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HOUSE BILL NO. 5904
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406cc.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3406cc. (1) Beginning January 1, 2027, an insurer that 1
delivers, issues for delivery, or renews in this state a health 2
insurance policy shall provide coverage for the treatment of 3
infertility, including all of the following: 4
(a) Fertility diagnostic care. 5
(b) Fertility treatment. 6
April 28, 2026, Introduced by Reps. Steckloff, Miller, Tsernoglou, Price, Rheingans, McFall,
Dievendorf, Xiong, Foreman, Wilson, Breen, Hoskins, Arbit and Skaggs and referred to
Committee on Insurance.
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(c) Standard fertility preservation services. 1
(d) At least 4 complete oocyte retrievals with unlimited 2
embryo transfers from those oocyte retrievals or from any oocyte 3
retrieval. 4
(e) The medical costs related to an embryo transfer to be made 5
from or on behalf of an insured to a third party. However, the 6
insured's coverage must not extend to any medical costs of a 7
surrogate after the embryo transfer. 8
(f) Coverage regardless of whether donor gametes or embryos 9
are used or if an embryo will be transferred to a surrogate. 10
(2) Coverage for the treatment of infertility under this 11
section must be provided without discrimination on the basis of 12
age, ancestry, disability, domestic partner status, gender, gender 13
expression, gender identity, genetic information, marital status, 14
national origin, race, religion, sex, or sexual orientation. 15
(3) An insurer described in subsection (1) shall not impose 16
any of the following: 17
(a) Deductibles, copayments, coinsurance, benefit maximums, 18
waiting periods, or any other limitations on coverage for the 19
diagnosis and treatment of infertility, including the prescription 20
of fertility medications, different from those imposed on benefits 21
for services not related to infertility. 22
(b) Preexisting condition exclusions or preexisting condition 23
waiting periods on coverage for the diagnosis and treatment of 24
infertility or the use of any prior diagnosis, an individual's 25
disability, or prior treatment for infertility as a basis for 26
excluding, limiting, or otherwise restricting the availability of 27
coverage for required benefits. 28
(c) Limitations on coverage based solely on arbitrary factors, 29
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including number of attempts, dollar amounts, or age, or providing 1
different benefits to, or impose different requirements on, a class 2
protected under the Elliot-Larsen civil rights act, 1976 PA 453, 3
MCL 37.2101 to 37.2804, than that provided to other insureds. 4
(d) Exclusions, limitations, or other restrictions on coverage 5
of fertility medications that are different from those imposed on 6
any other prescription medications. 7
(e) Limitations under the policy based on anything other than 8
the medical assessment of an individual's licensed health care 9
provider. 10
(4) An insurer described in subsection (1) shall provide 11
coverage under this section regardless of whether the insured 12
foregoes a particular fertility treatment or procedure if the 13
insured's health care provider determines that the treatment or 14
procedure is likely to be unsuccessful or the insured seeks to use 15
previously retrieved oocytes or embryos. 16
(5) As used in this section: 17
(a) "Fertility diagnostic care" means procedures, products, 18
genetic testing, medications, counseling, and services intended to 19
provide information and counseling about an individual's fertility, 20
including laboratory assessments and imaging studies. 21
(b) "Fertility treatment" means procedures, products, genetic 22
testing, medications, counseling, and services intended to 23
establish a pregnancy or treat infertility and that are provided in 24
a manner consistent with established medical practice and 25
professional guidelines published by the American Society for 26
Reproductive Medicine. 27
(c) "Gamete" means sperm or egg. 28
(d) "Health care provider" means any of the following: 29
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(i) Nurse practitioner. As used in this subparagraph, "nurse 1
practitioner" means an individual who is licensed as a registered 2
professional nurse under part 172 of the public health code, 1978 3
PA 368, MCL 333.17201 to 333.17242, who has been granted a 4
specialty certification as a nurse practitioner by the Michigan 5
board of nursing under section 17210 of the public health code, 6
1978 PA 368, MCL 333.17210. 7
(ii) Physician. 8
(iii) Physician's assistant. As used in this subparagraph, 9
"physician's assistant" means an individual who is licensed to 10
engage in the practice as a physician's assistant under part 170, 11
175, or 180 of the public health code, 1978 PA 368, MCL 333.17001 12
to 333.17097, 333.17501 to 333.17556, and 333.18001 to 333.18058. 13
(e) "Infertility" means any of the following: 14
(i) The presence of a condition recognized by a health care 15
provider that impacts an individual's ability to establish a 16
pregnancy or to carry a pregnancy. This includes infertility 17
arising from disabilities or from medical treatments or conditions 18
associated with disability. 19
(ii) An individual's inability to establish pregnancy as an 20
individual or with a partner because the individual or the 21
individual and the individual's partner do not have the necessary 22
gametes to establish a pregnancy. 23
(iii) An individual's inability to establish a pregnancy or to 24
carry a pregnancy to live birth after 12 months of unprotected 25
sexual intercourse when the individual and the individual's partner 26
have the necessary gametes to establish pregnancy. Pregnancy loss 27
does not restart the 12-month period. 28
(iv) An individual's inability to establish pregnancy after 6 29
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months of unprotected sexual intercourse due to the individual's 1
age when the individual and the individual's partner have the 2
necessary gametes to establish pregnancy, or to carry a pregnancy 3
to live birth. Pregnancy loss does not restart the 6-month period. 4
(f) "Oocyte" means an ovum or egg cell before maturation. 5
(g) "Physician" means either of the following: 6
(i) A physician licensed to engage in the practice of medicine 7
under part 170 of the public health code, 1978 PA 368, MCL 8
333.17001 to 333.17097. 9
(ii) A physician licensed to engage in the practice of 10
osteopathic medicine and surgery under part 175 of the public 11
health code, 1978 PA 368, MCL 333.17501 to 333.17556. 12
(h) "Standard fertility preservation services" means 13
procedures, products, genetic testing, medications, counseling, and 14
services intended to preserve fertility, consistent with 15
established medical practice and professional guidelines published 16
by the American Society for Reproductive Medicine, or the American 17
Society for Clinical Oncology for an individual who has a medical 18
or genetic condition, including conditions related to disability or 19
chronic illness, or who is expected to receive medical treatment 20
that has a side effect or possible side effect of a risk to an 21
individual's fertility and includes, but is not limited to, 22
expenses related to evaluation, laboratory assessments, 23
medications, and treatment, as well as the procurement and 24
cryopreservation of gametes, embryos, and reproductive material and 25
storage. 26