Connecticut requires all fully insured individual and group plans to cover infertility diagnosis and treatment including up to 2 IVF cycles per lifetime, 4 ovulation induction cycles and 3 IUI cycles — with no blanket age limit since 2016.
Your plan
What the law does
Fully insured, employer group plans (any size)
Likely required to cover IVF — 2 egg retrievals, unlimited transfers. Applies when the plan renews on or after 2005-10-01.
Individual / marketplace plan
Likely required to cover IVF.
Self-funded employer plan (card says "administered by")
Exempt from state law (ERISA). Coverage, if any, is your employer's choice — check the Summary Plan Description for a fertility rider or lifetime maximum.
Medicaid
Does not cover IVF.
Free, 5 steps, nothing saved unless you choose to.
The one thing to check first: is your plan self-funded?
State fertility laws only reach fully insured plans. Most workers at large employers are in self-funded plans, which are governed by federal ERISA law and exempt from every state mandate — 67% of covered workers nationally, and about 80% at firms with 200+ employees (KFF 2025).
Look at your insurance card. If it says "administered by" (an insurer's name as the third-party administrator), your plan is probably self-funded. If it says "insured by" or "underwritten by," it is probably fully insured. The card is a strong hint, not proof — the only definitive answer comes from HR: "Is our medical plan self-funded or fully insured?"
This also decides where a denied claim goes: fully insured plans appeal to the state insurance regulator; self-funded plans appeal under ERISA rules to the U.S. Department of Labor.
What the law requires
Cycle cap: 2 completed egg retrievals with unlimited embryo transfers — Lifetime maximum of 2 cycles of IVF, GIFT, ZIFT or low tubal ovum transfer, with not more than 2 embryo implantations per cycle. Separate lifetime maximums of 4 ovulation induction cycles and 3 IUI cycles. The statute does not define 'cycle' as a retrieval; carriers generally count a stimulation/retrieval plus transfer as one cycle..
Who qualifies: the statute uses an older definition that may require a period of unprotected intercourse or a spouse's sperm — single and LGBTQ+ patients should ask specifically how the plan applies it.
Step therapy: the law allows plans to require IUI before IVF except: patients whose physician determines less expensive treatments are unlikely to succeed (statute permits limiting IVF to those unable to conceive through 'less expensive and medically viable' covered treatments).
Medications: not addressed by the law — plan-specific.
PGT-A genetic testing: not addressed by the law — plan-specific.
Embryo storage: not required.
Donor eggs/sperm: not addressed by the law — plan-specific.
Surrogacy: not covered.
Fertility preservation before cancer treatment: required.
Where people get surprised
Only 2 IVF cycles for life — the lowest cap among IVF-mandate states — so a failed fresh cycle plus one FET may exhaust the benefit; ask how your carrier counts cycles.
Carriers may require you to try less expensive treatments (IUI) first unless your physician documents they are unlikely to work.
Until P.A. 26-33 takes effect, the definition of infertility is a one-year inability to conceive or sustain a pregnancy, which carriers have applied in ways that exclude single and LGBTQ+ patients.
Long-term storage of frozen eggs, sperm or embryos is not mandated.
Religious employers and individuals with religious objections may exclude infertility coverage if requested in writing; self-funded plans are exempt.
What may change
HB 5374 — Public Act 26-33 — Broadens the definition of infertility to include the need for medical intervention — including donor gametes, donor embryos or a gestational surrogate — to establish a pregnancy as an individual or with a partner, making single and LGBTQ+ patients eligible. Status: Passed both chambers May 2026; reported signed by Governor Lamont June 2026 (secondary source); effective date not confirmed.
HB 5483 — An Act Concerning Fertility Care Under the Medicaid Program — Would add fertility treatment coverage to HUSKY Health. Status: Did not pass in 2026 session.
How to appeal a denial
Internal appeal — you have 180 days from the denial to file. The plan must decide within 30 days (before service) or 60 days (after service); 72 hours if urgent.
External review — available for at least 4 months after the final internal denial, for medical-necessity and "experimental" denials (PGT-A, ICSI, step therapy). An independent reviewer decides within 45 days. Contractual exclusions are not eligible for external review — those go to the regulator as a complaint.
Regulator — Connecticut Insurance Department (CID). CID External Review program (independent review of medical-necessity and experimental denials after internal appeal) File a complaint. Copy the regulator on every appeal letter; clinics report it speeds things up.
If your plan is self-funded, skip the state regulator: your appeal runs under ERISA and complaints go to the U.S. Department of Labor's Employee Benefits Security Administration.
Frequently asked
Is IVF covered by insurance in Connecticut?
Connecticut requires all fully insured individual and group plans to cover infertility diagnosis and treatment including up to 2 IVF cycles per lifetime, 4 ovulation induction cycles and 3 IUI cycles — with no blanket age limit since 2016.
My employer is large but my card says 'administered by' — does the state law apply?
Probably not. 'Administered by' usually means a self-funded plan, which federal ERISA law exempts from state insurance mandates. Confirm with HR.
The law took effect but my plan doesn't cover IVF yet — why?
The requirement applies to plan years beginning on or after 2005-10-01. If your plan year renews mid-year, coverage starts at that renewal.
What if my claim is denied?
File an internal appeal within 180 days, request the exact policy language relied on, and copy the regulator. Medical-necessity and 'experimental' denials can go to external review.
This page explains public coverage rules and typical prices as of the dates shown. It is an estimate and an interpretation, not a coverage decision by your plan, and not legal, medical, tax, or insurance advice. Your plan documents control. We never store what you enter here unless you choose to save a plan.