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Lawsuit Involving Aetna Fertility Coverage For LGBTQ+ Customers Is Settled

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(CTN News) – A health insurer has agreed to settle a lawsuit accusing it of discriminating against LGBTQ+ patients seeking fertility treatment.

As part of the deal announced Friday, the insurer will cover artificial insemination as a standard for all customers nationwide, and will work to ensure patients have equal access to more expensive in-vitro fertilization procedures, according to the National Women’s Law Center, which represented plaintiffs.

Nearly 19 million people receive commercial health insurance through Aetna Fertility ,

A CVS Health Corp. company. As a result of some of the insurer’s New York policies, $2 million will be set aside to reimburse people who have been denied reimbursement for artificial insemination, a procedure in which sperm are placed directly into a woman’s uterus.

In a statement, CVS Health said it was pleased with the resolution of the case and committed to providing quality care to all individuals regardless of their sexual orientation or gender identity.

In order for the deal to be approved, a federal judge must still give his approval.

It stems from a 2021 lawsuit filed in a New York federal court. Aetna rejected several requests for coverage from Emma Goidel and her husband, Ilana Caplan, for fertility treatments their second child. As students at Aetna Fertility Columbia University, the couple had health insurance.

Before the insurer would cover fertility treatments, people who could not conceive naturally had to pay thousands of dollars for artificial insemination cycles.

In the lawsuit, heterosexual couples were not charged the same amount. A few months of sex without protection was sufficient to qualify for coverage.

“You never know how long it will take and how much it will cost when you start trying to conceive at the doctor,” Goidel stated. As a matter of fact, it was unexpected.”

The couple’s second child was born after six cycles of artificial Aetna insemination – each costing a few thousand dollars – and a failed attempt at in vitro fertilization, in which sperm and eggs are mixed in a laboratory dish.

As a result of the settlement, Goidel is “thrilled” about Aetna’s policy change, and expects to be reimbursed.

The number of employers offering fertility treatment coverage has risen in recent years, especially among those looking to attract and retain employees.

A study by Mercer, a benefits consulting firm, found that 45% of companies with 500 or more employees covered in vitro fertilization last year. In comparison with 2021, this represents a 36% increase. In many cases, a lifetime maximum benefit is set or a limit is placed on the number of treatment cycles.

The American Society for Aetna Reproductive Medicine reports that many insurers also cover artificial insemination as a standard benefit.

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Alishba Waris is an independent journalist working for CTN News. She brings a wealth of experience and a keen eye for detail to her reporting. With a knack for uncovering the truth, Waris isn't afraid to ask tough questions and hold those in power accountable. Her writing is clear, concise, and cuts through the noise, delivering the facts readers need to stay informed. Waris's dedication to ethical journalism shines through in her hard-hitting yet fair coverage of important issues.

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