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Improper Denials of Fertility Preservation Services in California are Routine

By Kaitlin Perry

August 27, 2019

(SACRAMENTO, CA) –– Although the California Department of Managed Health Care (DMHC) requires health plans to cover fertility preservation as a basic health care service, thousands of young adults in the state continue to receive denials. Because medical treatments that compromise fertility often must be administered in a matter of days, such as chemotherapy after a cancer diagnosis, and that fertility preservation should be done prior to cancer or other treatment, these denials and the time it takes to resolve them can force already vulnerable patients and families to pay out-of-pocket for treatment or, for those who cannot self-pay, forego fertility preservation altogether and miss out on the opportunity to have biological children.

The DMHC repeatedly overturns fertility preservation denials, yet health plans continue to withhold this treatment. Specifically, Kaiser Foundation Health Plan, Inc. has blatantly defied the state’s regulatory agency even after the DMHC sent an Order to Cease and Desist stating, among other issues, that “Kaiser’s providers incorrectly continue to inform enrollees that fertility preservation services are not covered by Kaiser.” This practice of routine denials for individuals undergoing medical treatments such as chemotherapy is set to be curbed with passage of a bill pending in the California Legislature. Senate Bill 600 (Portantino) will confirm that fertility preservation is medically necessary for patients undergoing treatment that can compromise their fertility and will help prevent inappropriate denials.

“After receiving my diagnosis, I was initially told that my health insurer would not cover fertility preservation. Already facing major medical decisions, my husband and I confronted the reality that starting a family hinged on our ability to pay for this service out-of-pocket,” said Emily Greenfield, a recently diagnosed breast cancer patient and doctoral student at Stanford. “Fortunately, we eventually learned that my policy did provide partial coverage, but we know that many in the same situation face denial after denial. We need to ensure that all Californians know they have a right to coverage – and that insurance companies honor that right. SB 600 is a critical step toward achieving those goals.”

Fertility preservation is different than infertility treatment, which treats existing difficulty in becoming pregnant and is not always covered by health insurance. Fertility preservation allows a person set to undergo chemotherapy or radiation treatment for cancer to freeze their eggs, sperm or embryos until their treatment is concluded.

“By denying fertility preservation in defiance of the law and DMHC, health plans are making the unconscionable decision to take away the ability to have a family from young patients who’ve been given a second chance at life,” said Ruben Alvero, MD, Professor and Division Director of Reproductive Endocrinology and Infertility at Stanford. Prior to his current position at Stanford, Dr. Alvero was instrumental in helping pass fertility preservation legislation in Rhode Island while serving as the Division and Fellowship Director of Reproductive Endocrinology and Infertility at the Women & Infants Hospital of Rhode Island. “With the passage of SB 600, Californians will better understand their right to access fertility preservation services without being forced into a lengthy and inappropriate appeals process.”

If you or a loved one believe you are experiencing wrongful denials, visit – an online resource created by the California Chronic Care Coalition to help patients receive the care they need, when they need it. My Patient Rights provides information on how to file a complaint with a patient’s health plan, as well as the DMHC. It’s imperative for all health care consumers to know that they have the right to an appeal and they are not alone in their struggle to get the treatment they need.

About My Patient Rights
My Patient Rights was launched by the California Chronic Care Coalition in 2015 to help people who have been denied treatment or medicines, experienced delays or are dissatisfied with the decisions made by their health plan. In 2019, My Patient Rights expanded nationally to help consumers throughout the country get the care they need and deserve. Like My Patient Rights on Facebook, follow on Twitter or visit to learn more.

About California Chronic Care Coalition
The California Chronic Care Coalition (CCCC) is a unique alliance of more than 30 leading consumer health organizations and provider groups that engage policy makers, industry leaders, providers and consumers to improve the health of Californians with chronic conditions. We envision a system of care that is accessible, affordable and of a high quality that emphasizes prevention, coordinated care and the patient’s wellness and longevity. Follow CCCC on social media (@CAChronicCare) or visit for more information.