Aetna will cover fertility treatments for LGBTQ people under court settlement

[May 04, 2024]  By Daniel Wiessner

(Reuters) - Aetna will pay $2 million and update its coverage policies to settle a lawsuit claiming the health insurer required LGBTQ beneficiaries to pay more out of pocket for fertility treatments than heterosexual people, according to a Friday court filing.

Lawyers for four people who in 2021 sued Aetna, a subsidiary of CVS Health Corp, asked a Manhattan federal court to approve the settlement, in which the company agreed to establish a new standard health benefit plan that covers artificial insemination regardless of sexual orientation.

Previously, Aetna required heterosexual couples simply to represent that they had tried for six or 12 months to get pregnant before covering fertility treatments.

But couples who could not conceive through intercourse first had to pay for treatments out of pocket for up to a year before they were covered, according to court filings.

Aetna denied wrongdoing in the settlement. In a statement, the company said it is "committed to providing quality care to all individuals regardless of their sexual orientation or gender identity and pleased to reach a resolution to this matter."

Under the settlement, Aetna will establish a $2 million fund to reimburse beneficiaries for out-of-pocket expenses they incurred under the old policy. The company also agreed to re-process eligible claims for coverage and modify its clinical policies to ensure equal access to fertility treatments.

A logo of Aetna is displayed on a monitor above the floor of the New York Stock Exchange shortly after the opening bell in New York, U.S., December 5, 2017. REUTERS/Lucas Jackson/File Photo

Emma Goidel, the lead plaintiff in the case, called the settlement "a big win for queer families" in a statement provided by her lawyers. Goidel claims she and her spouse were forced to spend nearly $45,000 on fertility treatments as a result of Aetna's policy.

A spokeswoman for the National Women's Law Center, which represents Goidel and the other plaintiffs, said that similar discriminatory coverage policies are "an industry-wide problem" and that the group hopes other insurers will follow Aetna's lead.

(Reporting by Daniel Wiessner in Albany, New York, Editing by Alexia Garamfalvi and Cynthia Osterman)

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