NY requires infertility coverage for all

ALBANY - New York’s health insurers will be required to provide coverage for fertility treatment regardless of marital status or sexual orientation, according to new state guidelines.

The state Department of Financial Services unveiled the new guidelines Wednesday, circulating a letter to insurers across the state making clear that they can't restrict fertility-related coverage if the patient otherwise qualifies.

“All women who wish to have a child are entitled to insurance coverage for fertility treatment regardless of their sexual orientation or marital status, just as all women have the right to reproductive choice and to decide if and when to start a family, and New York will always stand up to protect and preserve those rights,” Gov. Andrew Cuomo said in a statement.

► READ the state's letter here

The new guidelines are based on the state department's interpretation of "infertility."

State law requires insurers to cover treatment for infertility and use the American Society for Reproductive Medicine's definition of the term to determine when fertility-treatment coverage kicks in.

The society defines infertility as the “failure to achieve a successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or therapeutic donor insemination.”

But that definition is silent on marital status and sexual orientation, which the state's new guidelines attempt to clear up.

Under the new guidelines, insurance companies must provide coverage for all individuals who meet the society's definition of infertility, regardless of their sexual orientation or relationship status.

"If an individual meets the definition of infertility and otherwise qualifies for coverage, then an issuer must provide coverage regardless of sexual orientation, or marital status or gender identity," Financial Services Superintendent Maria Vullo said in a statement.

Leslie Moran, senior vice president of the New York Health Plan Association, said her organization has not been made aware of insurers denying coverage for infertility treatment.

"We are not aware that there have been any issues and have actually been told by the Department of Financial Services that the announcement was simply a reiteration of the governor’s commitment to ensuring women’s health and reproductive rights are a top priority,” Moran said.

The new guidelines were panned by New Yorkers for Constitutional Freedoms, a Spencerport-based evangelical group that is active at the state Capitol.

"(The) proposed regulation disregards the best interests of children by promoting the decision to bear and raise a child outside of an intact, married family that provides the child with both a mother and a father," Executive Director Jason McGuire said in a statement.

Includes reporting by Albany Bureau staff writer Jon Campbell.