Insurance, Health, Accident

Plain English Breakdown

The bill summary does not specify the exact number of oocyte retrievals and embryo transfers that must be covered.

Freedom to Grow Our Tennessee Families Act

This bill requires health insurers to cover fertility diagnostic care, treatment, and preservation services for people in Tennessee without discrimination or waiting periods.

What This Bill Does

• Requires health insurance companies to provide coverage for fertility diagnostic care, treatment, and preservation services starting January 1, 2026.
• Prohibits health insurers from imposing waiting periods or using past diagnoses to limit fertility coverage.
• Ensures that health insurers do not discriminate based on race, sex, disability, ancestry, or relationship status when providing fertility coverage.
• Requires health insurers to cover at least three complete oocyte retrievals with unlimited embryo transfers for eligible individuals.

Who It Names or Affects

• Health insurance companies operating in Tennessee
• People seeking fertility diagnostic care, treatment, and preservation services

Terms To Know

Fertility Diagnostic Care

Services that provide information about an individual's ability to conceive.

Experimental Fertility Procedure

A procedure for which there is not enough medical evidence to consider it standard practice.

Limits and Unknowns

• The bill does not require health insurers to cover nonmedical costs related to donor gametes, embryos, or surrogacy.
• Health insurers can limit coverage based on an enrollee's medical history and clinical guidelines adopted by the insurer.

Official Summary Text

This bill enacts the "
Freedom to Grow Our Tennessee Families Act
," which requires a
health insurer that issues, delivers, amends, or renews a health benefit plan that is to be in effect in this state on or after January 1, 2026,
to
provide coverage for
f
ertility diagnostic care
, f
ertility treatment
,
and
f
ertility preservation services.

Relative to such coverage, a health insurer must not do any of the following:



Impose a waiting period
.



Use a prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of such coverage
.



Impose limitations on coverage for fertility services based on an enrollee's use of donor gametes, donor embryos, or surrogacy
.



Impose different limitations on coverage for, provide different benefits to, or impose different requirements on a class of persons on account of an individual's actual or perceived race, color, sex, disability, ancestry, or relationship status.

This bill requires a
health insurer
to cover
at least
three
complete oocyte retrievals with unlimited embryo transfers from those oocyte
retrievals or from any oocyte retrieval performed prior to January 1, 2026, in accordance with the guidelines of the American Society for Reproductive Medicine

or a comparable organization
, using single embryo transfer when recommended and medically approp
riate
. The coverage must b
e provided regardless of whether donor gametes or embryos are used or an embryo is transferred to the uterus of a person acting as surrogate.

This bill further requires c
overage for fertility preservation services
to
be provide
d regardless of an enrollee's past or present treatment for cancer, sickle cell disease, lupus, menorrhagia, endometriosis, or uterine fibroids.
"
Fertility preservation services
"

m
eans procedures, products, medications, and services intended to preserve f
ertility, consistent with established medical practice and professional guidelines published by the American Society for Reproductive Medicine

or a comparable organization
,
for an individual who has a medical condition or who is expected to receive medical
treatment that may cause or has the potential to cause a risk of impairment of fertility
. Such preservation services i
nclude evaluation expenses; laboratory assessments; medications; treatment associated with fertility preservation services; the procurem
ent and cryopreservation of gametes, embryos, and reproductive material; and storage from the time of cryopreservation for a period of at least three years
.

LIMITATIONS

This bill requires that a
ny limitation a health insurer imposes on the coverage req
uired by this
bill
be based on an enrollee's medical history and clinical guidelines adopted by the health insurer. Any clinical guidelines used by a health insurer must be based on current guidelines developed by the American Society for Reproductive Med
icine

or a comparable organization
; must cite with specificity any data or scientific reference relied upon; must be maintained in written form; and must be made available to an enrollee in writing upon request.

This
bill
does not require a health insurer to provide coverage for
a
n experimental fertility procedure
or n
onmedical costs related to donor gametes, donor embryos, or surrogacy.
An "e
xperimental fertility procedure
"

i
s a procedure for which the published medical
evidence is not sufficient for the American Society for Reproductive Medicine
,

or a comparable organization
,
to regard the procedure as established medical practice
.

RULEMAKING

This bill authorizes t
he commissioner of commerce and insurance to promulga
te rules to effectuate this
bill
. When promulgating such rules, the commissioner
must
consider the clinical guidelines developed by the American Society for Reproductive Medicine
or a comparable organization
.

TENNCARE

This bill adds fertility care for
a fertility patient as described above to the kind of medical assistance to be covered by TennCare.

TEMPORARY ASSISTANCE

Under welfare-related programs and services for children, present law provides that a
family
is
eligible for temporary assistance if
all of the following conditions are met
:



A dependent child resides in this state with a caretaker relative in that family, or an individual who applies for temporary assistance is pregnant, or as otherwise defined by the
department
of human services
.



The family meets income standards based upon the standard of need for a family based upon its size and income and based upon resource limits as determined by the department in its rules
.



The family members are engaged in work activities
, unless
exempted
.



The caretaker relative has agreed to and complies with a personal responsibility plan as developed by the department
.



The family or individual of the family is otherwise eligible pursuant to federal or state laws or regulations.

Present law provides
that a
caretaker relative who becomes ineligible for any reason other than a failure to comply with work requirements or to cooperate with child support obligations
is
eligible for transitional childcare assistance for a period specified by the department
while the caretaker relative is employed, in school, or in employment training.

Childcare assistance terminated due to failure to comply with work requirements
must
be reinstated upon verification by the department that the work requirements were, in fact
, being met immediately preceding such ineligibility.

This bill removes these provisions

and, instead, provides that a
caretaker relative who becomes ineligible for any reason is eligible for transitional childcare assistance for a period of not less than
s
ix
months.
This bill requires the department of human services to
pay childcare assistance on a sliding fee scale based upon a family's income for so long as federal funding or any related waiver is in effect.

Current Bill Text

SENATE BILL 463
By Briggs

HOUSE BILL 595
By Hemmer

HB0595
002107
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 56
and Title 71, relative to families.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. This act is known and may be cited as the "Freedom to Grow Our
Tennessee Families Act."
SECTION 2. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by
adding the following as a new section:
(a) As used in this section:
(1) "Enrollee" means a person on whose behalf a health insurer is
obligated to pay benefits or provide services under a health benefit plan;
(2) "Experimental fertility procedure" means a procedure for which the
published medical evidence is not sufficient for the American Society for
Reproductive Medicine, its successor organization, or a comparable organization
to regard the procedure as established medical practice;
(3) "Fertility diagnostic care" means procedures, products, medications,
and services intended to provide information and counseling about an individual's
fertility, including laboratory assessments and imaging studies;
(4) "Fertility patient" means:
(A) An individual or couple with infertility;
(B) An individual unable to conceive as an individual or with a
partner because the individual or couple does not have the necessary
gametes for conception; or

- 2 - 002107

(C) A couple that is at increased risk of transmitting a serious
inheritable genetic or chromosomal condition to a child;
(5) "Fertility preservation services":
(A) Means procedures, products, medications, and services
intended to preserve fertility, consistent with established medical practice
and professional guidelines published by the American Society for
Reproductive Medicine, its successor organization, or a comparable
organization, for an individual who has a medical condition or who is
expected to receive medical treatment that may cause or has the
potential to cause a risk of impairment of fertility; and
(B) Includes evaluation expenses; laboratory assessments;
medications; treatment associated with fertility preservation services; the
procurement and cryopreservation of gametes, embryos, and
reproductive material; and storage from the time of cryopreservation for a
period of at least three (3) years;
(6) "Fertility treatment" means procedures, products, medications, and
services intended to achieve pregnancy that results in a live birth with healthy
outcomes and that are provided in a manner consistent with established medical
practice and professional guidelines published by the American Society for
Reproductive Medicine, its successor organization, or a comparable
organization;
(7) "Gamete" means sperm or eggs;
(8) "Health benefit plan" means a contract or policy for health insurance
coverage, as defined in § 56-7-109;

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(9) "Health insurer" means a health insurance entity, as defined in § 56-
7-109; and
(10) "Infertility" means:
(A) The inability to establish pregnancy or to carry a pregnancy to
live birth after twelve (12) months of regular, unprotected sexual
intercourse when the couple has the necessary gametes for conception,
or a period of less than twelve (12) months due to a person's age or other
factors when the couple has the necessary gametes for conception. A
pregnancy that does not result in a live birth does not toll or restart the
twelve-month period of time described in this subdivision (a)(7)(A); or
(B) The presence of a condition recognized by a licensed
physician that impacts an individual's ability to establish pregnancy or to
carry a pregnancy based on a patient's medical, sexual, and reproductive
history, age, physical findings, or diagnostic testing, or any combination of
such factors.
(b) A health insurer that issues, delivers, amends, or renews a health benefit
plan that is to be in effect in this state on or after January 1, 2026, shall provide
coverage for all of the following:
(1) Fertility diagnostic care;
(2) Fertility treatment; and
(3) Fertility preservation services.
(c) Coverage required by subsection (b) must:
(1) Include at least three (3) complete oocyte retrievals with unlimited
embryo transfers from those oocyte retrievals or from any oocyte retrieval
performed prior to January 1, 2026, in accordance with the guidelines of the

- 4 - 002107

American Society for Reproductive Medicine, using single embryo transfer when
recommended and medically appropriate; and
(2) Be provided regardless of whether donor gametes or embryos are
used or an embryo is transferred to the uterus of a person acting as surrogate.
(d) Coverage for fertility preservation services pursuant to subsection (b) must
be provided regardless of an enrollee's past or present treatment for cancer, sickle cell
disease, lupus, menorrhagia, endometriosis, or uterine fibroids.
(e) Relative to coverage required by subsection (b), a health insurer shall not:
(1) Impose a waiting period;
(2) Use a prior diagnosis or prior fertility treatment as a basis for
excluding, limiting, or otherwise restricting the availability of such coverage;
(3) Impose limitations on coverage for fertility services based on an
enrollee's use of donor gametes, donor embryos, or surrogacy; or
(4) Impose different limitations on coverage for, provide different benefits
to, or impose different requirements on a class of persons on account of an
individual's actual or perceived race, color, sex, disability, ancestry, or
relationship status.
(f) Any limitation a health insurer imposes on the coverage required by this
section must be based on an enrollee's medical history and clinical guidelines adopted
by the health insurer. Any clinical guidelines used by a health insurer must be based on
current guidelines developed by the American Society for Reproductive Medicine, its
successor organization, or a comparable organization; must cite with specificity any data
or scientific reference relied upon; must be maintained in written form; and must be
made available to an enrollee in writing upon request.
(g) This section does not require a health insurer to provide coverage for:

- 5 - 002107

(1) An experimental fertility procedure; or
(2) Nonmedical costs related to donor gametes, donor embryos, or
surrogacy.
(h) The commissioner of commerce and insurance is authorized to promulgate
rules to effectuate this section, including, but not limited to, cost-sharing, benefit design,
and clinical guidelines. When promulgating such rules, the commissioner shall consider
the clinical guidelines developed by the American Society for Reproductive Medicine, its
successor organization, or a comparable organization. The rules must be promulgated
in accordance with the Uniform Administrative Procedures Act, compiled in title 4,
chapter 5.
SECTION 3. Tennessee Code Annotated, Section 71-3-104(b)(1), is amended by
deleting the subsection and substituting the following:
(1) A caretaker relative who becomes ineligible for any reason is eligible for
transitional childcare assistance for a period of not less than six (6) months. The
department shall pay childcare assistance on a sliding fee scale based upon a family's
income for so long as federal funding or any related waiver is in effect.
SECTION 4. Tennessee Code Annotated, Section 71-5-107(a), is amended by adding
the following as a new subsection:
(29) Fertility care for a fertility patient, as described in SECTION 2.
SECTION 5. This act takes effect January 1, 2026, the public welfare requiring it.