Aetna's Landmark Settlement Revolutionizes Fertility Coverage! Find Out How

Aetna's Landmark Settlement Revolutionizes Fertility Coverage! Find Out How

Aetna has reached a settlement in a lawsuit accusing the health insurer of discriminating against LGBTQ+ customers seeking fertility treatment. Under the agreement announced on Friday, Aetna will standardize coverage of artificial insemination for all customers nationwide and ensure equal access to more expensive in-vitro fertilization procedures. The National Women’s Law Center, representing the plaintiffs, confirmed the agreement. Aetna, the health insurance arm of CVS Health Corp., covers nearly 19 million people with commercial coverage, including employer-sponsored health insurance.

As part of the settlement, Aetna will establish a $2 million fund to reimburse individuals who were denied coverage for artificial insemination under some of its commercial insurance plans in New York. A CVS Health spokesman expressed the company's commitment to providing quality care regardless of sexual orientation or gender identity.

The settlement, subject to approval by a federal judge, follows a 2021 lawsuit filed in a federal court in New York. Emma Goidel and her spouse, Ilana Caplan, incurred over $50,000 in fertility treatment costs after Aetna rejected their requests for coverage. Their Columbia University student health plan required them to pay for artificial insemination cycles before receiving coverage for fertility treatments, unlike heterosexual couples who only needed to attest to unsuccessful attempts at natural conception.

Goidel became pregnant after six costly cycles of artificial insemination and one unsuccessful $20,000 attempt at in vitro fertilization. She expressed happiness over Aetna changing its policy and expects reimbursement.

In recent years, fertility treatment coverage has become more common among employers, with 45% of those with 500 or more workers offering IVF coverage in 2023, up from 36% in 2021, according to benefits consultant Mercer. Many insurers also cover artificial insemination as a standard benefit for all policyholders, according to Sean Tipton of the American Society for Reproductive Medicine.

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