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SB 922

Insurance: health insurers; coverage for the treatment of infertility; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406cc.

2025-2026 Regular Session Introduced by Rosemary Bayer and 11 co-sponsors

Starting Jan 1, 2027, Michigan insurers must cover comprehensive infertility care (diagnostics, treatments, four oocyte retrievals, embryo transfers, and preservation) with non-dis

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Bill Summary · SB 922

Summary of SB 922 (Michigan, 2025-2026)

Purpose

SB 922 proposes to amend the Michigan Insurance Code to require health insurers operating in Michigan to cover the treatment of infertility. The bill sets out specific coverages, protections against discrimination, and related terms, with coverage effective starting January 1, 2027.

Key Provisions

Coverage Requirements

  • Beginning January 1, 2027, insurers that issue, deliver, or renew health insurance policies in Michigan must provide coverage for:
    • Fertility diagnostic care
    • Fertility treatment
    • Standard fertility preservation services
    • At least 4 complete oocyte retrievals with unlimited embryo transfers from those retrievals or from any retrieved oocytes
    • Medical costs related to embryo transfers made to a third party (but not costs incurred by a surrogate after embryo transfer)
    • Coverage must apply regardless of whether donor gametes/embryos are used or if embryos are transferred to a surrogate

Non-Discrimination and Coverage Standards

  • Coverage must be provided without discrimination on a broad set of attributes, including age, ancestry, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, and sexual orientation.
  • Insurers may not impose:
    • Deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limitations on infertility-related benefits that are different from those for non-infertility benefits
    • Preexisting condition exclusions or waiting periods for infertility diagnosis or treatment
    • Limitations on coverage based on arbitrary factors (e.g., number of attempts, dollar amounts, or age) or based on protected classes
    • Exclusions or restrictions on fertility medications that differ from other prescription medications
    • Policy limitations based on factors other than a medical assessment by a licensed health care provider

Medical Guidance and Exceptions

  • Coverage is provided even if the insured foregoes a treatment or procedure because a health care provider determines it is unlikely to be successful or if the insured uses previously retrieved oocytes or embryos.

Definitions (simplified)

  • Fertility diagnostic care: Tests, testing, counseling, medications, and services to inform about fertility (including labs and imaging).
  • Fertility treatment: Procedures, medications, testing, counseling, and services to establish pregnancy or treat infertility, aligned with best medical practice and guidelines from the American Society for Reproductive Medicine.
  • Gamete: Sperm or egg.
  • Infertility: Conditions affecting the ability to establish or carry a pregnancy, with several criteria including duration of unanswered trying, age-related criteria, and certain medical conditions.
  • Oocyte: Egg cell prior to maturation.
  • Standard fertility preservation services: Preservation-related procedures, medications, evaluations, storage, and related services for individuals at risk of fertility loss due to medical treatment or conditions, as per ASRM or ASCO guidelines.

Health Care Providers

  • Allowed providers for infertility services include nurse practitioners, physicians, and physician’s assistants as defined by Michigan public health code classifications.

Who Would Be Affected

  • Health insurers operating in Michigan that deliver, issue for delivery, or renew health insurance policies.
  • Individuals and families seeking infertility diagnosis, treatment, and fertility preservation services in Michigan.

Timeline and Procedural Details

  • Effective date for mandatory coverage: January 1, 2027.
  • The bill establishes detailed coverage requirements and anti-discrimination protections that insurers must follow starting on the effective date.
  • The bill is introduced in April 2026 and referred to the Committee on Finance, Insurance, and Consumer Protection for potential consideration and amendment.

Practical Impact

  • Potentially broader and more uniform access to infertility care for Michigan residents enrolled in participating health plans.
  • Increased insurer costs due to comprehensive coverage mandates (notably four complete oocyte retrievals with unlimited embryo transfers and standard fertility preservation).
  • Administrative requirements to ensure non-discrimination and parity with other medical benefits, especially regarding medications and treatment limitations.
  • Clarified definitions to align coverage with professional guidelines (ASRM/ASCO).

If you’d like, I can provide a plain-language quick-reference card or a comparison with current Michigan insurance coverage practices for infertility.

Compiled from official sources — confirm details with the bill’s official record.

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