Many large US employers now include IVF benefits, but most employees remain unaware, risking significant out-of-pocket expenses for fertility treatments.

Key Highlights

  • The share of US employers with 500+ workers offering IVF coverage has nearly doubled since 2019, rising to current levels.
  • Workers unaware of benefits may face expenses of $23,474 per IVF cycle, a common cost in the US.
  • Carrot Fertility serves over 1,000 employers with fertility benefits platforms.
  • State mandates do not apply to self-funded employer plans, leaving many workers without coverage.
  • A proposed federal rule could allow standalone fertility benefits with a $120,000 lifetime cap.

A significant portion of large US employers now include in vitro fertilization in their health benefits, yet many employees remain unaware of the coverage. This lack of awareness can lead workers to pay substantial sums out of pocket for treatments that might otherwise be covered.

The typical expense for a single IVF cycle in the US is $23,474. Since many patients require multiple cycles, total costs can accumulate quickly. One New Jersey mother reported spending $8,000 across two treatment rounds, even with employer-provided coverage. Without such benefits, expenses could have been far higher.

Carrot Fertility, a fertility benefits provider, works with over 1,000 employers to help employees access treatments that might otherwise be financially prohibitive. Despite these efforts, awareness of available benefits remains low, with some workers either paying unnecessarily or avoiding treatment altogether.

Fifteen states and Washington, D.C., have mandates requiring IVF coverage, but these laws do not extend to self-funded employer plans. Since more than half of US employers use self-funded insurance, many workers lack mandated protections. A federal proposal under consideration could address this by permitting standalone fertility benefits with a $120,000 lifetime cap, though the rule is still under review.

The expansion of fertility benefits among employers has been notable since 2019, when only 22% of large companies offered coverage. The increase reflects rising demand for family-building support, but communication gaps persist. Workers who assume coverage is unavailable may postpone or forgo treatment due to financial concerns.

The financial impact of IVF extends beyond individual families. Employers may face higher turnover as workers seek roles with more comprehensive benefits. Companies that provide fertility coverage could gain an advantage in retaining talent, particularly in sectors with a high proportion of female employees.

This article is for informational purposes only and does not constitute financial advice. Please consult a licensed financial adviser before making investment decisions.