Since January 1, 2026, California's SB 729 (signed September 29, 2024) requires large-group health plans to cover infertility diagnosis and treatment, including IVF with at least three completed egg retrievals and unlimited embryo transfers. Small-group plans only have to offer that coverage, and the employer decides whether to buy it. Medi-Cal managed care, Medicare Advantage and religious employers are excluded, and CalPERS plans are exempt until July 1, 2027. Picture as of October 2026.
| Point | What applies | Source and date |
|---|---|---|
| Signed | September 29, 2024 | Ogletree Deakins, December 2025 |
| Start date | Originally July 1, 2025; Assembly Bill 116 (2025) moved it to January 1, 2026 | DMHC, December 2025 |
| Large-group plans | Must cover diagnosis and treatment consistent with ASRM guidelines: at least 3 completed egg retrievals and 3 sperm retrieval attempts, unlimited embryo transfers (single embryo transfer as the statute requires), donor and surrogacy-related services, freezing and at least 5 years of storage | DMHC, February 2026 |
| Small-group plans | Must offer (not automatically include) coverage with at least 1 egg and 1 sperm retrieval attempt and at least 1 year of storage | DMHC, February 2026 |
| Not included | Medi-Cal managed care, Medicare Advantage, religious employers | DMHC, February 2026 |
| CalPERS | SB 729 does not apply until July 1, 2027 | DMHC, February 2026 |
DMHC = California Department of Managed Health Care. Its All Plan Letter 25-021 (revised February 23, 2026) sets out how plans must apply SB 729.
Separately, SB 600 (2019) requires plans and insurers to cover standard fertility preservation when a treatment may cause infertility, with Medi-Cal managed care excluded (Triage Cancer, September 2025). DMHC confirms this coverage sits alongside SB 729. Before SB 729, California's 1990 law was only a mandate to offer: insurers had to tell employers infertility coverage was available, IVF was excluded, and employers did not have to buy it (KFF, May 2020). KFF Health News reported that about nine million people would qualify under SB 729 (June 2025).
Your coverage depends on the type of plan, not only on the state. State mandates do not apply to self-insured employer plans, which cover 67% of US workers with employer coverage (healthinsurance.org, June 2026). If your employer self-insures, SB 729 may not reach your plan. Your plan documents or HR department can tell you which kind of plan you are on.
This page follows DMHC guidance; policies regulated by the California Department of Insurance were not checked separately. Confirm your benefits with your insurer before you start.
SB 729 counts retrievals and transfers separately, so it helps to know what each step is. Map to the Positive explains that the embryo transfer can happen in the same cycle (fresh transfer) or in a later cycle (frozen embryo transfer), and that many centers now prioritize frozen transfer for slightly better rates.
The transfer is Phase 4 of the five phases in Chapter 35 of Map to the Positive, IVF demystified, in Station IV. The chapter ends with the questions to ask before you start, and the same station covers when to see a specialist, choosing a doctor and the treatment ladder.
Take 30 days. If it does not give you more clarity than everything you have read for free so far, ask for a refund and you get every cent back. We cannot promise you a pregnancy. We can promise you will not be guessing.
References: State Laws Aim To Reverse Baby Bust And Cut IVF Costs (Ogletree Deakins, via Mondaq) (2025-12-12) · APL 25-021: Implementation of Senate Bill 729 (2024) (California Department of Managed Health Care) (2025-12-30) · REVISED APL 25-021: Implementation of Senate Bill 729 (2024) (California Department of Managed Health Care) (2026-02-23) · Health Insurance: Fertility Services (Triage Cancer state laws chart) (2025-09) · Coverage and Use of Fertility Services in the U.S., Appendix 1: Private Insurance (KFF) (2020-05) · California's Much-Touted IVF Law May Be Delayed Until 2026, Leaving Many in the Lurch (KFF Health News) (2025-06-25) · Q. Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)