Aetna hit with lawsuit, accused of LGBTQ discrimination in fertility treatments

Health insurance company Aetna has been sued for allegedly discriminating against LGBT people in a case in which a claimant says they were required to pay more out of pocket for fertility treatment coverage than straight couples.

Plaintiff Emma Goidel filed a class-action lawsuit in Manhattan in which she claimed that she and her spouse had to pay $45,000 for fertility treatments due to the fact that Aetna requires same-sex couples to pay for treatment out of pocket before they are eligible for coverage.

While straight couples who are trying to conceive through intercourse can receive coverage from Aetna simply by saying that they have tried for six or 12 months, couples of other sexual orientations or genders who cannot conceive through intercourse must initially pay out of pocket for six or 12 months of intrauterine insemination (IUI), according to the complaint.

Goidel claims in the complaint that she and her partner paid for four unsuccessful IUI cycles as well as one unsuccessful in vitro fertilization (IVF) cycle, before becoming pregnant through a fifth IUI cycle. Aetna refused to cover all five of the cycles, according to the complaint. 

“We learned of this suit only yesterday and are still actively investigating the facts,” Aetna said in a statement shared with The Hill. “Aetna is committed to equal access to infertility coverage and reproductive health coverage for all its members, and we will continue to strive toward improving access to services for our entire membership.”

An Aetna spokesperson said in a follow-up statement shared with The Hill that some of Goidel and her partner’s costs were “improperly denied.”

“Upon further review, certain costs were improperly denied after a change in New York State coverage requirements only weeks earlier,” the statement said. “Those costs will be promptly covered, and we’ll review similar cases to ensure coverage decisions were made according to the new requirements. We have a history of support for the LGBTQ community, which we’ll continue to build on.”

The lawsuit called the costs prohibitive.

“Aetna’s discriminatory policy is an illegal tax on LGBTQ individuals that denies the equal rights of LGBTQ individuals to have children,” Goidel alleged. “At best, these individuals incur great costs due to Aetna’s policy language. At worst, these exorbitant costs are prohibitive and entirely prevent people who are unable to shoulder them — disproportionately LGBTQ people of color — from becoming pregnant and starting a family.”

Goidel’s lawsuit referenced a February report from New York’s Department of Financial Services stating that policies like Aetna’s infringed upon state law.

Updated Wednesday at 4:12 p.m.