Half of large US employers now cover IVF — but most workers don't know it. At $23K a cycle, that's tens of thousands that could be left on the table

In 2024, Glass had a daughter, also via IVF. Even with coverage, she and her husband estimate they paid about $8,000 out of pocket across two rounds. Without it, they could have been on the hook for far more: the average cost of a single IVF cycle in the U.S. is $23,474, according to FertilityIQ. And many patients need several rounds before they’re successful, which could drive the cost up even more.

However, a lot of workers with IVF coverage don’t even know they have it, which means they might be paying out of pocket — or even not having the children they want due to the cost.

IVF coverage isn’t consistent across employers

Currently, about half of U.S. employers with at least 500 workers offer IVF coverage, up from just 22% in 2019, according to consulting firm Mercer. As of 2026, 15 states — plus Washington, D.C. — have laws specifically requiring IVF coverage, while 25 states have some form of fertility care mandate on the books.

While that sounds like good news, those laws don’t apply equally to everyone. Self-funded employer plans, in which the company bears the risk rather than relying on an outside health insurance company, are exempt from state mandates. And with more than half of all employers using self-funded insurance, that means even if your state mandates IVF coverage, your plan might not be required to follow the law.

There are signs of a federal push for IVF coverage, something Trump promised during his campaign. The administration recently proposed a rule that would let employers offer standalone fertility benefit plans with a lifetime cap of up to $120,000, but the rule is still in a public comment period and experts caution it won’t result in near-term changes.

“Fertility treatments are time sensitive,” Sean Tipton, chief advocacy officer for the American Society for Reproductive Medicine, told CNN. “Do not delay your treatment thinking there’s going to be a benefit from this policy anytime soon.”

How to cover fertility treatments

You don’t have to wait for policy changes to grow your family. If you’re looking at fertility treatments today, here’s where to start.

Read your benefits document carefully

The first step is to see what your plan covers, and you should be able to find that in the Summary of Benefits and Coverage document for your plan. Look for terms like “fertility,” “infertility treatment,” “assisted reproductive technology” or “IVF.” If you’re still not sure, reach out to your insurer directly.

Consider switching plans

Most employers offer several options for insurance coverage. If yours does, look at what other plans might offer and consider switching during open enrollment time, which usually starts in November. And, if you’re married, look at the options on your spouse’s plan as well.

Tap your HSA or FSA

Even if your insurance doesn't cover IVF, an HSA or Flexible Spending Account (FSA) may help you cover the costs. IVF-related expenses, including medications, egg retrieval and storage, are generally considered eligible expenses. In 2026, the annual HSA contribution limit is $8,750 for families, while the FSA limit is $7,500 for families. That won't cover a full cycle, but because these are pre-tax dollars, it could provide a meaningful discount on treatment.

Check state laws

See if your state laws mandate IVF coverage — and if the laws apply to you. Remember, many larger employers use self-funded insurance, which may not be required to follow state laws. Still, it’s worth looking into before paying thousands out of pocket.

Talk to HR

Some employers partner with platforms like Carrot Fertility to provide benefits that go beyond standard health insurance. If your HR department hasn’t mentioned it, it’s worth asking about. These programs are sometimes separated from insurance and might not be well-publicized. If your employer doesn’t offer coverage, ask if adding it is an option.

IVF can be expensive, but there’s a good chance your company offers some level of coverage to help you grow your family. Digging deeper into your benefits — and comparing plans — could help you get treatment without paying entirely out of pocket.