PD20-12 DISPARITIES IN INFERTILITY COVERAGE IN THE UNITED STATES

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD20-12 DISPARITIES IN INFERTILITY COVERAGE IN THE UNITED STATES Arshia Sandozi, Dhaval Jivanji, Ariel Schulman, and Jacob Khurgin Arshia SandoziArshia Sandozi More articles by this author , Dhaval JivanjiDhaval Jivanji More articles by this author , Ariel SchulmanAriel Schulman More articles by this author , and Jacob KhurginJacob Khurgin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003286.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One in five heterosexual couples in the United States experience infertility. The costs of diagnosis and treatment may not be covered by health insurance. This study aimed to evaluate disparities in infertility coverage in the United States. METHODS: State essential health benefit benchmark (EHB) insurance plans submitted to Centers for Medicare and Medicaid were reviewed. We identified provisions that detailed coverage or exclusions for infertility. A literature search was performed to identify states with legislation related to coverage for infertility. State demographic information was derived from Census data. RESULTS: Data was available for 50 states and the District of Columbia. Twenty states had legislation related to infertility coverage. Two states required employers to offer at least one such plan, and one state only prohibited exclusions for treatment based on the diagnosis of infertility. In benchmark offerings, 19 states did not provide any minimum coverage for diagnosis or treatment of infertility. Twenty-five states offered some type of treatment, of which 9 covered treatments only for underlying causes of infertility (i.e. fibroids, ductal obstruction). Ten states codified coverage for prescription medications, 10 states for artificial insemination, and six states codified coverage for assisted reproductive technologies such as in vitro fertilization (IVF). Two states codified cryopreservation of ova, but only for patients actively undergoing treatment for infertility. Higher state median income was significantly associated with a state-requirement to offer infertility coverage as well as coverage of artificial insemination (p=0.039), but not with other coverage options, including IVF. States with higher populations enrolled in Medicaid or Children’s Health Insurance Program were more likely to have requirements for some level of infertility coverage (p=0.039). CONCLUSIONS: Nineteen states do not codify any minimum level of infertility coverage in EHB benchmark plans. Higher state median income is associated with codification of coverage of artificial insemination, but most types of coverage are not significantly associated with income. Overall, health insurance coverage for the diagnosis and treatment of infertility is highly variable and continues to be a barrier faced by patients desiring to conceive. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e589 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arshia Sandozi More articles by this author Dhaval Jivanji More articles by this author Ariel Schulman More articles by this author Jacob Khurgin More articles by this author Expand All Advertisement PDF downloadLoading ...