州不育法律中男性和女性保险范围的不平等。

Inequity between male and female coverage in state infertility laws.

作者信息

Dupree James M, Dickey Ryan M, Lipshultz Larry I

机构信息

Department of Urology and Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.

Scott Department of Urology, Baylor College of Medicine, Houston, Texas.

出版信息

Fertil Steril. 2016 Jun;105(6):1519-22. doi: 10.1016/j.fertnstert.2016.02.025. Epub 2016 Mar 5.

Abstract

OBJECTIVE

To analyze state insurance laws mandating coverage for male factor infertility and identify possible inequities between male and female coverage in state insurance laws.

DESIGN

We identified states with laws or codes related to infertility insurance coverage using the National Conference of States Legislatures' and the National Infertility Association's websites. We performed a primary, systematic analysis of the laws or codes to specifically identify coverage for male factor infertility services.

SETTING

Not applicable.

PATIENT(S): Not applicable.

INTERVENTION(S): Not applicable.

MAIN OUTCOME MEASURE(S): The presence or absence of language in state insurance laws mandating coverage for male factor infertility care.

RESULT(S): There are 15 states with laws mandating insurance coverage for female factor infertility. Only eight of those states (California, Connecticut, Massachusetts, Montana, New Jersey, New York, Ohio, and West Virginia) have mandates for male factor infertility evaluation or treatment. Insurance coverage for male factor infertility is most specific in Massachusetts, New Jersey, and New York, yet significant differences exist in the male factor policies in all eight states. Three states (Massachusetts, New Jersey, and New York) exempt coverage for vasectomy reversal.

CONCLUSION(S): Despite national recommendations that male and female partners begin infertility evaluations together, only 8 of 15 states with laws mandating infertility coverage include coverage for the male partner. Excluding men from infertility coverage places an undue burden on female partners and risks missing opportunities to diagnose serious male health conditions, correct reversible causes of infertility, and provide cost-effective treatments that can downgrade the intensity of intervention required to achieve a pregnancy.

摘要

目的

分析规定男性不育保险覆盖范围的州保险法,并确定州保险法中男性和女性保险覆盖范围之间可能存在的不平等情况。

设计

我们通过全国州议会会议和全国不育协会的网站,确定了与不育保险覆盖范围相关的法律或法规的州。我们对这些法律或法规进行了初步的系统分析,以具体确定男性不育服务的覆盖范围。

地点

不适用。

患者

不适用。

干预措施

不适用。

主要观察指标

州保险法中是否存在规定男性不育护理保险覆盖范围的条款。

结果

有15个州的法律规定了女性不育的保险覆盖范围。其中只有8个州(加利福尼亚州、康涅狄格州、马萨诸塞州、蒙大拿州、新泽西州、纽约州、俄亥俄州和西弗吉尼亚州)规定了男性不育评估或治疗的保险覆盖范围。马萨诸塞州、新泽西州和纽约州对男性不育的保险覆盖范围规定最为具体,但所有8个州的男性不育政策仍存在显著差异。有3个州(马萨诸塞州、新泽西州和纽约州)免除输精管复通术的保险覆盖范围。

结论

尽管有全国性建议,即男性和女性伴侣应同时开始不育评估,但在15个规定不育保险覆盖范围的州中,只有8个州将男性伴侣纳入保险覆盖范围。将男性排除在不育保险覆盖范围之外,给女性伴侣带来了不必要的负担,并有可能错过诊断严重男性健康状况、纠正可逆性不育原因以及提供可降低实现怀孕所需干预强度的经济有效治疗方法的机会。

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