New York Expands IVF Coverage with Unlimited Embryo Transfers Under New Legislation

The New York State Senate advances legislation on January 27 that would redefine how insurers count IVF coverage, shifting from a "cycle" model to a "retrieval" model with unlimited embryo transfers.

Two bills are at the center of the package to address how insurers have interpreted the state's 2020 IVF coverage mandate, which required large-group plans to cover three IVF cycles. The legislation, having passed the Senate, now awaits approval from the Assembly and Governor Hochul, clarifying its upcoming steps.

What The Bills Change

S.8866, the Equity in Fertility Treatment Act sponsored by Senator Julia Salazar, shifts coverage from "three IVF cycles" to "three completed oocyte retrievals with unlimited embryo transfers." It also explicitly includes donor egg retrievals, prohibits denials based on fertility preservation, and ensures coverage for LGBTQ+ and older women, promoting fairness and inclusivity.

"LGBTQ+ New Yorkers deserve the same reproductive insurance coverage as all New Yorkers, yet they are being unfairly excluded due to an unintended loophole in state law", Salazar said in a statement. "The Equity in Fertility Treatment Act will ensure that all New Yorkers who wish to become parents through IVF, and have the insurance coverage afforded by New York's 2019 legislation, will be able to do so."

S.3155, sponsored by Senator Jeremy Cooney, would close a potential loophole that could allow insurers to require women 35 and older to transfer all embryos from a previous IVF cycle as a condition of covering a subsequent cycle.

"Every single New Yorker deserves access to high-quality reproductive healthcare," Cooney said. "That's why I sponsor my IVF legislation to give New Yorkers more options and better outcomes when looking to build a family."

How Insurers Interpreted "Cycles"

When New York's large-group IVF mandate took effect in January 2020, it required coverage for "three cycles" of IVF. According to the New York Department of Financial Services, a "cycle" is defined as all treatments from the time medications are administered for either egg retrieval or endometrial preparation.

Under this definition, frozen embryo transfer cycles done without egg retrieval count toward the three-cycle limit. A patient could complete one egg retrieval, bank multiple embryos, then exhaust all three covered cycles through frozen transfers, leaving remaining embryos without insurance coverage for transfer.

The 2023 legislative memo for the bill's predecessor (S.6118-A) described the problem: "Currently, insurance companies have interpreted a complete cycle of IVF only to be one phase of the process. For example, insurers have interpreted retrieval as one completed cycle and transfer as another. As a result, some couples are left to pay out of pocket, even when transferring embryos from a covered cycle, or when additional cycles of IVF are needed."

The memo also notes that inadequate transfer coverage "serves as an incentive to transfer too many embryos in one transfer, which is risky and leads to bad medical outcomes for all involved."

Coverage Details

The expanded coverage would apply to large-group fully insured plans (100+ employees), the same population covered under the 2020 mandate. Small-group plans (fewer than 100 employees), self-funded ERISA plans, individual market plans, and Medicaid recipients remain excluded from the IVF mandate. The bills clarify existing coverage rather than expand who qualifies.

Following Other States' Models

New York's "unlimited embryo transfers" language mirrors approaches in other states. California's SB 729, which took effect January 1, 2026, requires large-group plans to offer "three completed oocyte retrievals and unlimited embryo transfers" in accordance with ASRM guidelines.

Delaware's mandate covers six completed egg retrievals per lifetime, unlimited embryo transfers, and follows ASRM guidelines on single-embryo transfer when medically appropriate.

Colorado's Building Families Act, effective January 2023, similarly provides coverage for three completed oocyte retrievals and unlimited embryo transfers for large-group plans.

What's Next?

The bills require approval by the New York State Assembly and Governor Hochul's signature before taking effect. Assembly companion bills have not been publicly identified, and effect dates have not been specified.

The legislation package also includes bills on health data privacy protections for reproductive information, contraception access expansion, and federally qualified health center reimbursement for injectable fertility drugs. Implementation details, including how the changes affect patients currently in treatment, will depend on final legislation and guidance from the Department of Financial Services.