Requiring Insurers to Cover Infertility Services

Department of Financial Services Circular Letter Builds on New York’s Nation-Leading Actions to Protect the Rights of All New Yorkers

New Action Part of 2021 Women’s Agenda

Governor Andrew M. Cuomo today announced the Department of Financial Services has issued guidance requiring New York health insurers to cover fertility services for all New Yorkers regardless of sexual orientation or gender identity. Under this new guidance, health insurers are now required to provide immediate coverage of services for the diagnosis and treatment of infertility for consumers covered under individual, small group, and large group health insurance policies and contracts who are unable to conceive due to their sexual orientation or gender identity. This guidance – first proposed in the Governor’s 2021 State of the State as a key component of the Women’s Agenda – builds on New York’s nation-leading actions to protect the rights of all New Yorkers. 

“Every New Yorker regardless of sexual orientation or gender identify should have the same opportunity to conceive a family, and we must do everything we can to ensure cost is not a barrier,” Governor Cuomo said. “In New York State, we believe love is what makes a family and that the law must work for everyone. This action will go a long way toward achieving that goal.” 

This circular letter builds on a number of nation-leading actions to protect the rights of both women and LGBTQ New Yorkers, including the required coverage of in-vitro fertilization services by insurers providing large group coverage, the enactment of Marriage Equality Act, GENDA, legalizing gestational surrogacy, banning conversion therapy and the gay and trans panic defense and, most recently, repealing the ‘Walking While Trans’ ban. 

Secretary to the Governor and Chair of the Council on Women and Girls Melissa DeRosa said, “Starting a family can be a personal and emotional challenge, especially for LGBTQ couples. With this action we are taking an important step forward toward family equity as we continue working to ensure all New Yorkers have full access to reproductive health services.”

Superintendent of New York State Department of Financial Services Linda A. Lacewell said, “Today we are taking another important step to support family equality in New York. Requiring New York insurers to provide day-one coverage of infertility services to individuals who are unable to conceive due to their sexual orientation or gender identity is necessary to prevent discrimination against members of the LGBTQ community.”

Current Insurance Law requires insurers to cover infertility services. However, before qualifying for coverage, individuals who are unable to conceive due to their sexual orientation or gender identity must nonetheless sometimes pay 6 or 12 months of out-of-pocket expenses for infertility treatments such as testing and intrauterine insemination to demonstrate infertility.

The circular letter issued today directs insurers to provide immediate coverage for basic infertility treatments (e.g., intrauterine insemination procedures) that are provided to individuals covered under an insurance policy or contract who are unable to conceive due to their sexual orientation or gender identity in order to prevent discrimination.

A copy of the Circular Letter can be found here