Texas § 1366.005 CONDITIONS APPLICABLE TO COVERAGE.

Texas Statutes

§ 1366.005 — CONDITIONS APPLICABLE TO COVERAGE.

Texas § 1366.005

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Bluebook

Tex. Insurance Code Code Ann. § 1366.005 (2026).

Text

Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The coverage offered under Section 1366.003 is required only if:

(1)the patient for the in vitro fertilization procedure is an individual covered under the group health benefit plan;

(2)the fertilization or attempted fertilization of the patient's oocytes is made only with the sperm of the patient's spouse;

(3)the patient and the patient's spouse have a history of infertility of at least five continuous years' duration or the infertility is associated with:

(A)endometriosis;

(B)exposure in utero to diethylstilbestrol (DES);

(C)blockage of or surgical removal of one or both fallopian tubes; or

(D)oligospermia;

(4)the patient has been unable to attain a successful pregnancy through any less costly applicable infertility treatments for

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Sec. 1366.005. CONDITIONS APPLICABLE TO COVERAGE. The coverage offered under Section 1366.003 is required only if:
(1) the patient for the in vitro fertilization procedure is an individual covered under the group health benefit plan;
(2) the fertilization or attempted fertilization of the patient's oocytes is made only with the sperm of the patient's spouse;
(3) the patient and the patient's spouse have a history of infertility of at least five continuous years' duration or the infertility is associated with:
(A) endometriosis;
(B) exposure in utero to diethylstilbestrol (DES);
(C) blockage of or surgical removal of one or both fallopian tubes; or
(D) oligospermia;
(4) the patient has been unable to attain a successful pregnancy through any less costly applicable infertility treatments for which coverage is available under the group health benefit plan; and
(5) the in vitro fertilization procedures are performed at a medical facility that conforms to the minimal standards for programs of in vitro fertilization adopted by the American Society for Reproductive Medicine.