Infertility-services-precertification-request-form Accessible PDF 2025

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The bad news first: Infertility treatment is not one of the essential health benefits mandated by the ACA. If your health insurance did not cover fertility treatments before, it does not have to now. Now for the good news. Infertility is considered a pre-existing condition.
For example, IVF may be an option if you or your partner has: Fallopian tube damage or blockage. Ovulation disorders. Endometriosis. Uterine fibroids. Previous surgery to prevent pregnancy. Issues with . Unexplained infertility. A genetic disorder.
Aetna now offers IUI as a covered medical benefit for eligible plans to evaluate infertility, regardless of sexual orientation or partner status. Our updated coverage policy began nationwide on September 1, 2024 for many plans. It will become effective on a rolling basis for most plans on renewal.
Major insurance providers such as Aetna, Blue Cross Blue Shield, Cigna, United Healthcare and Tricare offer a wide spectrum of fertility benefits, including IVF treatment; however, your employer has to purchase these features in order for you to be covered.
States with comprehensive IVF and infertility insurance coverage. Only 11 states require both IVF and fertility preservation coverage: Colorado, Connecticut, Delaware, Maryland, Maine, New Hampshire, New Jersey, New York, Rhode Island, Utah, and Washington D.C.
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Aetna agreed to a $2 million class action lawsuit settlement to resolve claims its health insurance policy discriminated against LGBTQ+ individuals by denying equal access to fertility treatments.

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