WASHINGTON — Expecting or new mothers will see expanded coverage and added benefits under federal health insurance plans for 2023.
Providers of the Federal Employee Health Benefits program were directed by the White House’s Office of Personnel Management to broaden coverage for prenatal and postpartum care, with extra emphasis put on treatments for infertility.
The new offerings make an effort to address “a disproportionate share of maternal health morbidity and mortality,” for Black and native patient populations, according to OPM’s program letter to carriers.
Starting next month, beneficiaries can chose 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 a non-FEHB benefit for discounted ART procedures.
ART is a body of medical procedures used primarily to address infertility, such as in-vitro fertilization or the use of fertility medication, according to the Centers for Disease Control and Prevention.
In August, Rep. Gerry Connolly (D-Va.) and 23 other Democratic members of Congress wrote a letter criticizing federal employee health plans for skimping on fertility treatments and offering only limited options that were prohibitively expensive.
The letter urged OPM Director Kiran Ahuja to prioritize fertility and maternity care in negotiating health plans.
“Providing medical coverage for ART services is critical to ensure federal agencies can compete with the private sector for top talent and promote optimal health outcomes among their employees,” the letter read.
The National Infertility Association found that one in eight couples struggle to conceive, not including LGBTQ+ couples who may wish to utilize reproductive technology to start or grow families.
Expanded services will also include childbirth education classes, group prenatal care, home visits during pregnancy and postpartum, 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 cover infertility treatments.
All carriers will also cover the full range of contraceptives and contraceptive care for adolescent and adult women as provided in the Women’s Preventive Services Guidelines without cost sharing.
What to know ahead of open enrollment
The overall average increase in costs for the FEHB Program will be the highest in more than a decade.
The average government contribution will increase by 6.6%, while the enrollee’s share will increase an average of 8.7%. That means for a biweekly pay period, an employee on a self-only plan will pay about $8.11 more. Those in a family plan can expect an average increase of $20.87.
Open season for federal employees to re-enroll or change their health insurance for next year starts on Nov. 14 and goes through Dec. 12. With 271 plan options, OPM encourages enrollees to comparison shop.
Specific plan information for dental and vision benefits and rates 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 U.S., covering more than 8.2 million federal civilian employees, annuitants, and their families.
Molly Weisner is a staff reporter for Federal Times where she covers labor, policy and contracting pertaining to the government workforce. She made previous stops 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.