Since January 1, 2020, New Hampshire's RSA 417-G (enacted by SB 279 in 2019) has required carriers issuing group health policies to cover medically necessary fertility treatment, diagnosis of infertility and standard fertility preservation. Plans may not limit coverage based only on arbitrary factors such as number of attempts, dollar amounts or age, and cost sharing must match other services. This is the picture as of October 2026.
| Item | New Hampshire rule |
|---|---|
| Who must cover | Carriers that issue or renew group accident or health policies with medical or hospital benefits |
| Fertility treatment | Medically necessary treatment, including evaluations, lab assessments, medications and treatments associated with procuring donor eggs, sperm and embryos |
| Diagnosis | Diagnosis of the cause of infertility |
| Fertility preservation | Cryopreservation of embryos, eggs and sperm before surgery, radiation, chemotherapy or other treatment that risks impaired fertility; storage covered for the policy term |
| Cost sharing | No different deductibles, copays, coinsurance, benefit maximums or waiting periods for fertility care |
| Limits | No limits based solely on arbitrary factors such as number of attempts, dollar amounts or age |
| Not covered by the mandate | Plans through the Small Business Health Options Program (SHOP) and Extended Transition to ACA-Compliant Policies |
Sources: ASRM ReproductiveFacts.org (New Hampshire); Triage Cancer (September 2025).
The law defines infertility as a disease that impairs a person's ability to become pregnant or carry a pregnancy to live birth, or to cause pregnancy and live birth in a partner.
Because New Hampshire bars arbitrary caps, coverage turns on what is medically necessary for you. Ask your carrier how it decides that, and ask your doctor to document why each step is indicated.
The mandate applies to group policies the state regulates. State mandates do not apply to self-insured employer plans, which cover 67% of workers with employer coverage nationwide (healthinsurance.org, June 2026), and SHOP plans are exempt. Your plan documents or HR department can tell you which you have.
Confirm current benefits with your insurer, and with HR if coverage comes through work, before you start treatment.
Map to the Positive groups fertility treatment into three levels of rising complexity. Knowing them helps you discuss what is medically indicated:
Each level is explained in Chapter 34 of Map to the Positive, in Station IV, with success rates by age and the treatment ladder that ties them together. The same station covers when to see a specialist and what happens in 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: New Hampshire (ReproductiveFacts.org, American Society for Reproductive Medicine) (accessed 2026-10-30) · Health Insurance & Fertility Services: State Laws (Triage Cancer) (2025-09) · Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)