Queer Couple Sues Aetna Over Denied Fertility Treatments

In a class action lawsuit filed on September 13 in Manhattan federal court, Emma Goidel and her spouse claim they spent $45,000 on fertility treatments because Aetna's policy calls for LGBTQ couples to pay out of pocket for fertility services before receiving coverage. In the 23-page complaint, the couple accuses Aetna of sex discrimination and anti-LGBTQ bias for denying to cover fertility services for LGBTQ individuals.

The lawsuit claims that Aetna violated a state policy established this year directing the Department of Financial Services to eliminate any extra costs facing same-sex couples seeking fertility treatments, such as in vitro fertilization, egg freezing, sperm donations, and more. Lawyers at Emery Celli Brinckerhoff Abady Ward and Maazel LLP and the National Women's Law Center are handling the case.

"Aetna's discriminatory policy is an illegal tax on LGBTQ individuals that denies the equal rights of LGBTQ individuals to have children," Goidel alleged in the lawsuit. "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, who is covered through her partner's Aetna health insurance plan for Columbia University students, said last year they paid for multiple failed fertility treatments, which the insurance company did not cover. The complaint states that the couple's attempts at intrauterine insemination and in vitro fertilization treatments were initially unsuccessful, and they became pregnant in through their fifth insemination.

According to the complaint, Aetna's policy states that if a same-sex couple cannot get pregnant because of their sexual orientation or gender identity, they must pay out of pocket for 12 cycles of fertility treatments. However, heterosexual couples facing the same reproductive challenges can obtain immediate coverage for fertility treatments if they are unsuccessful in getting pregnant for a year.

Aetna is vowing to address the issue with the couple and undergo a broader review to make sure others are not impacted moving forward.

"Upon further review, certain costs were improperly denied after a change in New York State coverage requirements only weeks earlier," a spokesperson said in a written statement. "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."