# Tex. Insurance Code § 1366.005: CONDITIONS APPLICABLE TO COVERAGE

> Texas · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.005

## Section

- **Citation:** Tex. Insurance Code § 1366.005
- **Heading:** CONDITIONS APPLICABLE TO COVERAGE
- **Jurisdiction:** Texas
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** TX Code / Code in / Chapter 1366 / Section 1366.005

## Text

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.

## Nearby sections

- [Tex. Insurance Code § 1366.001 § 1366.001. APPLICABILITY OF SUBCHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.001.md)
- [Tex. Insurance Code § 1366.002 § 1366.002. EXCEPTION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.002.md)
- [Tex. Insurance Code § 1366.003 § 1366.003. OFFER OF COVERAGE REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.003.md)
- [Tex. Insurance Code § 1366.004 § 1366.004. REJECTION OF OFFER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.004.md)
- [Tex. Insurance Code § 1366.005 § 1366.005. CONDITIONS APPLICABLE TO COVERAGE.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.005.md)
- [Tex. Insurance Code § 1366.006 § 1366.006. CERTAIN ISSUERS OF HEALTH BENEFIT PLANS NOT REQUIRED TO OFFER COVERAGE.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.006.md)
- [Tex. Insurance Code § 1366.007 § 1366.007. RULES.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.007.md)
- [Tex. Insurance Code § 1366.051 § 1366.051. SHORT TITLE.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.051.md)
- [Tex. Insurance Code § 1366.052 § 1366.052. DEFINITIONS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.052.md)
- [Tex. Insurance Code § 1366.053 § 1366.053. APPLICABILITY OF SUBCHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.053.md)
- [Tex. Insurance Code § 1366.054 § 1366.054. EXCEPTION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.054.md)
- [Tex. Insurance Code § 1366.055 § 1366.055. COVERAGE FOR INPATIENT CARE REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.055.md)
- [Tex. Insurance Code § 1366.056 § 1366.056. COVERAGE FOR POSTDELIVERY CARE REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.056.md)
- [Tex. Insurance Code § 1366.057 § 1366.057. PROHIBITED CONDUCT.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.057.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1366_S1366.005. Check the current official text before relying on it. Not legal advice.