Governor Updates Infertility Coverage Guidelines; Same Sex Couples And Single Women Benefit

Apr 21, 2017

Governor Andrew Cuomo has updated coverage guidelines for infertility treatment that could be especially significant for single women and same sex couples. A letter sent to insurance companies clarifies that all patients – regardless of sexual orientation, marital status or gender identity - are entitled to infertility treatment coverage.

“We haven’t seen insurance companies outright deny someone coverage because of their sexual orientation or their marital status. I haven’t seen that,” said Dr. Kathleen Hoeger, director of Strong Fertility Center. “But there’s different standards. And so they end up, in all intents and purposes, being shut out of coverage until they meet those criteria.”

New York is one of several states that already mandate insurance coverage for infertility treatments. The current standard requires that a patient tries to get pregnant for 12 months before potentially being eligible for insurance coverage. This regulation update could be significant because it acknowledges that for single women and same-sex couples “earlier treatment could be justified.”

Hoeger added that although New York has a regulation in place for infertility coverage, not all insurance companies are required to follow it.

“Today in New York we have this law that they have to cover fertility services but it excludes certain privately funded insurers and self-funded companies. So it’s not as broad as it might otherwise seem. We do have many heterosexual couples who don’t have fertility coverage in New York, because of those restrictions,” she said. 

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