United States – Aetna has agreed to settle the lawsuit, which brought in charges against Aetna for discriminating against LGBTQ+ individuals seeking fertility treatment.
Equal Access Victory
According to the National Women’s Law Center, which defended the plaintiffs in the case, the insurer will make artificial insemination coverage a standard practice for all close nationally and work to ensure equal access to more expensive in-vitro fertilization procedures from the agreement announced on Friday, as reported by HealthDay.
Aetna, a CVS Health Corp-owned health insurance division, provides coverage for approximately 19 million people with commercial coverage, including a health insurance plan sponsored by employers.
Governance Board and Compensation Fund
The insurer will establish a governance board and reserve a USD 2 million fund to repay the people who were denied reimbursement for artificial insemination (which involves the placement of sperm directly inside a woman’s uterus) through the commercial insurance plans it offered in New York.
A CVS Health spokesman stated that the company was glad to wrap up the case and “determined to render superior health services to each and every person irrespective of their sexual orientation or gender identification.”
Till today, a federal court judge must approve the same.
This lawsuit was lodged in the federal court in New York in 2021, which formed the basis for the settlement. With Aetna’s declining coverage of multiple medications, Emma Goidel, who is married to Ilana Caplan, went beyond USD 50,000 on fertility treatments to have a second child.
The couple enrolled for insurance through a Columbia University student health plan.
The artificial insemination cycle cost will have to be paid by people who do not have kids naturally, and then the insurance will start covering fertility treatment only at that stage.
The lawsuit stated the straights don’t face the same costs. What they had to do was just declare that pregnancy did not occur after months of having unprotected sex and then get the coverage.
“You never know when you start trying to conceive and you have to do it at the doctor, how long it’s going to take and how much it’s going to cost,” Goidel said. “It was unexpected, to say the least.”
For the second time, Goidel needed six cycles of artificial insemination, in which each cycle cost a few thousand dollars, and there was one unsuccessful, USD 20,000 attempt at in vitro fertilization in which an embryo is developed by mixing eggs and sperm in a lab dish.
Goidel noted that she’s “happy” with Aetna’s change in policy under the settlement and expects to be reimbursed.
Infertility treatment insurance has grown more widespread nowadays, mostly among companies that are looking to hire and keep employees.
Growing Support for Infertility Treatment
According to Mercer, a human resources consultant, 95% of employers with 500 or more employees are now providing support or IVF coverage. That is an increase to 59% from 36% in 2021. A lot of healthcare plan sponsors limit the number of treatments one could have or set a specific lifetime maximum, as reported by HealthDay.
Besides that, he stated that numerous insurers cover artificial insemination as one of the standard benefits for all their policyholders.