Aetna, a CVS Health Company, now offers intrauterine insemination (IUI) as a medical benefit for eligible plans. Members may access fertility services as a test of fertility and, in some cases, to increase the chances of pregnancy. Aetna’s landmark policy change increases access to family-building possibilities, regardless of sexual orientation or partner status.
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As the first major insurer to update this coverage policy nationally, Aetna aims to better represent the needs of the communities it serves by offering fertility services.
“Expanding IUI coverage is yet another demonstration of Aetna’s commitment to women’s health across all communities, including LGBTQ+ and unpartnered people,” said Cathy Moffitt, MD, Senior Vice President and Aetna Chief Medical Officer, CVS Health. “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.”
Aetna’s Approach to Clinical Policy
Aetna’s team of clinical experts update and assess clinical policies on an ongoing basis to ensure they reflect the latest understandings and guidelines. Across the industry, coverage of IUI services typically has applied to individuals who 1) purchased separate infertility benefit coverage and 2) could demonstrate an infertility diagnosis.
Aetna’s updated coverage policy begins nationwide on September 1, 2024 for many plans and will be effective on a rolling basis for most plans on renewal. Aetna plan sponsors do not need to make changes, as this is a policy change for eligible medical plans. As a standard process, self-funded plan sponsors may modify their coverage of any benefit, including infertility. For more information, plan sponsors should reach out to their account managers.
Aetna remains committed to facilitating transparency and open communication with members, providers and customers by continuing to make its clinical policies public.
Commitment to Women and Equity
Many women in different communities will benefit from this change. “We know firsthand the barriers people face in accessing needed medical care to start or grow their families,” said Chief Clinical Officer, Kate Steinle, of a nationwide health care provider for the LGBTQ+ community, FOLX. “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.”
CVS Health has a long history of supporting and advancing women’s health and equity, and it remains focused on meeting their unique needs. This includes providing access to safe, legal and evidence-based reproductive health services, information and FDA-approved products.
