For years, many LGBTQ+ individuals seeking to start families faced a hidden, discriminatory barrier often referred to as the “Gay Tax.” While straight couples could often access fertility benefits by simply stating they had been trying to conceive naturally for six to twelve months, queer couples were frequently forced to prove “infertility” by paying for expensive medical procedures out of pocket first.
That era is coming to a definitive end. Following the landmark settlement in Berton v. Aetna, preliminarily approved by the U.S. District Court for the Northern District of California in late 2025, Aetna has committed to a nationwide policy change that guarantees equitable access to fertility treatments. For thousands of families, this isn’t just a legal victory, it is the removal of a massive financial and emotional hurdle on the road to parenthood.
The Cost of Discrimination
The class-action lawsuit was sparked by the experience of Mara Berton, a California resident who, like many others, found that her insurance plan’s definition of “infertility” was built around a heteronormative framework.
Under Aetna’s old policy, a woman with a male partner could qualify for coverage after a period of “unprotected sex.” However, Berton, who has a female partner, was told she had to undergo, and pay for, up to 12 cycles of artificial insemination before Aetna would consider her “infertile” and begin covering her care. For many queer couples, these out-of-pocket costs can exceed $45,000, creating a “pay-to-play” system for basic reproductive healthcare.
A Nationwide Shift in Policy
The Berton case builds on the momentum of a previous New York-based suit, Goidel v. Aetna. While Goidel secured wins for New Yorkers, Berton has successfully expanded these protections to be legally enforceable nationwide.
As part of the settlement, Aetna is modifying its clinical policies to align with the latest guidelines from the American Society for Reproductive Medicine (ASRM). These updated standards redefine infertility in a way that includes LGBTQ+ individuals and single people, ensuring that the requirements to access advanced treatments like IVF are no more burdensome for queer policyholders than they are for heterosexual ones.
Compensation for Impacted Families
The settlement doesn’t just look forward; it attempts to “right the wrong” for those already harmed. Aetna has agreed to a multimillion-dollar fund to compensate eligible class members—specifically LGBTQ+ California residents who were denied coverage for artificial insemination (IUI or ICI) between April 17, 2019, and December 31, 2024.
Key Settlement Figures:
- $11,000: The approximate compensation most eligible class members who submit a qualifying claim can expect to receive.
- $2 Million+: The total common fund established for damages and reprocessing of claims.
- $250,000: A “Special Harms Common Fund” for those who suffered additional specific losses.
How to File a Claim
If you believe you were unfairly denied coverage under an Aetna plan in California during the class period, the window to act is open.
- Official Website: www.californiainfertilitysettlement.com
- Deadline: All claims must be submitted by June 29, 2026.
- Eligibility: Generally includes California residents with Aetna commercial or student plans who sought and were denied coverage for IUI/ICI during the class period due to the old “infertility” definition.
The Bigger Picture: A Benchmark for the Industry
This victory, led by the National Women’s Law Center (NWLC) and firms Katz Banks Kumin LLP and Altshuler Berzon LLP, sends a clear message to the entire insurance industry. In an era where reproductive rights are under intense scrutiny, this settlement reinforces the Affordable Care Act’s anti-discrimination provisions, specifically Section 1557, which prohibits discrimination based on sex (including sexual orientation and gender identity).
“This landmark settlement sets a benchmark that we hope others in the health care coverage industry will follow,” said Connie Chan, co-lead counsel.
For the 2.8 million LGBTQ+ Aetna members nationwide, the path to building a family is finally becoming less about the thickness of their wallets and more about the depth of their dreams. The “Gay Tax” on fertility is being repealed, one court order at a time.
