Connecticut HB 5483: AN ACT CONCERNING FERTILITY CARE UNDER THE MEDICAID PROGRAM.

Bill Text

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General Assembly Substitute Bill No. 5483
February Session, 2026

AN ACT CONCERNING FERTILITY CARE UNDER THE MEDICAID
PROGRAM.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. (NEW) (Effective January 1, 2027) (a) As used in this section: 1
(1) "Fertility diagnostic care" means counseling, products, 2
medications, procedures, genetic testing and services intended to 3
provide information about an individual's fertility, including, but not 4
limited to, laboratory assessments and imaging studies; 5
(2) "Infertility" means (A) the inability to establish or carry a 6
pregnancy based on an individual's medical, sexual and reproductive 7
history, age, physical findings, diagnostic testing or any combination of 8
those factors, including, but not limited to, infertility arising from 9
disabilities or from medical treatments or conditions associated with a 10
disability, (B) the need for medical intervention to establish a pregnancy 11
either as an individual or with a partner, (C) an individual's inability to 12
establish a pregnancy or carry a pregnancy to live birth after twelve 13
months of unprotected sexual intercourse when the individual and the 14
individual's partner have the necessary gametes to establish a 15
pregnancy, provided a pregnancy loss shall not restart the twelve-16
month period, or (D) an individual's inability to establish a pregnancy 17
or to carry a pregnancy to live birth after six months of unprotected 18
sexual intercourse due to the individual's age when the individual and 19

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the individual's partner have the necessary gametes to establish a 20
pregnancy, provided a pregnancy loss shall not restart the six-month 21
period; 22
(3) "Intrauterine insemination" means a procedure that places sperm 23
directly into an individual's uterus at the time of ovulation to increase 24
the chances of fertilization; 25
(4) "In-vitro fertilization" or "IVF" means a medical procedure where 26
an egg is fertilized by sperm in a laboratory setting; and 27
(5) "Standard fertility preservation services" means counseling, 28
products, medications, procedures, genetic testing and services 29
intended to preserve fertility, consistent with established medical 30
practice and professional guidelines published by the American Society 31
for Reproductive Medicine or the American Society for Clinical 32
Oncology, for an individual who (A) has a medical or genetic condition, 33
including, but not limited to, conditions related to disability or chronic 34
illness, or (B) is expected to receive medical treatment that has a side 35
effect or possible side effect of a risk to an individual's fertility and 36
includes, but is not limited to, expenses related to evaluation, laboratory 37
assessments, medications and treatment, as well as the procurement and 38
cryopreservation of gametes, embryos and reproductive material and 39
storage. 40
(b) Beginning on January 1, 2027, the Commissioner of Social Services 41
shall provide Medicaid coverage, to the extent permissible under federal 42
law, for: 43
(1) Fertility diagnostic care; 44
(2) Standard fertility preservation services, including, but not limited 45
to, storage of gametes from the time of cryopreservation, provided 46
coverage for such storage shall extend until the individual reaches the 47
age of thirty, or for a period of five years, whichever is later, unless the 48
commissioner extends the period of time; and 49

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(3) Treatment of infertility, including, but not limited to, (A) any 50
medically necessary ovulation-enhancing medications and medical 51
services related to prescribing and monitoring the use of the ovulation-52
enhancing medications for at least three cycles of ovulation-enhancing 53
medication treatment, and (B) at least six cycles of intrauterine 54
insemination. 55
(c) In implementing the coverage required in this section, the 56
Commissioner of Social Services shall not: 57
(1) Impose a waiting period; 58
(2) Use any prior diagnosis, an individual's disability or prior fertility 59
treatment as a basis for excluding, limiting or otherwise restricting the 60
availability of coverage required under this section; 61
(3) Impose any limitations on coverage for any fertility services based 62
on an individual's use of donor gametes; and 63
(4) Impose different limitations on coverage for, provide different 64
benefits to or impose different requirements on a class of persons on 65
account of their age, ancestry, color, disability, ethnicity, gender 66
identity, genetic information, marital status, national origin, race, 67
religion, sex or sexual orientation. 68
(d) The Commissioner of Social Services shall consult with the 69
Centers for Medicare and Medicaid Services on whether in-vitro 70
fertilization is a medically reasonable and necessary procedure as 71
required for Medicaid coverage under federal law. N