Aetna settles suit, expands IVF coverage for LGBTQ couples
A federal judge in the Northern District of California has preliminarily approved a landmark national class action settlement requiring Aetna to cover fertility treatments like artificial insemination and IVF for same-sex couples on the same terms as heterosexual couples, ending policies that conditioned benefits on 'unprotected heterosexual intercourse' or numerous self-funded insemination attempts. The deal, believed to be the first to mandate such parity across a major insurer’s entire U.S. book of business, is expected to affect about 2.8 million LGBTQ Aetna members, including 91,000 Californians, and will provide at least $2 million in damages to eligible California enrollees who submit claims by June 29, 2026. Advocates say the case could pressure other insurers to revise similar infertility definitions that effectively denied coverage to LGBTQ people and single individuals.
📌 Key Facts
- U.S. District Judge Haywood Gilliam Jr. in the Northern District of California approved a preliminary settlement in a class action against Aetna over infertility coverage.
- The settlement requires Aetna to cover fertility treatments for same-sex couples on the same terms as heterosexual couples across all its plans nationally, affecting an estimated 2.8 million LGBTQ members (including 91,000 in California).
- Aetna will pay at least $2 million in damages to qualifying California-based members, who must file claims by June 29, 2026.
- The challenged policy had required 6–12 months of 'unprotected heterosexual sexual intercourse' to qualify as infertile, and forced women without a male partner to self-fund 6–12 unsuccessful artificial insemination cycles before coverage.
- Aetna says it is 'committed to equal access to infertility coverage and reproductive health coverage for all its members' and will provide benefits in accordance with members’ plans and applicable law.