Antega United States
Fertility treatment, insurance and law in Illinois
Illinois requires group policies and HMOs that provide pregnancy-related benefits to cover the diagnosis and treatment of infertility, including IVF, GIFT, ZIFT, embryo transfer and artificial insemination (215 ILCS 5/356m). It is one of the more comprehensive state requirements in the country.
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
Illinois requires group policies and HMOs that provide pregnancy-related benefits to cover the diagnosis and treatment of infertility, including IVF, GIFT, ZIFT, embryo transfer and artificial insemination (215 ILCS 5/356m). It is one of the more comprehensive state requirements in the country.
Private-insurance requirement: Required to be covered
Illinois requires group policies and HMOs that provide pregnancy-related benefits to cover the diagnosis and treatment of infertility, including IVF, GIFT, ZIFT, embryo transfer and artificial insemination (215 ILCS 5/356m). It is one of the more comprehensive state requirements in the country.
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: A religious employer exemption exists, and small employers below the statutory threshold may be outside the requirement.
Self-funded employer plans (ERISA): Self-funded employer plans are governed principally by federal ERISA rules, so a large Illinois employer may lawfully offer nothing at all despite the mandate.
- Applies to insured group plans that already cover pregnancy
- IVF, GIFT and ZIFT generally follow the failure of less costly covered treatment
- Treatment must be provided at a clinic meeting the standards referenced in the statute
- Clinical criteria follow ASRM, ACOG and SART standards
4. Important exclusions and limitations
Employer exemptions: A religious employer exemption exists, and small employers below the statutory threshold may be outside the requirement.
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 Illinois Gestational Surrogacy Act (750 ILCS 47) sets eligibility requirements for the carrier and the intended parents and provides a process completed before delivery.
Parentage: Where the statutory certifications are completed before birth, parentage is established by operation of law at birth and the birth record is issued accordingly, so no adoption is needed.
9. Sources and last reviewed date
Illinois requires group policies and HMOs that provide pregnancy-related benefits to cover the diagnosis and treatment of infertility, including IVF, GIFT, ZIFT, embryo transfer and artificial insemination (215 ILCS 5/356m). It is one of the more comprehensive state requirements in the country.
Sources
- 215 ILCS 5/356m, infertility coverageIllinois General Assembly · checked 2026-09-08
- 750 ILCS 47/35, Gestational Surrogacy ActIllinois General Assembly · checked 2026-09-08
- Surrogacy and birth recordsIllinois Department of Public Health · 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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