In vitro fertilization (IVF) is a complex series of treatments to assist in pregnancy. The treatments, medications, and procedures are not cheap. Some healthcare insurance policies do not cover these treatments, stating they are elective. Care through the Veterans Affairs (VA) department makes receiving care for IVF treatment difficult to impossible, per lawsuits filed in early August in New York and Boston.
Per the lawsuits, it is reported that IVF coverage was not allowed for those who did not meet the VA’s definition of infertility. Per the Women Veteran’s Health Care website, infertility is when a couple does not become pregnant after 12 months of trying to conceive, while other couples should seek care earlier than 12 months. The VA site further noted that IVF may be covered if the couple is legally married, male spouses can produce sperm (or have cryopreserved sperm), and female spouses have an intact uterus and can produce eggs.
Per the lawsuits, the rejections for IVF coverage are only for those with a service-connected condition that causes infertility, and further criteria are met: being single, an unmarried couple, in a same-sex relationship, or a couple with the same reproductive organs or if they lack proof that infertility is related to service.
Per a statement by Air Force veteran Ashely Sheffield who is suing the VA in Boston, I’m shocked and disappointed that the VA is denying me and other veterans IVF benefits because we’re in same-sex marriages. We are entitled to equal treatment and should no longer be treated as second-class citizens.”
In 2021, a class-action lawsuit was filed against insurer Aetna for discriminating against same-sex couples who wanted IVF. Aetna specifically defines infertility as the inability to become pregnant after “frequent, unprotected heterosexual sexual intercourse” for at least six months to a year age dependent. Other insurance companies like Cigna and United Healthcare also cover fertility treatments for heterosexual couples but not same-sex couples. The resolution of this lawsuit was not found in the research for this piece.
The lawsuit in New York noted that infertility is common in the military due to combat-related injuries, exposure to toxic chemicals and environmental hazards, sexual assault, and post-traumatic stress disorder.
Members of the military community are exposed to toxic chemicals and environmental hazards in combat and stateside, and the VA has released questionnaires to follow those who were around burn pits in combat zones. It is not known what the burn pits will cause in the long term as the exposures began almost twenty years ago and have been seen with Vietnam’s Agent Orange, the effects can take years before noted, and then it is about tracing the route cause. The questionnaires are being used as research to understand the long-term health effects, but no known health effects are currently listed.
IVF is known to be an expensive process. Military Treatment Facilities (MTF) may cover some lab work but do not typically do infertility treatments. Bigger facilities like Naval Medical Center San Diego and Walter Reed Army Medical Center in Maryland currently perform infertility treatments, but there is a waiting list. Four other MTFs that may offer a wider range of fertility treatments include Tripler Army Medical Center in Hawaii, Womack Army Medical Center in North Carolina, Madigan Army Medical Center in Washington, and San Antonio Military Medical Center in Texas. Even with treatments there, there is still a portion of payment required by the military member which, per the report to Congress of Efforts to Treat Infertility of Military Families, was around $5,000. With military members frequently moving in and out of these coverage areas, they may not be able to receive these treatments through the MTF.
Per the VA website, the VA will cover some treatments for infertility, including infertility assessments and counseling, laboratory testing, imaging service, hormone therapies, fertility medications, intrauterine insemination (also known as artificial insemination), tubal ligation reversal, vasectomy reversal, oocyte and sperm cryopreservation (egg and sperm freezing) and sperm retrieval techniques. As noted above, IVF with the VA is only covered under certain circumstances, one of which being that a service-connected condition caused infertility.
While the litigation is ongoing, there are no results to report.
