BCBS of Illinois LGBTQ Discrimination in Infertility Treatments Illinois Class Action

Do health insurance policies cover fertility treatments? And if so, do LGBTQ individuals have an equal right to receive them? This class action alleges that Health Care Service Corporation, which does business as Blue Cross and Blue Shield of Illinois (BCBSIL), discriminates against LGBTQ people, because it imposes more onerous and expensive prerequisites on them than it does for heterosexual couples who wish to receive this kind of treatment.

The class for this action is all individuals who, while covered by a BCBSIL health insurance plan in Illinois, have been denied coverage for fertility treatment by BCBSIL because, due to their sexual orientation or gender identity, they cannot meet BCBSIL’s prerequisite of a diagnosis of infertility based upon an inability to conceive a child after a year of “unprotected sexual intercourse.”

Federal and state law defines sex discrimination to include discrimination against LGBTQ individuals, the complaint alleges, such as the plaintiff in this case, Kelsey Murphy. Murphy and her partner would like to have children. However, they cannot conceive via intercourse with each other, the complaint points out, but only via infertility treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF).

Murphy has health insurance through BCBSIL’s Blue Cross Blue Shield Blue Advantage HMO policy, which does offer coverage for IUI and IVF, the complaint says: “BCBSIL’s Policy provides immediate coverage, without any out-of-pocket cost, to individuals based on their representation that they have not gotten pregnant after having unprotected sexual intercourse for 12 months.”

But the rule appears to be different for LGBTQ insureds. The complaint alleges that the “same Policy requires individuals who cannot conceive through intercourse due to their sexual orientation or gender identity to pay out of pocket for one year of medically based and supervised methods of conception, including artificial insemination, before BCBSIL will provide them with coverage for fertility treatments.”

Murphy paid $19,000 for such treatments, which resulted in a single pregnancy, the complaint alleges—$19,000 that others did not have to pay in order to receive this kind of medical treatment from BCBSIL. The pregnancy ended in a miscarriage after eight weeks, the complaint claims.

According to the complaint, “BCBSIL’s Policy language openly discriminates against [Murphy] and other LGBTQ individuals based on their sex, sexual orientation, and/or gender identity and violates their rights under Section 1557 of the Patient Protection and Affordable Care Act (‘ACA’).” Furthermore, it claims, these costs are simply too high for many people to be able to afford them, thus preventing them from starting families at all. The heaviest burden, the complaint says, falls on LGBTQ people of color.

Article Type: Lawsuit
Topic: Insurance
Tags: Health Insurance, Insurance, LGBT Discrimination, Medical Care