Aetna to Cover Fertility Care for Same-Sex Couples Nationwide

Key TakeawaysAetna must now cover fertility care for same-sex couples nationwideAbout 2.8 million LGBTQ members could benefit from the settlementEligible people in California can claim compensation through June 29, 2026.MONDAY, Dec. 29, 2025 (HealthDay News) — For years, many same-sex couples have had to pay tens of thousands of dollars out of pocket to try to have children, even when their insurance covered fertility care for straight couples.That’s now set to change.In a landmark legal settlement approved last week, Aetna agreed to cover fertility treatments for same-sex couples the same way it does for heterosexual couples.The deal applies nationwide and is expected to benefit about 2.8 million LGBTQ members, including 91,000 people in California.The case was brought by couples who said Aetna’s rules unfairly blocked them from coverage. Under the old policy, members had to prove infertility by showing six to 12 months of unprotected heterosexual intercourse.As a result, many LGBTQ families were forced to pay on their own for treatments like artificial insemination or in vitro fertilization (IVF), which can cost $45,000 or more."We knew it wasn't right," Mara Berton, one of the plaintiffs in the case, said in an interview with CalMatters. "What we're fighting for is about family building and having kids ... It was really important to both of us, I think, that other couples not have to do this."Berton and her wife, June Higginbotham, live in California and wanted to start a family.Despite having insurance, they were denied fertility benefits and told they would need to go through 12 failed cycles of artificial insemination before qualifying for coverage, even though doctors usually recommend three to four cycles before moving to IVF.Experts said policies like that were designed to discourage people from using their benefits."We were looking at that as an issue of inequality — that folks who were in same-sex relationships were being treated differently," Alison Tanner of the National Women’s Law Center, which supported the lawsuit, told CBS News.Under the settlement, Aetna will also pay at least $2 million to eligible California members who were denied coverage in the past. Those who may qualify must submit a claim by June 29, 2026.In a statement, Aetna spokesperson Phillip Blando told CBS News that the company "is committed to equal access to infertility coverage and reproductive health coverage for all its members, and we will continue to strive toward improving access to services for our entire membership."Starting in January, a new California state law will require many insurance plans to cover fertility treatment for same-sex couples and single people.Sean Tipton of the American Society for Reproductive Medicine said the case reflects a growing recognition that fertility care should be based on medical need, not sexual orientation."The driving force was a realization that it takes two kinds of gametes to have kids," Tipton said. "Regardless of the cause of that absence, you have to have access in order to be treated for a fertility issue."Although Berton and Higginbotham had their twin daughters before the case was resolved, they say the settlement could change everything for other families."I know people that don't have children, that wanted children, because the stuff isn't covered. I know people that their timeline was delayed and maybe they have fewer kids than they wanted," Higginbotham told CBS News. "The settlement is such a huge step forward that is really righting a huge wrong."More informationWeill Cornell Connect has more on LGBTQ family planning.SOURCE: CBS News, Dec. 22, 2025.What This Means For YouFor those in a same-sex relationship with Aetna insurance, fertility treatments like IVF may be covered..Sign up for our weekly HealthDay newsletter