New Request Made to Boost Fertility Coverage Benefits in FEHB / PSHB

The letter asks OPM to require all plans to match the level of benefits offered by the DC Health Link, the health insurance exchange through which members of Congress obtain health insurance coverage. Image: 1000Photography/Shutterstock.com

Two congressional Democrats active in civil service issues have asked OPM to require FEHB/PSHB carriers to expand fertility coverage benefits, saying that “would bring fairness to the Federal workforce; strengthen recruitment and retention; and provide clarity, consistency, and improved IVF access across FEHB.”

A letter from Rep. James Walkinshaw, D-Va., and Sen. Tammy Duckworth, D-Ill., is the latest in a series of such requests and comes as the annual process of negotiating coverage terms and premiums with carriers is about to begin.

“Over the past several plan years, OPM’s leadership has helped secure baseline fertility protections across the program and spurred expanded IVF options, including requirements for coverage of artificial insemination and associated drugs and a requirement that all FEHB carriers cover IVF-related drugs for three cycles annually, with a growing number of plans covering IVF services themselves,” they said, calling such benefit enhancements “hard-won by devoted members of Congress and the dedicated federal employees in the FEHB office.”

For the 2026 plan year, HMO plans in states with IVF mandates were required to propose benefits that met those mandates. OPM also required, at a minimum, retrieval and cryopreservation of sperm and eggs, along with storage costs for at least one year, for individuals with iatrogenic infertility from non-elective procedures.

The letter asks OPM to require all plans to match the level of benefits offered by the DC Health Link, the health insurance exchange through which members of Congress obtain health insurance coverage. Many of the carriers that participate in that exchange also participate in the FEHB/PSHB, they wrote, and “it would be relatively simple for FEHB carriers to extend their existing DC Health Link plan designs to their FEHB plans.”

OPM has not publicly posted the annual “call letter” that formally kicks off the negotiating process, although it recently told carriers to more closely monitor billing for telehealth services—which increased during the pandemic and remain at higher levels than before—out of concern over potentially fraudulent billing.

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