Current Policy Priority Successful Effort
Fertility Services Now Covered by Federal Employee Health Plans
In 2023, for the first time ever, Federal employees will have insurance coverage for fertility preservation and four plan options that will cover Assisted Reproductive Technology (ART).
The Office of Personnel Management (OPM) released federal benefits information for the 2023 plan year, expanding coverage for family building for federal beneficiaries and their family members. All federal insurance carriers will provide coverage for standard fertility preservation procedures for individuals facing the possibility of medically induced (iatrogenic) infertility, including infertility associated with cancer treatments or risk-reducing surgery. Additionally, four new plan options will provide ART within their Federal Employees Health Benefits (FEHB) benefits package for a total of 18 plan options in 2023; one new plan option will provide a non-FEHB benefit for discounted ART procedures. This is incredible progress for federal beneficiaries and their families—and serves as an example for other health insurers.
People diagnosed with cancer or other serious medical conditions often undergo treatments that may affect their fertility. In the hereditary cancer community, those at increased risk of ovarian cancer are advised to undergo risk-reducing bilateral salpingo-oophorectomy (surgical removal of the ovaries and fallopian tubes) after childbearing, but some individuals opt for this surgery earlier based on family history or other factors. The new coverage provided by federal health insurance providers will help ensure that these people have the option to preserve their fertility by harvesting and freezing eggs or sperm, providing them with the opportunity to build a family (should they choose to) in the future.
In Vitro Fertilization (IVF), a type of ART, is a procedure in which eggs are removed from an ovary and combined with sperm outside the body to form embryos. The embryos are grown in the laboratory and then placed in a woman’s uterus or frozen for future use. A single IVF cycle can cost more than $10,000, depending on the individual's medication needs.
FORCE is working with other organizations to require coverage of fertility preservation and IVF for anyone with or at risk of hereditary cancer. To date, 20 states have passed fertility insurance coverage laws, 14 of which include coverage for IVF. Twelve states have fertility preservation laws for iatrogenic (medically induced) infertility.
Some people who carry an inherited genetic mutation linked to cancer—such as ATM, BRCA1/2, PALB2, etc.—or another serious disease opt for Preimplantation Genetic Diagnosis (PGD), also known as Preimplantation Genetic Testing (PGT). This medical procedure allows them to have children who do not have the mutation. Note that no state laws currently require coverage of PGD/T.
8/14/2023 - Joined stakeholders in a letter to the American College of Physicians expressing disappointment with the preventive colorectal cancer screening guidance it published, which conflicts with recommendations provided by the USPSTF, NCCRT, ACS, NCCN and other reputable organizations.
7/21/2023 - Wrote House and Senate leadership, expressing support for increased funding for the Agency for Healthcare Research and Quality (AHRQ) in its staffing and administrative support of the U.S. Preventive Services Task Force (USPSTF) as part of the FY24 appropriations bill.
6/7/2023 - Joined physicians and patient advocacy groups to support California AB 632, which will allow patients to receive prostate cancer screening without a deductible, copayment, or coinsurance for prostate cancer screening, including men over the age of 40 who are at high risk for prostate cancer.
- The Oncofertility Consortium maintains a national database of healthcare providers with expertise in fertility preservation and treatment of people who are diagnosed with cancer or at high risk for cancer due to an inherited mutation.