BCBS of Illinois Discriminates Against LGBTQ Individuals Over Fertility Treatment Coverage, Class Action Alleges

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A proposed class action lawsuit alleges Blue Cross and Blue Shield of Illinois has illegally denied lesbian, gay, bisexual, transgender, queer, intersex and non-binary individuals full and equal access to coverage for fertility treatments. 

The 12-page complaint alleges the plaintiff, her partner and other LGBTQ individuals who cannot conceive through intercourse are required by BCBS of Illinois to pay out of pocket for one year of medically based and supervised methods of conception, including artificial insemination, before the insurer will provide coverage for fertility treatments. The lawsuit describes this apparent requirement as an “illegal tax” on LGBTQ individuals that denies their equal rights to have children. 

As a result, proposed class members have been forced to pay tens of thousands of dollars out of pocket—in the plaintiff’s case roughly $19,000 for one successful pregnancy—that others are not required to pay in order to become pregnant, the lawsuit says. 

“BCBSIL’s Policy language openly discriminates against Plaintiff 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,” the filing alleges. 

Per the lawsuit, BCBS of Illinois’ policy provides individuals with immediate coverage, with no out-of-pocket costs, based on their representation that they have not gotten pregnant after having unprotected sexual intercourse for 12 months. According to the case, the “exorbitant costs” LGBTQ individuals must pay before they can receive insurance coverage for fertility treatments are prohibitive and entirely prevent people who are unable to pay the price—disproportionately LGBTQ people of color, the suit says—from becoming pregnant and starting a family. 

The case argues that for LGBTQ individuals, the only way to meet BCBS of Illinois’ definition of “infertility” is to pay for 12 months of a costly procedure such as intrauterine insemination or other “medically based and supervised methods of conception.” Under Illinois law, however, an insurance policy, according to the suit, “may [not] impose any exclusions, limitations, or other restrictions on coverage of any fertility services based on a covered individual’s participation in fertility services provided by or to a third party,” nor may it impose any other limitations on coverage for the diagnosis of infertility, treatment for infertility and standard fertility preservation services. 

“Under Illinois’ revised law … ‘infertility’ includes ‘a person’s inability to reproduce either as a single individual or with a partner without medical intervention,” the complaint states.

The lawsuit alleges BCBS of Illinois has deliberately engaged in discrimination of LGBTQ individuals and continued to enforce the policy at issue despite both the passage of Section 1557 and the clear definition of sexual discrimination under federal and state laws. 

The case looks to represent all individuals who, while covered by a Blue Cross Blue Shield of Illinois health insurance plan in the state, have been and/or will be denied coverage for fertility treatment because the individual, due to their sexual orientation or gender identity, cannot meet the insurer’s prerequisite of a diagnosis or treatment of “infertility” based upon the inability to conceive a child after one year of “unprotected sexual intercourse.” 

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