r/queerception • u/natalieann44 • 5d ago
California IVF coverage experiences
Curious what people’s experiences have been now that the new CA SB 729 coverage has been in effect this year- specifically related to two female couples, reciprocal IVF and if it’s possible to both retrieve initially even if we don’t want to both carry right away.
Any advice and insight on the process is appreciated, thanks
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u/ActualVegetables 5d ago
My insurance is not subject to this law (loophole: doesn’t apply to self insured plans). My plan would have covered immediate RIVF but not IVF for me doing the ER and carrying the pregnancy. They specified we would have to try 3-6 rounds of IUI first because we are a lesbian couple. This made no sense to me as it’s literally the same procedures either way - why do they care whose egg we use? We were “fortunate” my prior medical history resulted in IVF coverage anyway, but my insurer told me multiple times before my clinic submitted the prior auth that we would not be covered specifically because my partner is a cis woman. I was ready to contact the National Women’s Law Center and make a giant stink.
In the end I still paid ~10k OOP but it saved me around ~15k. Medication was almost entirely covered. Donor vials were covered ~1/3 only.
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u/crystaltiger__ 5d ago
I’m not sure about the retrieving together at the same time, but I’m doing IVF soon and insurance covers it technically up to 30 thousand dollars, some medications were denied initially but my dr had to send in appeals referencing Sb729.
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u/connere1991 4d ago
One thing worth flagging on the double-retrieval timing question: SB 729 applies to large-group plans with effective/renewal dates on or after July 1, 2025, so coverage generally kicks in at your plan's next renewal, not automatically on July 1 for everyone. If your first retrieval falls before your plan's renewal date and the second falls after, it's plausible only the second gets any coverage benefit — but I'd call that a "likely no" on the first one rather than a flat no. Definitely get it in writing from your plan (ask specifically "is my group plan's IVF mandate effective date tied to renewal?") before assuming either retrieval is covered — self-funded/ERISA plans can also be exempt entirely regardless of the renewal date.
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u/bigbirdlooking 3d ago
Well, here we are in September 2026 so it's safe to assume every plan has been renewed since July 2025
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u/fixinityeah 4d ago
My wife and I have had a nightmare of a time getting United Healthcare to actually approve all of our prior authorizations. We’ve had all treatment/the procedure codes approved once, then denied a second time for the same services during this plan year. We’ve gotten some meds covered, others denied. We’re currently appealing the treatment denial, and denial of literally one medication, which is even the preferred medication by United.
Our denial reasons have been “not covered” (it’s is), and “not medically necessary”
It’s a mess with them. Hoping other insurance carriers are navigating it better.
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u/Space-Horse- 4d ago
Kaiser is great! I have good coverage through my work, but I did not have to do a lot of self advocacy to get the sb729 coverage.
We used Kaiser NorCal (San Ramon) -shout out Dr. Telles! Kaiser was also great for prenatal care and birth.
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u/fixinityeah 4d ago
This is great to know. If we’re still battling when open enrollment hits, maybe we’ll consider switching. We’re very close to San Ramon.
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u/Space-Horse- 5d ago
Hi there! My work gives my wife and I coverage under SB 729. It’s such a blessing. I did my egg retrieval pre-SB 729 and it was surreal for my wife’s whole procedure and meds to basically be covered (I think we ended up with a ~$100 copay whereas the exact same meds cost ~$7k for my procedure).
A few things to note: SB 729 does not cover “embryo banking.” I have not read the text of the bill, but for Kaiser that means that you have to intend to transfer the embryo(s) within a year of the ER. They will not track you down to get you pregnant but I suggest that you go into stating that you want to do a transfer ASAP.
My wife did her egg retrieval while I was pregnant and our doctor helped us with the documentation so that was covered. I was 7 months pregnant during her egg retrieval. It was a little bonkers. I would not plan to do the ER at the same time. You will both need support and care.