Aetna expands coverage of fertility services amid political uncertainty

CVS Health’s health insurer Aetna is expanding coverage of fertility services to increase access to “family-building opportunities regardless of sexual orientation or partner status.” the company said Tuesday.

Aetna, the nation’s third largest health insurer 27 million health plan memberssaid it offers now intrauterine insemination (IUI), also known as artificial insemination, as a medical benefit for eligible plans.

Aetna said yes the “first major insurer to update these coverage policies nationally,” but there are some employer-sponsored plans and union plans that have taken similar steps in the past year, including SAG-AFTRA health plan, which added infertility treatment to coverage from 2025. Also various regional health insurers such as Blue Cross Blue Shield of Massachusetts, with clients across the U.S., have broken down barriers to infertility treatments, such as the health plan’s elimination of prior authorization for IUI in 2018.

Aetna’s move in a few months after the insurer settled a discrimination case Coverage of LGBTQ+ fertility also comes as fertility treatments, and the question of whether they should be covered or even legal has become a campaign issue less than three months before November’s presidential election. Reproductive rights have generally been a key issue for Democrats since the U.S. Supreme Court overturned the case Roe v. Wade two years ago.

In particular, Democratic vice presidential candidate Tim Walz, the governor of Minnesota, has made his family’s struggle with infertility an important part of the first weeks of the campaign to elect Kamala Harris, the Democratic presidential candidate, and himself in their race against Republicans Donald Trump and JD Vance.

Walz’s wife Gwen used intrauterine insemination (IUI) to become pregnant, according to media reports. Almost 2% of women aged 15 to 49 years have tried such a procedure to start a family, according to statistics from the Centers for Disease Control and Prevention.

“Expanding IUI coverage is another demonstration of Aetna’s commitment to women’s health in all communities, including LGBTQ+ and unpartnered people,” said Dr. Cathy Moffittsenior vice president and chief medical officer of Aetna. “This industry-leading policy change is a commitment on the ground and reflects Aetna’s support for all who need to use this benefit as a preliminary step in building their families.”

Aetna said the updated coverage policy “will begin September 1, 2024 for many plans nationwide and will be in effect on a rolling basis for most renewal plans,” the company said.

“Aetna plan sponsors are not required to make any changes as this is a policy change for eligible medical plans,” the company added. “As a standard process, self-funded plan sponsors may change their coverage of all benefits, including infertility. For more information, plan sponsors can contact their account managers.”

Aetna said the policy change applies to all Aetna plans, but that “the greatest benefit” will be seen by the health insurer’s commercial and individual health plans, which are purchased by employers and individuals and approximately 19 million of the health insurance plan’s health insurance members company. Medicaid coverage for poor Americans and Medicare plans for disabled and elderly Americans administered by Aetna are “always based on state and federal guidelines,” the company said, and therefore may not cover reimbursement for artificial insemination.

Still, proponents of Aetna’s policy said in the company’s press release that many women in the U.S. will benefit from the change.

“We know firsthand the barriers people face in accessing the necessary medical care to start or grow a family,” said Kate Steinle, Chief Clinical Officer of FOLX, a healthcare company provider for the LGBTQ+ community. “As an in-network provider focused on the LGBTQ+ community, we applaud Aetna’s efforts to lower out-of-pocket costs so more people can have the families they dream of – and deserve.”