Infertility coverage might be expanding to same-sex couples. New Jersey residents Erin and Marianne Krupa, Sol Mejias, and Sarah Mills have filed a lawsuit against Richard J. Badolato who is the commissioner of the Department of Banking and Insurance. The main reason for the lawsuit was that the mandate discriminates against same-sex couples.
These women that are in monogamous same-sex relationships consider that the mandate, by its discriminatory language, excludes lesbian couples.
According to the lawsuit’s results, despite being diagnosed with infertility, Erin could not prove that she had unprotected sexual intercourse with a man because of her committed same-sex relationship. It was the reason why the two ladies were not protected by the mandate and had to spend $25,000 on fertility treatments.
The same situation revealed when Mejias was denied coverage when at-home insemination attempts failed repeatedly, but these were not proof enough that they were trying to conceive.
The four women that filed the lawsuit were ultimately given coverage for specific procedures only after each of them was first evaluated by doctors, but they were still not offered complete infertility treatment. They also needed to sustain notable personal costs that their insurance company, Horizon Blue Cross Blue Shield (HBCBS), failed to reimburse.
Serena Chen, the director of reproductive medicine at Saint Barnabas Medical Center admitted that the insurance companies would use the New Jersey mandate’s wording as an excuse to deny insurance claims. It is why many same-sex couples have to discover a way to get the fertility treatments they need.
The couples that have the financial stability end up paying out of pocket for the treatments. However, most of them seek companies that offer a better insurance coverage.
In February 2016, New Jersey State Senate majority leader Loretta Weinberg recommended an amendment that would extend the insurance coverage for women having same-sex relationships. To do so, the women must first be evaluated by specialists licensed to practice medicine and surgery in New Jersey to determine the couple‘s infertility.
After the lawsuit, a variety of medically-sound ways to determine a woman’s infertility were recommended. These could be done without the need of heterosexual intercourse.
Suing the state instead of the insurance companies seems to be the best way to fight the mandate change that all the insurance companies will later have to follow.
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