New Hampshire requires fully insured group plans (issued or renewed on/after Jan 1, 2020) to cover infertility diagnosis, medically necessary fertility treatment including IVF, and fertility preservation — with no arbitrary cycle, dollar, or age caps.
Your plan
What the law does
Fully insured, employer group plans (any size)
Likely required to cover IVF — no cycle cap in the statute. Applies when the plan renews on or after 2020-01-01.
Individual / marketplace plan
Not covered by the law.
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: none written into the statute — No numeric cap: carriers may not limit coverage based on 'arbitrary factors including, but not limited to, number of attempts, dollar amounts, or age'; limits must be based on clinical guidelines and the enrollee's medical history..
Who qualifies: the definition of infertility is inclusive — single people and LGBTQ+ patients qualify without a heteronormative 'unprotected intercourse' requirement.
Step therapy: the law does not require IUI before IVF (all — statute defines infertility as a disease/condition impairing the ability to achieve pregnancy or cause pregnancy in a partner, without marital-status or intercourse requirement; only clinical-guideline-based limits allowed) — but your plan's own clinical policy might; check the payer.
Medications: covered.
PGT-A genetic testing: not addressed by the law — plan-specific.
Embryo storage: covered.
Donor eggs/sperm: covered.
Surrogacy: not covered.
Fertility preservation before cancer treatment: required.
Where people get surprised
Self-funded employer plans (the card usually says 'administered by') are exempt under federal ERISA — appeals go through the plan's internal process and the U.S. Department of Labor, not the state regulator.
SHOP (small-business marketplace) plans and individual-market plans are not covered by the mandate — RESOLVE lists NH as a group-market mandate.
'Duration of the policy term' storage: if you change carriers, storage coverage may stop — confirm before the plan year ends.
Carriers may still apply clinical-guideline limits (e.g., ASRM-based) — ask for the written guideline used in any denial.
NH Medicaid does not cover IVF.
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 — New Hampshire Insurance Department (NHID). NHID external review (RSA 420-J) for medical-necessity and experimental denials 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 New Hampshire?
New Hampshire requires fully insured group plans (issued or renewed on/after Jan 1, 2020) to cover infertility diagnosis, medically necessary fertility treatment including IVF, and fertility preservation — with no arbitrary cycle, dollar, or age caps.
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 2020-01-01. 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.