**Landmark Settlement Forces Aetna to Cover Fertility Treatments for Same-Sex Couples Nationwide**
In a groundbreaking legal victory, U.S. District Judge Haywood Gilliam Jr. approved a preliminary settlement in a class action lawsuit requiring Aetna to extend fertility treatment coverage—such as artificial insemination and IVF—to same-sex couples on the same terms as heterosexual couples. The ruling, issued last week in the Northern District of California, marks the first time a health insurer has been legally compelled to apply such a policy nationwide, impacting an estimated 2.8 million LGBTQ members, including 91,000 Californians.
The lawsuit, led by Mara Berton and June Higginbotham, a same-sex couple from California, challenged Aetna’s previous policy, which mandated that enrollees undergo 6–12 months of "unprotected heterosexual intercourse" without conceiving before qualifying for fertility benefits. For women without a male partner, the policy required 6–12 failed artificial insemination cycles—a requirement plaintiffs argued was discriminatory and financially prohibitive. Berton and Higginbotham, who paid $45,000 out of pocket for treatments while heterosexual colleagues received coverage, described the experience as "dehumanizing."
Under the settlement, Aetna will pay at least $2 million in damages to eligible California members, with claims due by June 29, 2026. The company stated it will comply with the ruling, emphasizing its commitment to "equal access to infertility coverage." However, experts noted the policy’s previous design appeared intended to dissuade claimants, as medical guidelines typically recommend no more than 4 artificial insemination cycles before considering IVF.
The case aligns with broader shifts in reproductive health policy. In 2023, the American Society for Reproductive Medicine updated its definition of infertility to include LGBTQ individuals and single people, pressuring insurers to expand coverage. California will further mandate fertility benefits for same-sex couples and single individuals under a new law effective January 2025, though Aetna’s settlement applies independently of state regulations.
Berton and Higginbotham, who now have twin daughters after a grueling IVF journey, pursued the lawsuit to prevent others from facing similar financial and emotional barriers. "I know people who wanted children but couldn’t because the treatments weren’t covered," Higginbotham said. The settlement, advocates argue, corrects a systemic inequity—one that forced LGBTQ couples to either delay parenthood, limit family size, or forgo it entirely due to cost.
While the ruling applies only to Aetna, reproductive rights groups hope it will set a precedent for other insurers. As Alison Tanner of the National Women’s Law Center noted, the case underscored "an issue of inequality"—one that treated same-sex couples differently under the guise of medical definitions. With fertility access now expanding, the decision signals a critical step toward equitable healthcare for LGBTQ families.
Source: https://www.cbsnews.com/news/ivf-treatments-aetna-same-sex-couples-settlement/
Aetna, a CVS Health Company cybersecurity rating report: https://www.rankiteo.com/company/aetna
"id": "AET1766440692",
"linkid": "aetna",
"type": "Breach",
"date": "12/2025",
"severity": "85",
"impact": "4",
"explanation": "Attack with significant impact with customers data leaks"{'affected_entities': [{'customers_affected': '2.8 million LGBTQ members, '
'including 91,000 Californians',
'industry': 'Healthcare/Insurance',
'location': 'United States',
'name': 'Aetna',
'size': 'Large (2.8 million LGBTQ members affected)',
'type': 'Health Insurance Company'}],
'customer_advisories': 'Eligible California-based members must submit a claim '
'for damages by June 29, 2026.',
'date_resolved': '2024-06',
'description': 'A class action lawsuit against Aetna alleged that the health '
"insurer's fertility treatment policy discriminated against "
'same-sex couples by requiring them to pay out-of-pocket for '
'treatments like artificial insemination or IVF, while '
'heterosexual couples had these costs covered. The lawsuit '
'resulted in a landmark settlement requiring Aetna to cover '
'fertility treatments for same-sex couples nationally.',
'impact': {'brand_reputation_impact': 'Negative publicity and reputational '
'damage due to discriminatory policy',
'customer_complaints': 'Class action lawsuit filed',
'financial_loss': '$45,000 (out-of-pocket costs for plaintiffs)',
'legal_liabilities': 'At least $2 million in damages to '
'California-based members'},
'investigation_status': 'Resolved (settlement approved)',
'lessons_learned': 'Health insurers must ensure equitable access to fertility '
'treatments for all individuals, regardless of sexual '
'orientation or marital status. Policies should align with '
'updated medical definitions of infertility.',
'motivation': 'Policy-based discrimination against LGBTQ+ individuals',
'post_incident_analysis': {'corrective_actions': 'Policy updated to cover '
'fertility treatments for '
'same-sex couples and single '
'individuals nationally. '
'Payment of damages to '
'affected members.',
'root_causes': 'Outdated policy requiring '
'heterosexual intercourse as a '
'prerequisite for fertility '
'treatment coverage, excluding '
'same-sex couples and single '
'individuals.'},
'recommendations': ['Review and update insurance policies to comply with '
'non-discrimination laws and medical definitions of '
'infertility.',
'Provide training for staff on equitable healthcare '
'access.',
'Monitor and audit policy implementation to prevent '
'discriminatory practices.',
'Engage with LGBTQ+ advocacy groups to ensure policies '
'meet community needs.'],
'references': [{'source': 'CalMatters'}, {'source': 'The Associated Press'}],
'regulatory_compliance': {'legal_actions': 'Class action lawsuit settlement',
'regulations_violated': 'Discrimination under '
'healthcare equity laws'},
'response': {'communication_strategy': 'Public statements and interviews with '
'plaintiffs and legal representatives',
'containment_measures': 'Policy change to cover fertility '
'treatments for same-sex couples',
'remediation_measures': 'Settlement requiring national policy '
'change and payment of damages',
'third_party_assistance': 'Legal representation (National '
"Women's Law Center, class action "
'lawyers)'},
'stakeholder_advisories': 'Aetna committed to equal access to infertility and '
'reproductive health coverage for all members.',
'title': 'Aetna Fertility Treatment Policy Discrimination Against Same-Sex '
'Couples',
'type': 'Discrimination in Healthcare Policy'}