Victory in the Aloha State

After more than a decade of advocacy by Hawaiian patient and provider advocacy organizations, Hawaii Governor Josh Green signed HB 1864 into law on July 9, 2026. This legislation requires state-regulated health insurers to cover standard fertility preservation services for individuals facing iatrogenic infertility, including cancer patients. The new law will cover procedures such as sperm banking and egg and embryo freezing and go into effect for health plans issued or renewed in Hawaii after December 31, 2026.

Due to Hawaii’s Prepaid Health Care Act of 1974 (PHCA) – the nation’s only state employer health coverage mandate that predates federal ERISA law – coverage will reach a broader percentage of Hawaii’s population compared to other state fertility preservation laws. We estimate that more than 700,000 Hawaiians, approximately half of the state’s population, will now have fertility preservation coverage should they ever need it.

The Alliance for Fertility Preservation would like to thank every patient advocate and organization that has been fighting tirelessly for this coverage since the first Hawaii bill was introduced in 2012. We are especially grateful for the Hawaii Society of Clinical Oncology, ASCO, Fertility Institute of Hawaii, Breast Cancer Hawaii, ACS CAN, Blood Cancer United, Susan G. Komen and all of the patient advocates who bravely shared their stories throughout this long journey.

Fertility Preservation Toolkit

Thank you for your interest in our toolkits. Please read our Terms of Use carefully as we include information that applies to all our toolkits.

All toolkits are publicly available for individual use without licensing or royalty fees. Such use of toolkits is “single use,” meaning solely for the User’s research, clinical, educational, or other application. User’s email may be added to an email distribution list to receive scientific and updated information about the toolkit(s).

We encourage use of our toolkits. User agrees not to adapt, alter, amend, abridge, modify, condense, make derivative works, or translate toolkits without prior written permission from the Provider. User agrees not to sell or incorporate toolkits into materials that could be sold without prior written consent from the Provider. To inquire about permissions, please email info@a4fp.org.


Coverage Map

Explore Where Fertility Preservation Coverage Exists Across the U.S.

The coverage map from the Alliance for Fertility Preservation is an interactive tool that highlights which U.S. states have laws requiring insurance coverage for fertility preservation services. It helps patients, providers, and advocates quickly understand where coverage is available, what services are included, and the conditions that may apply in each state. For step-by-step instructions on how to use the map, visit the link provided.

This section displays a map of the United States with each state that has fertility coverage legislation colored light yellow. The filters highlight the relevant states in bright green. The State List select field includes the highlighted states. Choosing a state from the select menu or clicking a state in the map will open that state's page in a new browser tab.

Insurance Plans Included
Services Included
Restrictions
Alphabetical List

Updated 6/24/2026
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