covered individual's infertility may not be the result of a sexually transmitted 
disease; 
C.  The number of embryos implanted may not exceed the number set forth in 
standards adopted by the American Society for Reproductive Medicine or successor 
organization as outlined by the Society of Assisted Reproductive Technology or 
successor organization; and 
D.  The contract, policy or certificate may not include coverage for procedures 
defined by the American Society for Reproductive Medicine or successor 
organization as experimental or investigational. 
Sec. 5.  Application.  This Act applies to all policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in this State on or after 
January 1, 2012.  For purposes of this Act, all contracts are deemed to be renewed no 
later than the next yearly anniversary of the contract date. 
SUMMARY 
This bill requires that health insurance policies include coverage for the treatment of 
infertility if: 
1.  The covered individual is married; 
2.  The covered individual's infertility is not the result of a sexually transmitted 
disease; and 
3.  The number of embryos implanted does not exceed the number set forth in 
standards adopted by the American Society of Reproductive Medicine or a successor 
organization. 
Under this bill, a policy that provides such coverage may require a 50% or lower 
copayment by the insured. 
This bill applies to all policies in effect on or after January 1, 2012.