Aetna Announces Simplified Access to Fertility Services

Aetna has become the first major US insurer to expand access to fertility services by covering intrauterine insemination (IUI) as a medical benefit for all eligible plans, marking a significant move toward greater equity in family-building options for people of all backgrounds.

Image Credit: Prostock-studio - stock.adobe.com

Aetna has become the first major US insurer to expand access to fertility services by covering intrauterine insemination (IUI) as a medical benefit for all eligible plans, marking a significant move toward greater equity in family-building options for people of all backgrounds.¹ According to today's announcement, this policy is effective nationwide starting September 1, 2024.

“Expanding IUI coverage is yet another demonstration of Aetna’s commitment to women’s health across all communities, including LGBTQ+ and unpartnered people,” Cathy Moffitt, MD, senior vice president and Aetna chief medical officer at CVS Health, said in a statement.

The new IUI coverage is designed to serve as both a diagnostic tool and a means to enhance the chances of pregnancy. By removing barriers traditionally associated with fertility services, such as the need to purchase separate infertility coverage or provide proof of an infertility diagnosis, Aetna is aiming to set a new standard for inclusivity in family-building options.

Aetna’s approach to clinical policy reflects a commitment to continually assessing and updating its offerings to align with the latest medical guidelines and community needs, according to its statement. Historically, coverage for IUI services was often limited to individuals who had purchased additional infertility benefits and could demonstrate an infertility diagnosis. The updated policy eliminates these restrictions, making fertility services more accessible to a broader range of people.

"We know firsthand the barriers people face in accessing needed medical care to start or grow their families," Kate Steinle, chief clinical officer of FOLX, a nationwide health care provider for the LGBTQ+ community, said in the statement. "As an in-network provider focused on the LGBTQ+ community, we applaud Aetna’s efforts to reduce out-of-pocket costs so that more people can have the families they dream of – and deserve."

The policy change will automatically apply to most plans as they renew without requiring plan sponsors to take any action. Self-funded plan sponsors retain the option to modify their coverage, including for infertility services, if they choose.

In coverage from the 2023 American Society for Reproductive Medicine (ASRM) Scientific Congress & Expo, 2 studies were highlighted by The American Journal of Managed Care^® (AJMC^®) that examined the impact of the Dobbs v Jackson Women's Health Organization decision on embryo disposition and in vitro fertilization (IVF) treatment.² The first study found that while most patients' choices regarding cryopreserved reproductive cells and tissues remained consistent before and after the Dobbs decision, there was a notable decrease in the willingness to donate embryos post Dobbs, particularly among younger patients. The second study revealed that abortion procedures among IVF patients remained rare, and preimplantation genetic testing for aneuploidies did not significantly reduce the need for abortion or fetal reduction procedures post Dobbs.

Aetna's new policy change aligns with CVS Health's broader commitment to supporting and advancing women’s health and equity, according to the announcement.¹ The company described its long-standing history of providing access to safe, legal, and evidence-based reproductive health services, information, and FDA-approved products. By expanding IUI coverage, Aetna reinforces its dedication to meeting the unique needs of women and all individuals striving to build their families, the announcement stated.

"This industry-leading policy change is a stake in the ground, reflecting Aetna's support of all who need to use this benefit as a preliminary step in building their family," Moffit said.

References

1. Aetna first major insurer to expand and simplify access to fertility services. News release. Aetna. August 27, 2024.

2. Steinzor P. Navigating fertility care in a challenging care landscape post Dobbs decision. AJMC. October 20, 2024. Accessed August 26, 2024. https://www.ajmc.com/view/navigating-fertility-care-in-a-challenging-care-landscape-post-dobbs-decision