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Aurora same-sex couple says they were denied fertility insurance coverage

Posted: 5:00 PM, Feb 05, 2024
Updated: 2024-02-05 19:47:16-05
Sebastian and Douglas Mazur-Cohen.jpg

AURORA, Colo. — An Aurora same-sex couple said they feel discriminated against after they claim they were denied health insurance coverage for in vitro fertilization through employer-provided healthcare.

Sebastian and Douglas Mazur-Cohen are both employees of Children’s Hospital Colorado and said for the past year, they’ve been trying to start a family. The couple met in high school and were married 5 years ago.

“We wanted to have biological children just because it's just as expensive to adopt, which we've done a lot of intense research... So, we wanted to try to have biological children and we wanted to do one of mine and one of his and be related through the same mom. That's where our — I hate saying the term 'donor,' but our best friend… She was like 'Well, I'll donate my eggs to you,'” Sebastian said.

Sebastian said the couple decided to pursue in vitro fertilization but the process has been full of challenges.

The Mazur-Cohens said two Colorado clinics declined to perform the procedure due to a genetic disorder their friend carried.

“It was a less than 1% chance of even passing on the disorder,” Sebastian said. “And they (clinic employees) kept using the legal term of well, she's considered a donor. It's not your child. And we're like, but it is our child. Like, it's our genetic child.'”

After finding a clinic in Los Angeles that would move forward with the IVF process, the Mazur-Cohens said the insurance coverage they received through their employer was the next and the largest challenge.

“We work at Children's Hospital. One of the big things they push is that they're very inclusive with their benefits. They want everyone who works there to be able to access the same coverage for us to be able to start families. And so one of the big things that they did was — you used to have to be considered infertile in order to access the benefits. And we're not infertile, we're just a gay couple. So they took away that requirement that you needed to have a diagnosis of infertility to make it more equitable for everyone to access,” Douglas said. “And now that we're trying to get reimbursed for all this stuff they said that we were covered for. They're going back on it and saying that we don't have any coverage because she's not part of our plan. She's an egg donor.”

Sebastian and Douglas said a representative for Express Scripts, which provides medication coverage for UnitedHealthcare members, suggested a possible solution.

“She said ask your employer to put Elizabeth (donor) onto your plan as a temporary dependent with the quotations of 'donor,'" Sebastian said.

But the Mazur-Cohens said adding their friend to their plan was also denied and without insurance reimbursement, they are now $15,000 in debt.

“We've maxed out our credit cards,” Sebastian said.

Douglas said most of their debt stems from medication associated with IVF. Douglas said Express Scripts denied coverage for the medication because Douglas and Sebastian would not be the ones taking the medication.

“The procedure to pull those eggs — that was actually covered by our insurance,” Douglas said.

But the Mazur-Cohens provided Denver7 with emails showing a hospital benefits representative confirming. UnitedHealthcare said the initial approval was a mistake.

Aurora same-sex couple says they were denied fertility insurance coverage

In a statement to Denver7, Children’s Hospital Colorado said:

Children’s Hospital Colorado maintains benefit plans that are market competitive, provide flexibility and choice, and promote equity and consistency. Like other employers, we provide medical benefits to eligible team members and their dependents, as defined under our plan.

At times, medical benefits can be complicated to navigate, and we provide plan communications and engage third-party administrators to address any questions or concerns team members may have about coverage. Children's Hospital Colorado has provided guidance that all claims for benefits under the plan should be sent to the third-party administrator responsible for claims. 

We understand that there are team members experiencing challenges and we hope our third-party administrator resolves their concerns soon.

UnitedHealthcare also provided a statement which reads: “We are reviewing this issue further and will work with the member and his employer to determine coverage under his benefit plan.”

“We just want to exist. We just want to have a normal life like everyone. And, you know, yes, I do drag and stuff. But outside of that, I have a home, I go to work, I want to have kids, I love my nieces and nephews, and I want them to have cousins,” Sebastian said.

Sebastian and Douglas said they are speaking out now to help other couples.

“People are moving from different states to Colorado now and it's because of the liberties that they say we have here. You know, equality, protection at our jobs, access to health care for people who are part of our community," Douglas said. "And so we're seeing more and more people from states like Texas and Florida, where they're being oppressed and don't have access to these things. But then, you come here and it's a big gleaming ray of sunshine. But the reality is a little bit different. And so I'm hoping that through things like this, and bringing awareness to the issue, that it really can open the eyes of people and what it truly means to be inclusive. It doesn't mean just saying you are allowed to try and do this. It means you are allowed to actually go through with this whole process and we'll support you with it."

Denver7 has launched a Denver7 Gives fundraiser to help Sebastian and Douglas Mazur-Cohen with their medical debt. If you would like to donate, visit Denver7 Gives and select "Help Couple With IVF Bills."

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