Health insurers would cover fertility preservation for cancer patients

Insurers would cover services that preserve fertility when needed cancer treatment may harm it. The rule covers individual and group medical plans issued by Pennsylvania-licensed insurers when medically necessary cancer treatment may impair a person's fertility. Services must follow nationally recognized medical or professional guidelines in place when the section takes effect. Policy rules for medical review and patients' share of costs would apply. Listed limited or specialized policies, including Medicare supplements and TRICARE, are excluded. Certain religious employers could obtain an exemption. If enacted, the act would take effect immediately. For policies requiring filings, coverage would apply when a form or rate is first filed on or after 180 days after that date. Otherwise, it would apply to policies issued or renewed on or after that same threshold.

Insurers would cover storage and could set limits on the benefit. These rules apply to fertility preservation covered under the cancer-treatment requirement. Storage would use an in-network facility unless none is available or the facility becomes unavailable. Any lifetime benefit cap must be at least $100,000 per covered person. Insurers could end coverage at the earlier of three years after the fertility-threatening treatment or the date the person is no longer covered by the policy.

Insurers would grant an exemption upon written request when coverage conflicts with a qualifying religious employer's sincere religious beliefs and practices. The exemption applies to health coverage provided by a qualifying religious employer. Eligible employers include tax-exempt churches, church associations, and elementary or secondary schools controlled, operated, or mainly supported by a church. The exemption would not bar enrollees from buying separate fertility preservation insurance at their own expense. An employer that obtains an exemption would have to give written notice to each prospective enrollee.