WASHINGTON — Expectant or new mothers will see expanded coverage and additional benefits under federal health insurance plans for 2023.
Providers of the Federal Employees Health Benefits Program were directed by the White House Office of Personnel Management to expand coverage of prenatal and postpartum care, with additional emphasis on infertility treatment.
The new proposals make efforts to address “a disproportionate share of maternal health morbidity and mortality” for black and Native American patient populations, according to OPM’s program letter to carriers.
Starting next month, beneficiaries can choose from four plan options that will provide assisted reproductive technology for a total of 18 plan options in 2023. One new plan option will provide non-FEHB coverage for discounted ART procedures.
ART is a set of medical procedures used primarily to treat infertility, such as in vitro fertilization or the use of fertility drugs, according to the Centers for Disease Control and Prevention.
In August, Rep. Jerry Connelly (D-Va.) and 23 other Democratic members of Congress wrote a letter criticizing federal employee health plans for skimping on infertility treatments and offering only limited options that are prohibitively expensive .
The letter urged OPM Director Kiran Ahuja to prioritize fertility and maternity care when negotiating health plans.
“Providing medical coverage for ART services is critical to ensuring that federal agencies can compete with the private sector for top talent and promote optimal health outcomes among their employees,” the letter said.
The National Infertility Association found that one in eight couples struggle to conceive, not including LGBTQ+ couples who may wish to use reproductive technology to start or raise families.
Expanded services will also include childbirth education classes, group prenatal care, pregnancy and postpartum home visits, and care management for high-risk pregnancies.
Carriers have already increased reimbursement or expanded coverage for certified nurse-midwives, birth centers and perinatal support services such as doulas and nurse home visits.
Currently, 20 states require regulated commercial plans to cover infertility treatment.
All carriers will also cover the full range of contraceptives and contraceptive care for adolescent and older women, as provided in the Guidelines for Preventive Services for Women, without cost sharing.
What you need to know before open enrollment
The overall average cost increase for the FEHB program will be the highest in more than a decade.
The average state contribution will increase by 6.6%, while the share of enrollees will increase by an average of 8.7%. This means that for a two-week pay period, an employee on a stand-alone plan will pay about $8.11 more. Those with a family plan can expect an average increase of $20.87.
The open season for federal employees to re-enroll or change their health insurance for next year begins Nov. 14 and runs through Dec. 12. With 271 plan options, OPM encourages enrollees to compare.
Specific dental and vision benefit plan information and pricing will be available on BENEFEDS.com in late October or early November.
Established in 1960, FEHB is the largest employer-sponsored health benefits program in the US, covering more than 8.2 million federal civilian employees, annuitants and their families.
Molly Weisner is a staff reporter for the Federal Times, where she covers labor, politics and contracts related to the government workforce. She was previously at USA Today and McClatchy as a digital producer and worked at The New York Times as a copy editor. Molly majored in journalism at the University of North Carolina at Chapel Hill.