Ohio’s Insurance Mandate

The state of Ohio does have a requirement relating to infertility insurance coverage, but it is very limited in scope. First, it only applies to managed care companies, so if you are covered by any other type of insurance company or plan, there is no mandatory infertility coverage. Second, even managed care companies are only required to cover "medically necessary" treatments. The term "medically necessary" has been interpreted to mean those treatments necessary to treat an underlying medical condition. For example, surgery to treat pain related to endometriosis would be covered even if it has the incidental effect of enhancing fertility. However in vitro fertilization, which only serves to cause conception, is not required to be covered.

Join RESOLVE in Advocating for Better Insurance Coverage!

Many of our members and other people seeking treatment for infertility throughout Ohio and the rest of the country are struggling not only with the high emotional toll of infertility but also with high costs of treatment not covered by insurance. We hope that some day soon insurers will cover infertility treatments as they do treatments for any other medical condition. One way to hasten that day is to contact your state and federal legislators and encourage them to support legislation requiring meaningful infertility insurance coverage. Infertility is a condition often suffered silently, but our legislators need to hear from us, our families and our friends. 

Ohio’s Senators are Sen. Mike DeWine, US Senate, Washington, DC 20510, 202-224-2315; and Sen. George Voinovich, US Senate, Washington, DC 20510, 202-224-3353. 

Sample letter for your use. We recommend personalizing it with details from your own situation.

Date

The Honorable (Name)

Address

Dear Representative or Senator (Name):

I am writing to ask for your support of legislation that would require insurance companies to provide coverage for the diagnosis and treatment of infertility. As one of the more than 6 million men and women across the country impacted by infertility, I have faced obstacles in my attempts to build a much-wanted family; the most challenging is the lack of insurance coverage. This legislation will end the discriminatory practices of insurance companies and provide couples struggling with the disease of infertility with the opportunity to build a family.

Infertility is a medically-recognized disease. Still, many insurance companies do not provide coverage for treatment to overcome this disease. The financial burden that some of the treatments may place on couples can be large, and the emotional and physical consequences of experiencing infertility can be overwhelming. The strong desire to build a family gives me the strength to face these obstacles, but I also need your support.

Well-managed insurance coverage will not place a large burden on insurance companies. Studies have shown that coverage adds just a few dollars per year to an insurance premium. Infertile couples pay the same premiums as fertile couples, but are not able to access needed care. Most diseases and medical conditions are covered by insurance. The disease of infertility is often singled out for exclusion. Such discrimination is unfair.

The United States Supreme Court issued a ruling in 1998 in which it stated that reproduction is a major life activity under the Americans with Disabilities Act. This ruling demonstrates the importance of reproduction and the impact that infertility, in which the ability to reproduce is impaired, has on the lives of men and women. The ruling supports the need for infertility insurance coverage so that those with infertility are not unfairly discriminated against when denied coverage for this disease while most other diseases are covered.

Many affected by infertility do not feel comfortable speaking publicly about this very private struggle, but we represent all racial, religious, and ethnic groups, as well as both sexes. We are neighbors, co-workers, friends and relatives, and we just want to experience the joy of raising a family, an experience that so many fertile couples take for granted.

Thank you for your consideration of this important issue. I urge you to support legislation to require insurance companies to provide coverage for the diagnosis and treatment of infertility and help fulfill the dreams of thousands of people. For more information about infertility and about the costs and benefits of insurance coverage, contact RESOLVE of Ohio, Inc. at 1-800-414-6446, or RESOLVE, The National Infertility Association, at 617-623-1156.

Sincerely yours,

Name

Address