December 3, 2019
GOVERNOR CUOMO REMINDS NEW YORKERS OF THEIR RIGHT TO EXPANDED IVF COVERAGE TAKING EFFECT IN JANUARY
Improving Access to IVF and Fertility Preservation Services Is a Cornerstone of Governor's Women's Justice Agenda
Department of Financial Services Issues FAQs Providing Information to New Yorkers and Instructing Insurers on Their Responsibilities Related to IVF and Fertility Preservation Services
Large Group Health Insurance Policies Must Cover IVF Prescription Drugs
Governor Andrew M. Cuomo today reminded New Yorkers of their rights under New York's expansion of in vitro fertilization - or IVF - coverage and fertility preservation services that will take effect on January 1, 2020. To help New York residents and insurers better understand the new law, the State Department of Financial Services issued a Frequently Asked Questions document to clarify the changes to IVF coverage and fertility preservation services, including mandatory coverage of prescription drugs by large group health insurers provided in connection with IVF services. The FAQs provide New Yorkers with information to help understand eligibility and coverage details and instruct insurers on compliance with legal requirements under the expanded reproductive coverage.
"New York is leading the fight to expand reproductive health access for all New Yorkers, no matter who they love or how much money they have," Governor Cuomo said. "This new law will help break down economic barriers that have prevented too many individuals and families from having a child of their own and give New Yorkers more control over their reproductive health and family planning decisions."
Melissa DeRosa, Secretary to the Governor and Chair of the Governor's Council on Women and Girls, said, "Every person should have the choice to start a family, and New York is taking the lead by expanding coverage to IVF and egg-freezing services. There is more work to do but with this new law, more New Yorkers than ever before will have the right to choose and receive the safe, affordable reproductive healthcare that they need - regardless of socio-economic status, marital status, sexual orientation or gender identity."
Linda A. Lacewell, Superintendent of Financial Services and a Member of the Governor's Council on Women and Girls, said, "As our guidance today makes clear, DFS and New York State is on the side of families and we are reminding New Yorkers of their rights and insurers of their obligations under the state's new IVF and Fertility Preservation law. As Washington rolls back critical reproductive health rights, New York will continue to fight to ensure New Yorkers receive the care they deserve."
New mandated benefits under the law include:
- Mandatory Coverage of prescription drugs in connection with IVF services by large group health insurance policies.
- Access to fertility preservation services for insured New Yorkers who are about to undergo gender-affirming care.
- Health insurance policies that provide comprehensive care must cover fertility preservation services, which include egg and/or embryo storage if medically necessary until the three required IVF cycles are provided.
- Coverage for three cycles of IVF, including all treatment that starts when preparatory medications are administered for ovarian stimulation with the intent of undergoing IVF using a fresh or frozen embryo, by large group health insurance policies.
The law also prohibits age restrictions on IVF coverage and prohibits insurers from imposing lifetime limitations on fertility preservation services.
Senator Diane J. Savino said, "For many women, fertility treatment is the only way achieve and sustain pregnancy. In-vitro fertilization is widely recognized as the safest and most effective method. As the New Year with new regulations are right around the corner, it's important that New Yorkers are up to date and aware of their options. I'm glad we continue to fight to ensure costly procedures are no longer a roadblock to a healthy family in New York."
Assembly Member Aravella Simotas said, "Infertility is a heart breaking medical condition that affects countless New York families each year. In-vitro fertilization has long been considered the gold standard of care for this disease, but patients were unable to access this safe and effective treatment. I am heartened that many New Yorkers will finally be able to access IVF coverage without being forced to choose between paying exorbitant out-of-pocket medical costs and starting the families they desire."
IVF coverage is important for people who face fertility obstacles, including same-sex couples and single women. Fertility preservation coverage is also important for cancer patients or other patients receiving medical treatment that may impact their ability to have children. Mandating IVF coverage makes the service more widely available to many New Yorkers, regardless of socio-economic status, marital status, sexual orientation and gender identity.
Due to greater emphasis on careers, delays in marriages and financial feasibility, demand for IVF services continues to grow. The average age of first births among women in the U.S. has increased from 21 to 25 since 1970, driven primarily by an increase in first children born to women 35 and older. The percentage of first births in women aged 30 years or older increased from 5% to 26% from 1975 to 2010. As women are pressured to choose between a career and having a family, this new law helps many New Yorkers have appropriate access to affordable IVF coverage services.
A copy of the FAQs can be found on the DFS website.