OPM will require all insurance carriers in the government’s employer-sponsored health care program to cover artificial insemination and related drugs, as well as the drugs associated with up to three in vitro fertilization cycles per year. Vithun Khamsong / Getty Images
Multiple FEHBP carriers will offer 'comprehensive' IVF coverage next year
Biden administration officials said that two nationwide insurers in the federal government’s employer-sponsored health care program will offer $25,000 worth of in vitro fertilization and other fertility treatments.
The Biden administration announced Wednesday that in 2025, a slate of insurers participating in the Federal Employees Health Benefits Program will begin offering expanded coverage of fertility services, covering upwards of $25,000 in two nationwide plans.
“Today, the Office of Personnel Management is announcing a significant expansion for IVF coverage options for federal employees and their families in 2025,” said Jennifer Klein, director of the White House Gender Policy Council. “In this year’s open enrollment period, regardless of where they live, federal employees will be able to choose multiple plan options with comprehensive IVF care. One in five women struggle with infertility, and many rely on IVF. These are basic issues of reproductive freedom.”
Beginning this year, OPM requires all insurance carriers in the federal government’s employer-sponsored health care program to cover artificial insemination and related drugs, as well as the drugs associated with up to three in vitro fertilization cycles per year. But those drug benefits only account for 35% of the out-of-pocket costs of 15,000 to $30,000 associated with a single cycle of IVF.
As a result, federal employee groups and Democratic lawmakers have been urging OPM to ramp up its coverage requirements for fertility treatments, particularly in light of an Alabama Supreme Court decision that briefly halted the procedures’ availability in the state.
Acting OPM Director Rob Shriver acknowledged the federal workforce’s hunger for access to insurance programs that cover IVF as one of the drivers behind the effort to boost coverage for the procedures. OPM officials said that while the agency has not changed its coverage requirements, it was able to secure the expanded benefits through the annual negotiation process with carriers.
“FEHBP is vital to OPM’s mission to attract and retain top talent into the federal workforce, and there’s no question that offering fertility benefits will allow us to do just that,” Shriver said. “We recently released the Federal Employee Benefits Survey, and two-thirds of those surveyed agreed that fertility benefits should be available through FEHB plans. That number increases to 76% of people when you focus on those born after 1981, who are the most likely to use those benefits.”
When the federal government’s annual Open Season period, during which federal workers may change their enrollments in FEHBP, opens this fall, both Blue Cross Blue Shield and the Government Employees Health Association each will offer a nationally available plan option that includes $25,000 in IVF benefits, on top of the required coverage for three cycles of related drugs.
Additionally, there will be one or more additional options from regional carriers in California, Colorado, Hawaii, Illinois, Maryland, Michigan, New Mexico, New York, Pennsylvania, Texas, Utah, Virginia, Washington, D.C., Guam, Puerto Rico and the U.S. Virgin Islands. Some of these plans offer even more benefits, with no limits either in terms of cost or the number of cycles that will be covered in a year. Across the country, 25 carriers offer a total of 45 plans with IVF benefits above OPM’s requirements.