Health plans can support DEI with fertility and family-forming benefits

Diversity, equity, and inclusion (DEI) initiatives are high priority for today’s groups. Seventy-two percent of employers plan to promote DEI-related aspects of their benefits programs over the next few years. At the same time, the lack of inclusion in some health plans has been making headlines. A lawyer for New York City sued his employer because his insurance plan covered in vitro fertilization (IVF) for different-sex couples but didn’t cover options for him and his husband. The Biden administration is considering requiring some Affordable Care Act plans to require coverage for fertility treatments for members regardless of their sexual orientation or gender identity.

With expectations from both members and groups changing rapidly, inclusive fertility benefits can help health plans provide equitable access to care and drive top-line growth.

What makes a fertility benefit inclusive?

Some fertility benefit offerings don’t solve for all of the barriers to care members run into when pursuing parenthood. A truly inclusive fertility benefit should meet all of these requirements:

No infertility diagnosis requirement. Health plans have traditionally defined infertility as the inability to get pregnant through regular, unprotected intercourse for six months to a year, depending on age. This definition excludes coverage for same-sex couples and single-intending parents.

Support for all pursuits of parenthood. In addition to covering fertility treatment without an infertility diagnosis, in order to meet the needs of all members, health plans have the opportunity to support other family-forming journeys, such as adoption and gestational carrier (GC) services (commonly known as surrogacy). Comprehensive coverage should also include fertility preservation unrelated to cancer or radiation treatment. Members of the trans community, in particular, may benefit from fertility preservation before beginning hormone replacement therapy, but surveys show that they’re rarely given the option by doctors.

Proactive engagement and telehealth: Health plans can engage members early in their fertility and family-forming journeys by being better connected from the start. A comprehensive fertility benefit intervenes as soon as a member begins exploring their options.

Access to LGBTQ+-inclusive clinics and agencies. Members of the LGBTQ+ community continue to experience discrimination in healthcare settings. It’s especially common for trans and nonbinary people to encounter medical professionals with little experience in trans health. Fertility benefits that include care coordination can help members learn what clinics and agencies have been vetted for LGBTQ+ inclusivity so they’re more likely to have an affirming experience.

Consideration of income diversity. Income diversity isn’t talked about as frequently in the context of DEI, but it’s an essential part of an inclusive plan. Considering that most Americans don’t have $400 in savings to cover an emergency medical bill, benefits that include a deductible or require that members wait for reimbursement create a significant cost barrier. Providing access to telehealth services, especially when they’re available at no cost, is also a valuable way to provide ongoing support for members with tight work schedules or limited budgets.

Guidance to culturally competent care, including BIPOC providers. Birth inequities and maternal disparities between Black and white families are top of mind for groups committed to DEI. Health plans can help move the needle by incorporating fertility benefits that include some of the resources and providers that have been found to improve outcomes. For example, research shows that sharing a racial or cultural background with one’s physician can lead to higher patient satisfaction, better adherence to medication, and better outcomes. Coverage for pregnancy providers such as doulas can also help improve birth outcomes. Interest in how doulas can support the Black community specifically has been growing; New York City is launching a pilot program to provide free support from doulas to Black families.

Why partner with Carrot?

Carrot can fill in the gaps with existing health plan solutions to offer a more comprehensive solution that engages more members and more journeys and provides equitable access to high-quality fertility and family-forming care. Through Carrot, members have access to:

  • Inclusive support for all, regardless of sex, gender identity, sexual orientation, race, marital status, or geographic location.
  • Support for fertility testing, treatments, preservation, donor-assisted reproduction, adoption, and pregnancy.
  • Access to proactive support like at-home testing technology, advanced wearables, and dynamic educational content.
  • Access to unlimited telehealth chats with Carrot Experts, personalized care navigation, virtual small group sessions led by medical experts, and on-demand digital content, including self-serve education and resources.
  • Care navigation for connecting with BIPOC providers and LGBTQ+-inclusive clinics and agencies.

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