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Bill > SB566

WI SB566

WI SB566
Coverage of infertility services under health policies and plans and granting rule-making authority. (FE)

summary

Introduced
10/24/2025
In Committee
10/24/2025
Crossed Over
Passed
Dead

Introduced Session

2025-2026 Regular Session

Bill Summary

This bill requires health insurance policies and self-insured governmental health plans that cover medical or hospital expenses to cover diagnosis of and treatment for infertility and standard fertility preservation services. Coverage required under the bill must include at least four completed egg retrievals with unlimited embryo transfers in accordance with certain guidelines and single embryo transfer is allowed when recommended and medically appropriate. Policies and plans are prohibited from imposing an exclusion, limitation, or other restriction on coverage of medications of which the bill requires coverage that is not imposed on any other prescription medications covered under the policy or plan. Similarly, policies and plans may not impose any exclusion, limitation, cost-sharing requirement, benefit maximum, waiting period, or other restriction on diagnosis, treatment, or services for which coverage is required under the bill that is different from any exclusion, limitation, cost-sharing requirement, benefit maximum, waiting period, or other restriction imposed on benefits for other services. Also, policies and plans may not impose an exclusion, limitation, or other restriction on diagnosis, treatment, or services for which coverage is required under the bill on the LRB-0166/1 JPC:cdc 2025 - 2026 Legislature SENATE BILL 566 basis that an insured person participates in fertility services provided by or to a third party. Current law refers to health insurance policies as disability insurance policies. For further information see the state fiscal estimate, which will be printed as an appendix to this bill. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.

AI Summary

This bill requires health insurance policies and self-insured governmental health plans to cover diagnosis and treatment of infertility and standard fertility preservation services. The bill defines infertility as the inability to establish or carry a pregnancy to live birth after 12 months of unprotected sexual intercourse for women under 35, or 6 months for women 35 and older, and includes cases where medical intervention is necessary for reproduction. The coverage must include at least four completed egg retrievals with unlimited embryo transfers, following guidelines from the American Society for Reproductive Medicine. Insurers are prohibited from imposing different restrictions or limitations on infertility-related medications or services compared to other medical services, and cannot deny coverage based on a person's participation in third-party fertility services. The bill also requires coverage for fertility preservation services for individuals undergoing medical treatments that might impair fertility. The commissioner of insurance is tasked with developing rules to implement these requirements, with initial guidance based on the standards of the American Society for Reproductive Medicine. The bill will take effect on the first day of the fourth month after publication and will apply to insurance policy years beginning on or after that date, with special considerations for existing collective bargaining agreements.

Committee Categories

Agriculture and Natural Resources

Sponsors (29)

Last Action

Representative Mayadev added as a cosponsor (on 12/12/2025)
(1 Companion Bills)

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