Multiple FEHB Carriers Will Offer Expanded IVF Coverage in 2025

In April of this year, a group of 176 U.S. Congress members wrote to the U.S. Office of Personnel Management (OPM), urging the federal government’s HR department to require all insurance carriers in the Federal Employee Health Benefits (FEHB) program to cover in vitro fertilization (IVF) medical treatments and medications in plan year 2025.

The OPM has responded to those calls.

As Government Executive recently reported, the Biden administration has announced that, in 2025, two nationwide insurers participating in the FEHB program will begin offering expanded coverage of fertility services.

As Government Executive’s Erich Wagner pointed out, OPM began requiring all insurance carriers in the FEHB program—which provides benefits to more than 8 million federal enrollees and dependents—to cover artificial insemination and related drugs, in addition to drugs associated with up to three in vitro fertilization cycles annually.

Those drug benefits, however, only account for 35% of the out-of-pocket costs of $15,000 to $30,000 that accompany a single cycle of IVF, Wagner wrote. When the federal government’s annual Open Season period begins this fall, Blue Cross Blue Shield and the Government Employees Health Association will offer a nationally available plan option that includes $25,000 in IVF benefits, along with the already required coverage for three cycles of related drugs, according to OPM. There will be additional options from regional carriers in a number of states, including California, Colorado, Hawaii, Maryland, Michigan, Texas and Virginia.

Lawmakers and organizations have voiced support for the new requirement.

For example, RESOLVE: The National Infertility Association “applauds the federal government” for expanding fertility benefits.

“For decades,” the organization said in a statement, “federal employees had to scrimp and save to access needed fertility treatments, most of which were not covered through their health insurance provided through FEHB.”

Congressman Gerry Connolly (D-Va.), who was among the legislators responsible for the April letter pushing OPM to expand fertility benefits, was “thrilled” with the agency’s recent announcement.

“In 2025, every FEHB enrollee, regardless of where they live and work, will be able to choose from multiple nationwide plans that offer comprehensive IVF coverage. Additionally, every FEHB plan will be required to cover the prescription drugs required for three cycles of IVF annually, ensuring every enrollee in the country is able to choose a plan with fertility coverage,” Connolly said in a statement.

“Providing federal employees with options to start and grow their families will in turn help the government recruit and retain the federal workforce of the future.”