Illinois law (215 ILCS 5/356m) requires group insurance and HMO plans that include pregnancy benefits, for groups of more than 25 employees, to cover infertility diagnosis and treatment, including IVF. IVF can be limited to cases where cheaper treatments failed, with up to 4 egg retrievals, plus 2 more after a live birth. Since 2019, individual and group policies must also cover fertility preservation. Picture as of October 2026.
| Point | Illinois rule |
|---|---|
| Infertility mandate (215 ILCS 5/356m) | Group insurers and HMOs offering pregnancy-related coverage to groups of more than 25 employees must cover diagnosis and treatment of infertility |
| Treatments named | IVF, uterine embryo lavage, embryo transfer, artificial insemination, GIFT, ZIFT and low tubal ovum transfer |
| Condition for IVF, GIFT, ZIFT | Pregnancy could not be achieved or sustained with less costly covered treatments |
| Egg retrievals | Up to 4, plus 2 more after a live birth, for a lifetime maximum of 6 |
| Facilities | Must meet ACOG and ASRM standards |
| Exempt | Employers with fewer than 25 employees, religious employers, self-insured employers |
| Fertility preservation (215 ILCS 5/356z.32) | Individual and group policies amended, delivered, issued or renewed after January 1, 2019 must cover medically necessary standard fertility preservation when treatment may cause infertility |
Source: ASRM ReproductiveFacts.org, Illinois page (accessed October 2026). KFF's table (May 2020) dates the infertility law to 1991 and 1996.
Triage Cancer (September 2025) adds that the fertility preservation law, HB 2617 (2017), reaches individual, small and large group plans and Medicaid, and bars discrimination based on age, sex, sexual orientation, marital status and other factors.
The State Employees Group Insurance Program had to cover infertility diagnosis and treatment, including IVF, artificial insemination and preimplantation genetic diagnosis and screening, from January 1, 2024, with no different cost-sharing. That section applies to coverage before July 1, 2026 and is repealed on that date; what replaced it could not be confirmed. Triage Cancer also lists a January 1, 2026 date for the 356m mandate, which suggests a recent amendment; whether Illinois extended IVF coverage to individual and small-group plans was not confirmed.
The 356m mandate depends on who your employer is. State mandates do not apply to self-insured employer plans, which cover 67% of US workers with employer coverage (healthinsurance.org, June 2026). Your plan documents or HR department can tell you whether your plan is fully insured or self-insured, and how many employees it covers.
Illinois covers artificial insemination and allows plans to ask for less costly treatment before IVF. Map to the Positive describes intrauterine insemination (IUI) as low-complexity assisted reproduction: sperm is processed in a lab and placed directly into the uterus at the moment of ovulation, usually combined with ovulation induction.
IUI and the full treatment ladder are in Chapter 34 of Map to the Positive, in Station IV. The same station covers when to see a specialist, how to choose a doctor and what happens in each phase of IVF.
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 and Territory Infertility Insurance Laws: Illinois (ASRM ReproductiveFacts.org) (accessed 2026-10-30) · Health Insurance: Fertility Services (Triage Cancer state laws chart) (2025-09) · 5 ILCS 375/6.11B, Infertility coverage (State Employees Group Insurance Act, Illinois General Assembly) (accessed 2026-10-30) · Coverage and Use of Fertility Services in the U.S., Appendix 1: Private Insurance (KFF) (2020-05) · Q. Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)