Maine's fertility law, 24-A M.R.S. §4320-U (Public Law 2021, chapter 692), requires carriers offering health plans in Maine to cover fertility diagnostic care, fertility treatment and fertility preservation, with the mandate effective January 1, 2024. The Bureau of Insurance's Rule 865, for plans issued or renewed from January 1, 2025, lists IVF among the minimum covered services and lets carriers cap coverage at four completed egg retrievals per lifetime. This is the picture as of October 2026.
| Rule | What it says | Source |
|---|---|---|
| Who must cover | Carriers offering a health plan in Maine | §4320-U |
| What is covered | Fertility diagnostic care, fertility treatment, and fertility preservation (procurement and cryopreservation of eggs, sperm or embryos) | §4320-U |
| Start date | Mandate effective January 1, 2024; Rule 865 applies to policies issued or renewed from January 1, 2025 | ASRM; Rule 865 |
| IVF | Listed among minimum covered services, including IVF with donor eggs and fresh and frozen embryo transfers | Rule 865 |
| Egg retrievals | Carriers may limit coverage to the first four completed retrievals in a lifetime | Rule 865 |
| Cost sharing | No separate deductible; copays no higher than for comparable specialty services; fertility drugs treated no less favorably than comparable drugs | Rule 865 |
| Not required | Experimental procedures; nonmedical costs of donor gametes, donor embryos or surrogacy | §4320-U |
Sources: Maine Legislature (§4320-U); Maine Bureau of Insurance, Rule 865 basis statement; ASRM ReproductiveFacts.org. Rule 865 took effect a year after the statute because 2024 policies had already been approved.
Under §4320-U a carrier may not impose a waiting period, may not use a prior diagnosis or prior fertility treatment to exclude or restrict coverage, and may not limit coverage because you use donor eggs, donor sperm, donor embryos or surrogacy. Any limits must rest on your medical history and on clinical guidelines that follow current American Society for Reproductive Medicine (or comparable) guidance. Rule 865 also requires coverage regardless of sexual orientation, gender identity or expression, or family composition, including single parents.
Maine's law reaches plans that Maine regulates. It does not reach self-insured employer plans: state mandates do not apply to them, and they cover 67% of workers with employer coverage nationally (healthinsurance.org, June 2026). If your employer pays claims itself, Maine's IVF rules may not apply to you. Your plan documents or HR department can tell you which kind of plan you have.
Rule 865's dates and limits are as published by the Maine Bureau of Insurance. Confirm your own benefits with your insurer before you plan treatment.
Map to the Positive points out that "fertility specialist" is not a single specialty. Knowing the difference helps you book the right first visit:
The types of specialist and the age cutoffs for seeking one are in Chapter 29 of Map to the Positive, at the start of Station IV. The same station shows how to choose the right doctor, the treatment ladder from least to most invasive, and IVF step by step.
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: Maine Revised Statutes, Title 24-A, §4320-U. Coverage for fertility services (Maine Legislature) (accessed 2026-10-30) · Bureau of Insurance Rule Chapter 865, Standards for Fertility Coverage: Basis Statement (Maine Bureau of Insurance) (accessed 2026-10-30) · State and Territory Infertility Insurance Laws: Maine (ReproductiveFacts.org, American Society for Reproductive Medicine) (accessed 2026-10-30) · Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)