In a case decided by the Supreme Court of Maryland on April 27, 2026, the Court stated that the primary question was whether the petitioner, CareFirst BlueChoice, Inc., breached its contractual obligation to its insureds, respondents Matthew and Jamie Skipper, when it denied coverage for embryo thawing in connection with an in-vitro fertilization (“IVF”) procedure, and that the answer to that question turns on the proper interpretation of a policy exclusion for “[o]vum transplants and gamete intra-fallopian tube transfer, zygote intrafallopian transfer, or cryogenic or other preservation techniques used in these or similar procedures[.]” The Maryland Supreme Court held that the provision does not authorize the exclusion of any expenses associated with IVF procedures, including the expense of embryo thawing if that is a medically necessary component of IVF treatment.
In 1985, Maryland became the first state to mandate insurance coverage for expenses of IVF procedures, enacting the provision now codified at § 15-810 of the Insurance Article. The IVF coverage mandate is contained in § 15-810(c)(2) and (3), which provide: (2) An entity subject to this section that provides pregnancy-related benefits may not exclude benefits for all outpatient expenses arising from in vitro fertilization procedures performed on a policyholder or subscriber or on the dependent spouse of a policyholder or subscriber. (3) The benefits under this subsection shall be provided: (i) for insurers . . . , to the same extent as the benefits provided for other pregnancy-related procedures; . . .
The Maryland Supreme Court stated: “reading subsections (c)(2) and (3) together, the only reasonable interpretation of the plain language is that insurers must cover the expenses arising from IVF procedures to the same extent as expenses arising from other pregnancy-related procedures—which is to say, subject to the same terms, deductibles, co-pays, and limitations. In other words, insurers may not exclude benefits for “all” outpatient expenses arising out of IVF procedures, but they may exclude benefits for the same portion of those expenses they also do not pay in connection with other pregnancy-related procedures. Nothing in the statute suggests that insurers can cover only some medically necessary services arising from IVF procedures and exclude all expenses associated with others … except with respect to policies issued to small employers, § 15-810(c) requires insurers to cover expenses arising from IVF procedures to the same extent as expenses arising from other pregnancy-related procedures.”
An exclusion in an individual health insurance policy for “[o]vum transplants and gamete intra-fallopian tube transfer, zygote intra-fallopian transfer, or cryogenic or other preservation techniques used in these or similar procedures” does not authorize the exclusion of any medically necessary expenses arising from in-vitro fertilization procedures.
The Maryland Supreme Court also held that when a putative class action is initially filed in another court and the defendant tenders individual relief to the putative class representative before the case is dismissed for lack of
jurisdiction, substantially the same complaint promptly filed in state court will not be considered moot until the representative has had a reasonable opportunity to seek class certification.
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