IVF Coverage from FEHB plans in 2025

OPM’s requirement that FEHB plans expand their coverage of infertility services was one of the major benefit updates in 2024. This included all methods of artificial insemination and the fertility drugs associated with IVF, for up to three cycles annually. One national PPO plan, BCBS Standard, went beyond the required benefits and offered a $25,000 annual benefit for IVF procedures, and the cost of fertility drugs did not count toward that $25,000 limit.

What’s changing in 2025? Federal employees will have even more options for plans offering IVF coverage, including another national PPO plan. We’ll break down the key changes to infertility benefits and provide a guide to IVF coverage across all FEHB plans.

Expanded IVF Coverage for Plan Year 2025

All Federal employees will have two nationwide PPO plans to choose from next year for comprehensive IVF coverage: BCBS Standard, and now GEHA High.

GEHA High offers the same $25,000 annual IVF benefit as BCBS Standard, covering the procedure itself while keeping fertility drug costs separate from that limit. However, there are some differences in member costs: After the deductible, BCBS Standard has a 15% cost share for IVF, while GEHA High has a 20% share. Plus, premiums for both self-plus-one and self & family plans are higher with BCBS Standard. Families comparing both plans for IVF coverage should weigh the premiums, out-of-pocket costs, and provider access before deciding.

In addition to the nationwide plans, more local plans will offer IVF coverage next year. In total, 45 FEHB plans will provide IVF coverage that goes beyond what OPM requires, an increase from this year.

Even with the expanded coverage, families using these services will still face significant out-of-pocket costs. A single IVF cycle can run anywhere from $15,000 to $30,000, and coinsurance—what you have to pay—varies between 15% and 50% of the procedure’s total cost. That means families could be responsible for thousands of dollars in out-of-pocket expenses. Those planning to use IVF benefits should consider taking advantage of an FSA, which allows contributions of up to $3,300, to help cover those expenses.

Guide to IVF Coverage from FEHB plans

Below are the FEHB plans that offer IVF coverage beyond OPM’s required benefits. Plan options are grouped into nationwide plans, D.C. area plans, and plans available in other states. Make sure to read the official FEHB plan brochure to fully understand the IVF benefits and to learn about pre-authorization requirements. Coinsurance values displayed assume you’ll use in-network providers.

Nationwide Plans Offering IVF Coverage (open enrollment):

BCBS Standard – 15% coinsurance, deductible applies, limited to $25K per year

GEHA High – 20% coinsurance, deductible applies, limited to $25K per year (new in 2025)

Nationwide Plans Offering IVF Coverage (restricted enrollment):

Rural Carrier (PSHB only) – $0, up to the plan maximum for two complete cycles per year, must use Institute of Excellence infertility provider

Foreign Service Benefit Plan – 10% coinsurance, deductible applies

D.C. Area Plans Offering IVF Coverage:

Aetna Open Access High – 50% coinsurance, limited to $5K per year (new in 2025)

Carefirst – Standard – 50% coinsurance, limited to three attempts per live birth, limited to $45K per year(new in 2025), Blue Value Plus – 50% coinsurance, limited to three attempts per live birth, limited to $45K per year (new in 2025), BlueChoice Advantage HDHP – 50% coinsurance, deductible applies, limited to three attempts per live birth, limited to $45K per year (new in 2025)

Kaiser – High – 50% coinsurance, limited to three attempts per live birth, limited to $50K per year (new in 2025), Standard - 50% coinsurance, limited to three attempts per live birth, limited to $50K per year (new in 2025), Prosper - 50% coinsurance, deductible applies, limited to three attempts per live birth, limited to $50K per year (new in 2025)

MDIPA High – 50% coinsurance, limited to three cycles (new in 2025)

Sentara Health Plans High (Northern VA) – 20% coinsurance, limited to three cycles per year

IVF Coverage available from carriers in other states:

California – Western Health Advantage – 50% coinsurance (new in 2025), Sharp Health Plan – 50% coinsurance, limited to three cycles per year (new in 2025)

Colorado –  Kaiser - High – 50% coinsurance, limited to three cycles, limited to $50K per year (new in 2025), Standard – 50% coinsurance, deductible applies, limited to three cycles, limited to $50K per year (new in 2025), Prosper – 50% coinsurance, deductible applies, limited to three cycles, limited to $50K per year (new in 2025)

Hawaii – HMSA – High: 20% coinsurance, one IVF procedure per lifetime; Standard: 30% coinsurance, deductible applies, one IVF procedure per lifetime, Kaiser – High: 20% coinsurance, one IVF procedure per lifetime; Standard: 20% coinsurance, one IVF procedure per lifetime

Illinois/Indiana/Iowa – Health Alliance HMO – 25% coinsurance, deductible applies

Michigan – Blue Care Network of Michigan – 50% coinsurance, Priority Health – High: 50% coinsurance; Standard: 50% coinsurance, deductible applies; Value: 50% coinsurance, deductible applies

New Mexico – Presbyterian Health Plan – High: 20% coinsurance, deductible applies, up to three cycles per plan year; Standard: 20% coinsurance, up to three cycles per plan year; Wellness: 20% coinsurance, up to three cycles per plan year

New York – Independent Health – High: $40 copay, three cycles per lifetime (new in 2025); Standard: $50 copay, three cycles per lifetime (new in 2025); HDHP: 20% coinsurance, deductible applies, three cycles per lifetime (new in 2025)

Pennsylvania - Geisinger – Standard: 20% coinsurance, deductible applies, limited to three cycles; Basic: 30% coinsurance, deductible applies, limited to three cycles; UPMC – Standard: 20% coinsurance, deductible applies, limited to $25K lifetime; HDHP: 15% coinsurance, deductible applies, limited to $25K lifetime

Utah – SelectHealth – Standard: 50% coinsurance, after deductible, up to three cycles per plan year; HDHP - 50% coinsurance, after deductible, up to three cycles per plan year

Texas – Baylor Scott & White Health Plan – Standard: 30% coinsurance, deductible applies, limited to three cycles per year, limited to $15K per year; Basic – 50% coinsurance, deductible applies, limited to three cycles per year, limited to $15K per year

Virginia - Sentara Health - Hampton Roads – High: 30% coinsurance, deductible applies, up to three cycles per plan year; HDHP – 20% coinsurance, deductible applies, up to three cycles per plan year

IVF Coverage available from carriers in U.S. territories:

Guam/Northern Mariana Islands – Calvos Selectcare – High: $40 copay; Standard: 50% coinsurance

Puerto Rico/U.S. Virgin Islands – Triple S Salud – $7.50 copay, limited to $15K per year