Facing barriers on the path to building a family can affect nearly every part of your life, from your emotional well-being to your finances and future planning. For many in California, the cost of fertility treatments like IVF has been a defining obstacle. Senate Bill 729 brings new hope by expanding health insurance coverage to fertility benefits. It requires certain health insurance plans to cover infertility care – including IVF and some aspects of surrogacy – in a way that reflects modern family-building needs. If you’re considering fertility treatment or you believe you may be entitled to insurance coverage, it’s important to understand how this new law affects you and what steps to take next.
What Exactly Does Senate Bill 729 Cover?
Senate Bill 729 marks a significant change in how California approaches fertility care. Beginning January 1, 2026, most health insurance plans in California must provide coverage for the diagnosis and treatment of infertility, including in vitro fertilization (IVF). This shifts IVF from being “elective” or optional care to medically necessary treatment for those who qualify.
SB 729 expands access to fertility treatments in several important ways:
- Most insurance companies now must offer IVF: For large group policies that cover at least 101 employees, it is now required to provide coverage for a maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers of one embryo per transfer.
- For small group policies, the new law requires insurers to offer coverage for the diagnosis and treatment of infertility; however, the small group policy does not have to include coverage in its standard policy. (leading to it being likely an additional rider to the policy to purchase, so this will have less of an effect).
- Broader Definitions of Infertility – The law recognizes that infertility isn’t limited to heterosexual couples or defined by a specific timeframe of trying to conceive.
- Inclusive Family-Building – Coverage extends to individuals and couples using donor sperm, donor eggs, or gestational surrogates.
- Equal Treatment Across Relationships – Single individuals and LGBTQ+ couples are eligible for the same infertility benefits as heterosexual couples.
- Coverage for Key Fertility Procedures – Policies must include services such as egg retrieval, embryo creation, embryo transfer, and prescription medication.
How does this apply to surrogacy?
The law says contracts can’t deny people fertility coverage for fertility services that involve sperm donors, egg donors, or surrogates. The law says insurance contracts can’t exclude or deny fertility coverage based on “a covered individual’s participation in fertility services provided by or to a third party,” which includes “an oocyte, sperm, or embryo donor, gestational carrier, or surrogate that enables an intended recipient to become a parent.”
Additionally, the law specifically states that coverage for fertility services will be provided without discrimination based on factors such as “domestic partner status,” “gender identity,” or “sexual orientation.” This means that it is now easier to meet the standard of proof necessary to qualify as infertile and have treatments be covered by insurance plans.
So long as the covered individual is taking part in treatments that would enable them to become a parent, they cannot be denied coverage for those treatments, even if it involves a third party not covered under the insurance contract. In short, SB 729 aims to make fertility care more equitable, inclusive, and financially accessible. If you’ve faced roadblocks in getting your insurance to recognize your fertility needs in the past, this law could significantly change your options moving forward.
How Does the Law Expand the Definition of “Infertility” and Who Qualifies?
Under the previous framework, infertility was often defined in a very narrow manner – typically as the inability of a heterosexual couple to conceive after 6 months of unprotected intercourse if you’re under 25, and 12 months of unprotected intercourse if you’re over 35 years old.. The new law, Senate Bill 729, broadens that definition so that you may qualify for coverage even if your situation didn’t fit the old criteria. Some of the key changes include:
- Broader Diagnosis Basis – Infertility may now be recognized based on a licensed physician’s findings after they consider your medical history, sexual and reproductive history, diagnostic testing, and other relevant factors.
- Individual Eligibility – The new law allows infertility to be described as a person’s inability to reproduce either alone or with a partner without medical intervention. That means single individuals and LGBTQ+ couples are included.
- Non-Intercourse Situations Recognized – The old standard of 6 months to one year of unprotected intercourse is no longer the only path to qualify. Instead, the definition accommodates those whose infertility is not defined by heterosexual intercourse alone, expanding the rights of singles and LGBTQ+ couples.
- Anti-Discrimination Provisions – Insurers cannot impose different conditions or coverage limitations based on age, marital status, gender identity, sexual orientation, race, or other protected categories when it comes to infertility diagnosis and treatment.
Who qualifies under this expanded definition? You may qualify if:
- You’ve been unable to conceive or carry a pregnancy to live birth despite attempted treatments or diagnostic evaluation.
- You are single or in a LGBTQ+ relationship and need medical intervention such as IVF, donor sperm/eggs, or embryo donation to build your family.
- A licensed physician has determined, after appropriate evaluation of your personal case and medical history, that you require infertility treatment.
- You’re undergoing medical treatment (for example, chemotherapy) that may cause sterility, and you seek preservation or treatment as part of your fertility plan, so egg freezing, sperm storage or embryo creation will be included.
Because the definition of infertility has changed, if you were previously told you didn’t qualify for coverage under the terms of your insurance plan, you should re-check your situation under SB 729.
What Fertility Treatments Are Included Under SB 729?
When it comes to what treatments and services your insurance must cover under SB 729, the law sets out a number of key requirements – though the exact implementation may vary by plan. Below is a breakdown of what you should expect, and some questions you’ll want to ask.
Under the new law, covered infertility services in California include:
- Diagnosis and Treatment of Infertility – Including necessary tests, evaluations, and consultations, as well as medically necessary procedures.
- In Vitro Fertilization (IVF) – SB 729 removes the previous exclusion of IVF and requires health plans to cover the procedure for qualifying individuals under specific conditions.
- Egg Retrieval (Oocyte Retrievals) – For large group health insurance plans, the law specifies coverage of up to three completed egg retrievals.
- Embryo Transfers – SB 729 allows for unlimited embryo transfers in accordance with the guidelines of the American Society for Reproductive Medicine (ASRM), using single embryo transfer when recommended and medically appropriate.
- Medications for Fertility Treatment – The law prohibits plans from placing more restrictive limitations on fertility medications compared to other medicines.
- Third-Party Reproduction Medical Services – The law prohibits exclusion of coverage solely because treatment is provided via a donor or gestational carrier.
Even though SB 729 mandates broad coverage for fertility treatments, timing and plan category matter. For example, large group plans must comply with a certain effective date, typically on or after January 1, 2026. But if your employer does not renew its plans until later on in the year, the effective date will be later, when the plan is renewed.. Also, if your plan is self-funded (governed by federal ERISA rules) or if you’re covered by certain public programs, SB 729 may not apply – which means you’ll want legal advice to chart your next step.
By understanding the types of treatments included and asking the right questions, you’ll be better equipped to move ahead with your fertility journey without leaving coverage behind.
What Does SB 729 Cover for Surrogacy?
SB 729 brings limited but valuable support for individuals or couples pursuing surrogacy as part of their family-building journey. It’s important to note that the law does not require insurance plans to pay for all aspects of surrogacy, but it does require them to cover certain medical services directly tied to the intended parent’s infertility treatment.
Here’s what SB 729 covers when surrogacy is involved:
- Egg Retrieval and Embryo Creation – These procedures are typically performed on the intended parent and are considered part of infertility treatment.
- Embryo Transfers – If the transfer is performed on the surrogate, the medical part of the procedure may be covered if it’s linked to the intended parent’s infertility diagnosis.
- Fertility Medications – Medications for egg stimulation or embryo preparation may be covered for the intended parent, even if the embryos are used via a surrogate.
It’s also important to understand what is not covered under SB 729:
- Surrogate’s Medical Costs – Coverage for prenatal care, delivery, or other medical expenses for the gestational carrier is not included in this bill. These costs are managed through a separate insurance policy or legal arrangement. Most intended parents typically need to buy separate insurance policy for their surrogate, and while not common, some intended parents find that their surrogates carries insurance that will cover a surrogacy pregnancy.
- Baby’s Birth Hospital Coverage- Coverage for the intended parent(s)’ baby’s portion of the hospital bill or birth is not covered under SB 729. Coverage for baby is typically added to the intended parent(s) insurance policy once baby is born, exactly like parents who conceive on their own, without a surrogate.
If you’re thinking of using a surrogate, it’s wise to consult with your insurance provider about what’s covered and to clarify any limits or exclusions before beginning treatment. Working with an surrogacy attorney experienced in reproductive law can also help ensure that your surrogacy plan is legally sound, properly insured, and compliant with California law.
Which Insurance Plans Must Comply With SB 729?
SB 729 applies to a wide range of health insurance plans in California, but not all of them.
- Employer-Sponsored Group Health Plans – Most traditional employer-based large health plans offered in California will be required to include infertility coverage, including IVF, starting with plan years issued or renewed after January 1, 2026.
At the same time, certain plans and employers are exempt from SB 729:
- Public Employee Health Plans – Health benefit policies for public employees entered under CalPERS are exempt from the new law until July 1, 2027, while certain DMHC-regulated Medi-Cal managed care plans are also exempt.
- Self-Funded Employer Plans – These insurance plans are governed by federal law (ERISA) and generally do not have to comply with state insurance mandates like California’s new law. If your employer has this kind of plan, they’re not legally required to follow SB 729 unless they choose to adopt similar benefits.
- Religious Employers – Certain religious organizations are exempt from providing insurance coverage for infertility services, including IVF.
- Federal Health Plans – Programs like TRICARE or federal employee health benefits may not fall under California’s jurisdiction, so California law would not apply.
Your journey to building a family deserves support and clarity. Senate Bill 729 is a major change in California, offering new insurance protections for people pursuing fertility treatment. But understanding whether and how you are covered can still be complicated.
Moradi Neufer LLP advises intended parents and gestational carriers throughout the surrogacy process in its Family Formation practice.
Common Questions:
1. What is California Senate Bill 729, and when does it take effect?
Senate Bill 729 is a new California law that requires many health insurance plans to cover infertility diagnosis and treatment, including IVF. The law takes effect for most large-group insurance plans issued or renewed on or after January 1, 2026. Some exemptions apply, and certain plans (such as self-funded employer plans) may not be required to comply.
2. Who qualifies for infertility coverage under SB 729?
SB 729 expands the definition of infertility so more people qualify. You may be eligible if:
- A doctor determines that you cannot reproduce on your own without medical intervention
- You are a single parent by choice
- You are in an LGBTQ+ relationship
- You require donor eggs, donor sperm, or a gestational carrier
- You face medical treatment (such as chemotherapy) that may affect fertility
The older requirement of 6–12 months of unprotected heterosexual intercourse is no longer the only qualifying path.
3. Does SB 729 require insurance companies to cover IVF?
Yes. For most large-group plans, SB 729 requires coverage for:
- Up to three completed egg retrievals
- Unlimited single-embryo transfers
- IVF-related medications
- Necessary diagnostic evaluations and fertility treatment
Small-group plans must offer infertility coverage, but it may not be included automatically.
4. Are LGBTQ+ individuals and couples included in SB 729’s infertility coverage?
Absolutely. SB 729 includes strong anti-discrimination protections. Insurance companies cannot deny or limit fertility treatment based on:
- Sexual orientation
- Gender identity
- Domestic partnership status
- Marital status
LGBTQ+ individuals and couples now have equal access to fertility benefits.
5. What fertility treatments are covered under SB 729?
Covered fertility services may include:
- Diagnostic testing and consultations
- IVF
- Up to three completed oocyte (egg) retrievals
- Unlimited embryo transfers (single embryo recommended)
- Fertility medications
- Medical services related to donor eggs, donor sperm, or embryo creation
- Treatments needed before fertility-impacting medical procedures (e.g., egg or sperm freezing before chemotherapy)
Coverage may vary by plan type and renewal date.
