IVF coverage in Maryland for single and LGBTQ+ patients
Maryland's law uses an inclusive definition of infertility: you qualify based on a physician's finding or on being unable to conceive without medical intervention, with no requirement for a period of unprotected heterosexual intercourse. Plans in scope of the law cannot make single or same-sex-partnered patients pay out of pocket for the diagnostic phase that heterosexual couples get covered.
What to ask
- "How does the plan define infertility, and does it apply to me?"
- "Is donor sperm or donor egg purchase covered?" (Most state laws exclude the purchase; some carve-outs cover it.)
- "Are IUI cycles required before IVF, and do self-paid IUIs count?"
Where people get surprised
- Small-employer plans (50 or fewer employees) are exempt from the IVF mandate.
- Self-funded employer plans are exempt under ERISA — common among large Maryland employers and federal contractors.
- The $100,000 lifetime cap is on the benefit paid, and IVF medications and PGT may count against it depending on the plan.
- Same-sex and unmarried patients must document 3 IUI/AI attempts in a year before IVF is covered unless a qualifying medical condition applies.
- Religious organizations can request an exclusion; storage of frozen sperm/eggs is not covered under the fertility preservation section.