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Arkansas Infertility Mandate

The Arkansas infertility mandate was enacted in 1987. It provides coverage for In Vitro Fertilization for ALL individual and group policies that provide maternity benefits excluding HMO’s and self-insured employers.

Definition of Infertility

The law defines the cause of infertility to be a result of one of the following:

  • History of Unexplained Infertility for at least 2-years
  • Endometriosis
  • Exposure to DES
  • Blocked or Surgically Removed Fallopian Tubes, not the result of voluntary sterilization
  • Male Infertility

Requirements

If the definition, per the law, for infertility is met as defined above, then the following requirements must be met in order to qualify for treatment coverage:

  • Patient must either be the insurance policy holder or the spouse and covered dependent of the policy holder
  • Patient must be unable to sustain a successful pregnancy through less costly treatments covered by policy
  • Patient’s oocytes (eggs) must be fertilized by spouse’s sperm
  • IVF must be performed at one of the following:
    • a medical facility licensed or certified by the Arkansas Department of Health
    • a fertility clinic that conforms to ACOG guidelines for IVF Clinics
    • facility that meets the American Fertility Society minimal standards for IVF programs

 

Coverage Limits

  • $15,000 lifetime benefit for ALL fertility services
  • Benefits subject to same deductibles, co-insurance and out-of-pocket maximums that apply to the plan’s maternity benefits
  • Third Party reproductive services such as the use of donor sperm, donor eggs or a surrogate are not covered

What Services are Covered?

  • Lower-cost infertility services including diagnostics and treatment at the discretion of the insurer
  • In Vitro Fertilization (IVF)
  • Embryo Cryopreservation for future implantation

 

Schedule an initial consultation to begin your journey with MCRM Fertility.