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HB 5904

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 Noah Arbit and 13 co-sponsors

Requires Michigan health insurers to cover infertility care including diagnostics, treatment, preservation, and at least four oocyte retrievals with unlimited embryo transfers, sta

bill electronically reproduced 04/28/2026
#health:other #health:planning #insurance:healthinsurers
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Bill Summary · HB 5904

Summary of HB 5904 (2025-2026) – Michigan

A bill to amend the Insurance Code to require health insurers to cover infertility treatment starting January 1, 2027.

1) Purpose and intent

  • The bill requires health insurers that issue, deliver, or renew health insurance policies in Michigan to provide comprehensive coverage for infertility treatment.
  • The aim is to ensure insured individuals have access to fertility diagnostics, treatments, and related preservation services without discriminatory limits or exclusions.

2) Key provisions and changes

Coverage requirements (effective date: January 1, 2027)

Insurers must cover:
- (a) Fertility diagnostic care.
- (b) Fertility treatment.
- (c) Standard fertility preservation services.
- (d) At least four complete oocyte retrievals with unlimited embryo transfers from those retrievals or from any retrieved oocytes.
- (e) Medical costs related to embryo transfer when performed for or on behalf of an insured by a third party; coverage must not extend to surrogate-related medical costs after embryo transfer.
- (f) Coverage must apply regardless of whether donor gametes or embryos are used, or if an embryo is transferred to a surrogate.

Non-discrimination and scope

  • Coverage must be provided without discrimination on age, ancestry, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation.

Prohibited or restricted practices (insurers may not impose)

  • Deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limitations for infertility diagnosis/treatment that differ from those for non-infertility services.
  • Preexisting condition exclusions or waiting periods for infertility diagnosis/treatment.
  • Limitations based on arbitrary factors (e.g., number of attempts, dollar amounts, age) or on protected classes under the Elliot-Larsen Civil Rights Act.
  • Exclusions or restrictions on fertility medications different from other prescription medications.
  • Policy limitations based on factors other than medical assessment by a licensed health care provider.

Optional treatments and decisions

  • Coverage must continue even if the insured declines a treatment or procedure due to likelihood of failure or use of previously retrieved oocytes/embryos.

Definitions (selected)

  • Fertility diagnostic care: Procedures, products, genetic testing, medications, counseling, and services to provide fertility information and counseling.
  • Fertility treatment: Procedures, products, genetic testing, medications, counseling, and services to establish pregnancy or treat infertility, aligned with medical practice and ASRM guidelines.
  • Gamete: Sperm or egg.
  • Health care provider: Nurse practitioner, physician, or physician’s assistant (per Michigan licensing and public health code).
  • Infertility: Several defined scenarios, including failure to conceive after specified periods with/without a partner, or age-related timelines; includes infertility arising from disability or medical treatments.
  • Oocyte: Egg cell before maturation.
  • Physician: Licensed physician (MD) or osteopathic physician (DO).
  • Standard fertility preservation services: Includes procedures, products, testing, medications, counseling, and services to preserve fertility (e.g., cryopreservation) for conditions or treatments likely to affect fertility, per professional guidelines (ASRM or ASCO).

3) Who/what would be affected

  • Insurers: Health insurers issuing, delivering, or renewing policies in Michigan would be required to include the specified infertility coverage.
  • Policyholders/insured individuals: People seeking infertility diagnosis, treatment, or fertility preservation would gain access to defined covered services without the outlined restrictions.
  • Donor/ surrogate scenarios: Coverage extends to embryo transfers involving third parties or donor gametes/embryos, but surrogate-related medical costs post-transfer are not covered.

4) Procedural and timeline aspects

  • Introduced: April 28, 2026.
  • Committee: Referred to the House Committee on Insurance.
  • Effective date: January 1, 2027, for required coverage provisions.
  • The bill specifies that it applies to health insurance policies delivered, issued for delivery, or renewed in Michigan.

5) Notable considerations

  • The bill emphasizes non-discrimination in coverage and prohibits common barriers to infertility care (e.g., preexisting condition exclusions, overly restrictive limits).
  • It ensures a minimum standard of care by aligning with recognized medical guidelines (ASRM/ASCO) for defining infertility, fertility treatment, and preservation services.
  • The provision for at least four complete oocyte retrievals with unlimited embryo transfers represents a substantive expansion of coverage for individuals requiring ongoing treatment.

Overall, HB 5904 would significantly expand and standardize infertility coverage in Michigan, with explicit protections against discriminatory practices and a set of defined services and thresholds intended to improve access to fertility care.

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

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