Antega United States
Fertility treatment, insurance and law in District of Columbia
The District of Columbia is not a state, but it regulates insurance in its own right. From 1 January 2025, insurers offering individual, small-group and large-group plans must cover the diagnosis and treatment of infertility, including three rounds of IVF and standard fertility-preservation services (D.C. Code §31-3834.06, D.C. Law 25-49).
1. What applies now
The position in force on the review date below. Anything scheduled for the future is kept separate.
Broad infertility or IVF requirement in force
The District of Columbia is not a state, but it regulates insurance in its own right. From 1 January 2025, insurers offering individual, small-group and large-group plans must cover the diagnosis and treatment of infertility, including three rounds of IVF and standard fertility-preservation services (D.C. Code §31-3834.06, D.C. Law 25-49).
Private-insurance requirement: Required to be covered
The District of Columbia is not a state, but it regulates insurance in its own right. From 1 January 2025, insurers offering individual, small-group and large-group plans must cover the diagnosis and treatment of infertility, including three rounds of IVF and standard fertility-preservation services (D.C. Code §31-3834.06, D.C. Law 25-49).
State requirements do not necessarily apply to every health plan. Self-funded employer plans, federal plans and certain exempt employers may follow different rules. Check your plan documents or insurer for your individual coverage.
2. What fertility services may be covered
IVF
Required to be covered
IUI
Not established in the sources reviewed
Fertility preservation
Required to be covered
Fertility medicines
Not established in the sources reviewed
Diagnosis and testing
Required to be covered
3. Who the rule applies to
Employer size rules: Not identified in the sources reviewed.
Religious or conscience exemptions: Not identified in the sources reviewed.
Self-funded employer plans (ERISA): Self-funded employer plans are governed principally by federal ERISA rules and are generally outside the District's requirement, even for people living in DC.
- Applies across individual, small-group and large-group markets — broader than most states
- Cover is subject to medical necessity and recognised clinical standards
4. Important exclusions and limitations
Cycle or lifetime limits: At least three complete oocyte retrievals, with unlimited embryo transfers from those retrievals.
5. Medicaid
Not established in the sources reviewed
No Medicaid infertility benefit was identified in the sources reviewed. Medicaid is a public programme and is separate from commercial insurance.
6. Public and state-employee plans
Not established in the sources reviewed
No distinct public-employee fertility benefit was identified. A public-employee benefit, where one exists, is not a statewide private-insurance requirement.
7. Future changes already enacted
Law that has been passed but is not yet in force. It does not affect cover today.
No enacted law with a future effective date was identified.
8. Recent legislation that did not become law or remains pending
Proposals are never a guide to your current cover.
No pending, failed or expired fertility bills were recorded for this jurisdiction in this review.
Surrogacy, parentage and donor conception
Gestational surrogacy: Statutory framework permitting and regulating gestational surrogacy
The Collaborative Reproduction Amendment Act of 2016 (D.C. Code Ch. 16-4) expressly authorises surrogacy agreements that meet statutory requirements and establishes intended parents as legal parents regardless of genetic connection.
Parentage: Court orders of parentage may be obtained before or after birth, and compliant arrangements do not require a post-birth adoption.
LGBTQ+ family building: Parent status under the 2016 Act does not depend on a genetic connection to the child.
9. Sources and last reviewed date
The District of Columbia is not a state, but it regulates insurance in its own right. From 1 January 2025, insurers offering individual, small-group and large-group plans must cover the diagnosis and treatment of infertility, including three rounds of IVF and standard fertility-preservation services (D.C. Code §31-3834.06, D.C. Law 25-49).
Sources
- D.C. Code §31-3834.06Council of the District of Columbia · checked 2026-09-08
- D.C. Law 25-49, Expanding Access to Fertility Treatment Amendment Act of 2023Council of the District of Columbia · checked 2026-09-08
- D.C. Code §16-404, surrogacy agreementsCouncil of the District of Columbia · checked 2026-09-08
Last reviewed by the Antega editorial team: 2026-09-08.
This is general information about state rules, not legal or insurance advice, and it is not a guarantee of cover. Laws, mandates and plan rules change. Always confirm your own position with your insurer or plan administrator in writing, and take advice from a licensed attorney in your state before making legal arrangements.
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