Facing obstacles on the path to building a family can affect nearly every part of your life, from emotional well-being to finances and long-term planning. For many Californians, the cost of fertility treatment—particularly in vitro fertilization (IVF)—has long been one of the most significant barriers. Senate Bill 729 offers meaningful progress by expanding health insurance coverage for fertility care. The law requires certain health insurance plans to cover infertility services, including IVF and aspects of surrogacy, in a way that reflects how families are formed today. If you are considering fertility treatment or believe your insurance plan may now provide coverage, understanding how this law works is an important first step.
What Does Senate Bill 729 Cover?
Senate Bill 729 represents a major shift in California’s approach to fertility care. Beginning January 1, 2026, most health insurance plans regulated by the state must cover the diagnosis and treatment of infertility, including IVF. This change moves IVF out of the category of optional or elective care and treats it as medically necessary treatment for individuals who qualify.
SB 729 expands access to fertility treatment in several key ways:
- IVF coverage for large group plans – Health insurance policies covering 101 or more employees must include coverage for up to three completed oocyte (egg) retrievals, along with unlimited single-embryo transfers.
- Small group plans – Insurers must offer coverage for the diagnosis and treatment of infertility, although this coverage may be provided as an optional rider rather than included in the standard policy.
- Broader definition of infertility – The law recognizes that infertility is not limited to heterosexual couples or defined solely by months of unprotected intercourse.
- Inclusive family-building options – Coverage applies to individuals and couples using donor sperm, donor eggs, or gestational surrogates.
- Equal access regardless of relationship status – Single individuals and LGBTQ+ couples are eligible for the same infertility benefits as heterosexual couples.
- Coverage for core fertility procedures – Policies must include services such as egg retrieval, embryo creation, embryo transfer, and fertility-related prescription medications.
How Does SB 729 Apply to Surrogacy?
SB 729 makes clear that insurance contracts may not deny fertility coverage simply because treatment involves a third party, such as a sperm donor, egg donor, or gestational surrogate. The law prohibits exclusions based on “a covered individual’s participation in fertility services provided by or to a third party,” so long as those services are intended to help the covered individual become a parent.
The statute also requires fertility coverage to be provided without discrimination based on factors such as domestic partner status, gender identity, or sexual orientation. As a result, individuals pursuing parenthood through assisted reproduction may find it easier to meet the criteria necessary for insurance-covered treatment.
As long as the covered individual is undergoing treatment to become a parent, coverage generally cannot be denied solely because part of the process involves someone who is not insured under the same policy. Overall, SB 729 seeks to make fertility care more equitable and financially accessible for a broader range of Californians.
How the Law Expands the Definition of “Infertility”
Previously, infertility was often defined narrowly—typically requiring a heterosexual couple to attempt conception through unprotected intercourse for a specific period of time. Senate Bill 729 broadens that framework and allows infertility to be determined based on a more individualized medical evaluation.
Key changes include:
- Physician-based diagnosis – Infertility may be diagnosed based on a licensed physician’s assessment of medical history, reproductive history, diagnostic testing, and other relevant factors.
- Individual eligibility – Infertility is defined as a person’s inability to reproduce either alone or with a partner without medical intervention.
- Recognition beyond intercourse-based standards – The prior six- or twelve-month intercourse requirement is no longer the sole pathway to coverage.
- Anti-discrimination protections – Insurers may not impose different coverage conditions based on age, marital status, gender identity, sexual orientation, or other protected characteristics.
You may qualify under this expanded definition if:
- You have been unable to conceive or carry a pregnancy to live birth following evaluation or treatment.
- You are single or in an LGBTQ+ relationship and require medical assistance such as IVF or donor services.
- A licensed physician determines that infertility treatment is medically appropriate based on your circumstances.
- You are undergoing medical treatment, such as chemotherapy, that may cause sterility and are pursuing fertility preservation.
If you were previously told your insurance plan did not cover fertility treatment, SB 729 may change that analysis, and it may be worth reviewing your options again.
What Fertility Treatments Are Included?
SB 729 outlines a range of infertility services that must be covered by qualifying insurance plans, though specific benefits can vary by policy.
- Diagnosis and treatment of infertility, including testing, evaluations, and medically necessary procedures.
- In vitro fertilization (IVF) for qualifying individuals.
- Egg retrievals, with up to three completed retrievals required for large group plans.
- Embryo transfers, including unlimited single-embryo transfers consistent with ASRM guidelines.
- Fertility medications, without more restrictive limits than those applied to other prescription drugs.
- Third-party reproductive services, where treatment involves donors or gestational carriers.
Timing and plan type matter. Large group plans must comply beginning with plan years issued or renewed on or after January 1, 2026. Self-funded employer plans governed by ERISA and certain public programs may not be required to comply, making it important to review your specific coverage.
What SB 729 Covers—and Does Not Cover—for Surrogacy
SB 729 provides limited but important protections for intended parents using surrogacy. While it does not require insurance to cover every aspect of surrogacy, it does require coverage for certain infertility-related medical services.
Covered services may include:
- Egg retrieval and embryo creation performed for the intended parent.
- Embryo transfer procedures connected to the intended parent’s infertility treatment.
- Fertility medications related to stimulation and embryo preparation.
SB 729 does not require coverage for:
- The surrogate’s prenatal care, delivery, or pregnancy-related medical costs.
- The newborn’s hospital or birth-related expenses, which are typically added to the intended parent’s insurance after birth.
Because insurance coverage in surrogacy arrangements can be complex, intended parents are encouraged to confirm coverage details with their insurer before beginning treatment.
Which Insurance Plans Must Comply?
SB 729 applies to many, but not all, health insurance plans in California.
- Large employer-sponsored group plans regulated by California law must include infertility coverage starting with plan years renewed on or after January 1, 2026.
Exempt plans include:
- Public employee health plans under CalPERS until July 1, 2027.
- Certain Medi-Cal managed care plans.
- Self-funded employer plans governed by ERISA.
- Plans sponsored by qualifying religious organizations.
- Federal health plans such as TRICARE.
Building a family often involves complex legal and financial decisions. Senate Bill 729 introduces new insurance protections for Californians pursuing fertility treatment, but determining how those protections apply to your situation can still require careful review.
Moradi Neufer LLP advises intended parents and gestational carriers through the legal aspects of family formation, including surrogacy and assisted reproduction.
