SB 729 Explained: More Inclusive and Queer-Friendly Fertility Coverage Is Coming to California
Starting January 1, 2026, California will implement Senate Bill 729 (SB 729), significantly expanding fertility coverage for residents with large-group health insurance plans. The CalPERS Health Program, which provides healthcare coverage for active state employees and retirees in California, will expand fertility treatment coverage by July 1, 2027.
Why SB 729 Matters for LGBTQ+ Families
SB 729 introduces an inclusive definition of infertility. Unlike older insurance policies which often required a heterosexual couple to try conceiving for 12 months without success, this law recognizes infertility as the inability to reproduce without medical intervention, no matter your marital status, sexual orientation, or gender identity.
Key points:
Same-sex couples, single parents, and transgender individuals are explicitly included.
Discrimination based on sexual orientation, gender identity, or marital status is prohibited.
Small group plans (fewer than 100 employees) must offer infertility coverage as an option.
For queer families who’ve historically faced insurance barriers, this is a major step forward. Implementation was originally set for July 1, 2025, but was delayed to January 1, 2026 to ensure a smooth rollout. It’s worth noting that while this is when SB 729 takes effect, the exact timing of when your insurance begins covering fertility treatments will depend on your employer’s healthcare plan renewal schedule.
What’s Covered?
Thanks to SB 729, some fertility treatments that were previously out-of-pocket, like IVF cycles and medications, may soon be covered by insurance for more California families. Under this law, insurers must cover infertility diagnosis and treatments, including in vitro fertilization (IVF), with:
Up to three completed egg retrievals
Unlimited embryo transfers following clinical guidelines
Note: Fertility treatment coverage still varies widely in other states, and many LGBTQIA+ families rely on supplemental fertility benefit providers or pay out-of-pocket.
FSAs, HSAs, and Fertility Expenses
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can cover fertility-related expenses such as:
IVF medications
Sperm or egg storage
Insemination supplies
However, to provide coverage of these treatments, oftentimes these special health savings accounts require a documented medical diagnosis of infertility or a letter of medical necessity. This has historically been a hurdle for those who may not meet the traditional definition of infertility. SB 729, however, broadens the definition of infertility so that LGBTQIA+ individuals and single parents can more easily qualify for a medically recognized diagnosis.
Final Thoughts
SB 729 reflects a broader shift toward recognizing fertility care as essential healthcare, not a luxury. By explicitly addressing the needs of LGBTQIA+ and single-parent families, California is setting a progressive example for the rest of the country.
Thinking about starting or growing your family? Let’s talk about how these changes could impact your financial journey and hopefully make your path to becoming a parent a bit less expensive.
Disclaimer: This information is for educational purposes only and doesn't constitute financial advice. Consider consulting with a fee-only financial planner for personalized guidance.
