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.
Posts related to transgender rights and health care services under health insurance plans.
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.
Covered California has sent Certified Insurance Agents information and links on sensitivity and sales training for the Lesbian, Gay, Bi-Sexual and Transgender community. The sensitivity training presentation and social media icons were developed by Out2Enroll a national organization encouraging the enrollment of the LGBT community into Marketplace health insurance. While the overall information is good, there is underlying sales element that reduces the community down to dollar signs instead of human beings.
The Department of Health and Human Services has proposed health insurance rules that would prohibit the discrimination of health care services based a person’s gender identity. The proposed non-discrimination rule would apply nationwide to all health insurance offered through ACA Health Insurance Marketplaces. If the rule is adopted, transgender health related services could not be denied even in states that have not specifically enacted non-discrimination legislation.
With the passage of the Insurance Gender Nondiscrimination Act (IGNA), also known as AB 1586, all California health insurance plans must cover medically necessary transgender health care services. Unfortunately, many health plan customer service representatives and many health care providers are not aware of the law and have erroneously denied or delayed coverage and treatment […]
Anthem Blue Cross of California has included a section called Transgender Services in their Evidence of Coverage (EOC) documents for individual and family plans offered in California for 2015. While the seven paragraph section doesn’t provide a lot of details, it is a major step toward recognizing that individual plans must include such coverage to address the medically […]