Aetna announced today that it is expanding its fertility coverage, regardless of the insured’s gender identity or partner status.
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The announcement comes after Aetna agreed to eliminate disparities between heterosexual and LGBTQ+ policyholders for intrauterine insemination (IUI) coverage as part of a settlement agreement in a lawsuit starting this year. With this new policy, Aetna is the first major national health insurer to offer such coverage nationwide.
“The expansion of IUI coverage is another demonstration of Aetna’s commitment to women’s health across all communities, including LGBTQ+ and non-partners,” Cathy Moffitt, MD, vice president and chief medical officer, CVS Health, said in a press release. “This industry-leading policy change is an important milestone that reflects Aetna’s support for anyone who needs to use this benefit as an initial step in building their family.”
“We know firsthand the barriers people face in accessing the medical care needed to start or expand their families,” Kate Steinle, clinical director of LGBTQ+ healthcare provider FOLX, said in a press release. “As an in-network LGBTQ+ health care provider, we applaud Aetna’s efforts to reduce out-of-pocket costs so more people can build the families they dream of and deserve.”
Under its previous policy, Aetna offered IUI coverage to heterosexual couples who claimed they were unable to conceive after having unprotected vaginal intercourse in the previous six or 12 months, depending on age. LGBTQ+ individuals or couples had to self-pay for 12 IUI cycles before they could receive coverage.
This insurance policy was the subject of a lawsuit filed by author Emma Goidel and others with the help of the National Women’s Law Center (NWLC). Lead plaintiff Goidel and her partner, author Illana Caplan, were forced to pay $45,000 of their savings before Aetna provided them with IUI coverage as part of their insurance policy through the Columbia University student health insurance policy.
Goidel sued when the couple learned that heterosexual policyholders were only required to report that they had been unable to conceive a child after a year of unprotected sex in order to receive immediate coverage.
“How is it acceptable to say that if you’re straight and your partner can’t get you pregnant, you go to the doctor and we’ll cover your treatment, but if you’re gay and your partner can’t get you pregnant, pity for you? asked Goidel in an interview with ABC News in 2023.
Without admitting liability, Aetna agreed to take steps to eliminate the disparity in fertility treatment coverage for heterosexual and LGBTQ+ policyholders, regardless of their partner status. The insurer also agreed to reprocess and reimburse eligible claims up to plan limits and establish a $2 million fund to compensate each class member.
“This agreement is a major victory for gay families. It means that many of us hoping to become parents or have more children can now begin to do so with the same access to fertility treatment as heterosexual couples,” Goidel said in a press release in May announcing the deal. “We hope other insurers will follow Aetna’s lead and review their policies to ensure everyone has equal access to fertility care.”
Godel and Caplan have a son, Avi.
