Kevin Knauss: Health, History, Travel, Insurance
Posts related to transgender rights and health care services under health insurance plans.
In March of 2021, Blue Shield approved the plan member to receive gender dysphoria health care services from an out-of-network provider. Unfortunately, Blue Shield, according to the press release, inappropriately adjusted several of claims submitted by the health care professional. The payment dispute led to the health care professional suspending continued treatment until the claims dispute was resolved.
On top of the non-disruptive behavior, teachers have become utterly addle brained when trying to address the child by their chosen pronoun. Many teachers have broken down in tears being forced to say the plural ‘they’ when referring to a singular child. This cruelty to our teachers must stop and school districts are stepping up to put children back into the gender role chosen by society and stamp out the virus of progress.
Basic human rights and equal access to health care services is nonnegotiable. There can be no compromise. State’s rights do not supersede human rights. The goal of health care is to keep people healthy, productive, and sustainable. No state law should prevent a person from receiving care to remain healthy, productive, and sustainable.
The entire process of gender affirming surgery is intimate. Perhaps the most important relationship that you’ll want to secure is with your surgeon. Your health plan (Medi-Cal, Medicare, individual & family, employer group) will have a network of surgeons in the network. With luck, your preferred providers and surgeons will already be in the network of your health plan. Each health plan maintains an online list of providers for members to search. Healthcare networks are still learning and catching up with how to provide services to the transgender community.
The Department’s General Counsel Opinion Letter, issued pursuant to Insurance Code section 12921.9, was prepared in response to an inquiry from San Diego’s TransFamily Support Services regarding several denials of coverage for male chest surgery for patients under 18 years old who are transitioning from female to male. The Department determined that denying coverage for mastectomy and reconstruction of a male chest based solely on age is impermissible under state laws requiring coverage of reconstructive surgery. Health insurance companies must consider a patient’s specific clinical situation in determining medical necessity.
Blue Shield has added a gender identity category to align with the new state law even though health insurance companies are not required to do so. As an organization, Blue Shield recognizes our members whose gender identity is female, male or nonbinary. We want to honor any employee, and member their wish to be recorded as the gender they identify with.
Imagine for a moment that the day you born your religion, political party affiliation, and occupation were chosen for you. It was official. You could not change what had been entered into those fields on your birth certificate. You were designated a Roman Catholic, Democrat, Farmer. Your destiny and life had been chosen. The government would only recognize what was entered on the birth certificate.
One of the first changes consumers and agents will notice is under the information for household members. For the question of Sex (which should be gender), in addition to Male and Female, the drop down box will include Transgender: Male to Female and Transgender: Female to Male. While selecting the Sex is required, the Covered California application does not alert the consumer to the fact that rates are not based on gender AND you cannot be denied health insurance or receive a higher rate because you are transgender.
A Texas U.S. District Court Judge ordered the Department of Health and Human Services (HHS) not to enforce rules against discriminating against transgender health care services in health insurance policies. The order was issued on December 31, 2016 before the new nondiscrimination rules were set to go into effect. The nondiscrimination rules are part of Section 1557, the nondiscrimination provision of the Affordable Care Act (ACA). A lawsuit brought by The Becket Fund for Religious Liberty
As a Certified Insurance Agent for Covered California I am scrupulous when it comes to reading each question on the application for health insurance exactly as written, except when the Covered California application asks for the sex of the applicant. Instead, I ask for the person’s or dependent’s gender. Covered California should stop asking about a person’s sex and allow them to specify a gender.
