3Center or American Progress | FAQ: Health Insurance Needs or Transgender Americans
Do insurance plans usually cover care for transgender people?
Unorunaely, despie signican advances, many insurers coninue o rely on oudaedassumpions abou ransgender people o jusiy discriminaory ransgender-specicexclusions in heir policies.Sill, he rend o oering nondiscriminaory, comprehensive coverage or ransgenderpeople is growing. An increasing number o healh insurers are oering plans wihouransgender-specic exclusions, and many are also including armaive saemens o coverage or reamens needed or gender ransiion.Some o he insurers oering inclusive plans include Aena, Blue Cross Blue Shield,Cigna, Kaiser Permanene, and UniedHealhcare. Many employers are also oeringcomprehensive coverage o heir ransgender workers. Currenly, more han 25 perceno Forune 100 employers, including Kra Foods, Microso, and Nike, oer equal cov-erage or heir ransgender employees.
What are transgender-specific exclusions?
Many healh insurers specically arge he ransgender populaion or denial o servicesprovided o nonransgender people under he same plan. In some insances hese exclu-sions apply only o surgical reamens while permiting coverage or oher benes,such as menal healh services and hormone herapy. In many cases, however, he exclu-sions are sweeping, excluding, or example, coverage o any “services, drugs, or suppliesrelaed o sex ransormaion.”
ransgender-specic exclusions are unaccepable on boh medical and ehical grounds.Tey arbirarily arge ransgender people or discriminaion by orcing hem o pay ou-o-pocke or he same medically necessary services provided o nonransgender people. As discussed above,many medical services needed by ransgender people during ransi-ion and a oher poins in heir lives are par o he course o care required or ohermedical condiions and are rouinely covered by healh insurance plans. Hormone her-apy, or insance, may be uilized or paiens wih low esoserone or esrogen levels oroher endocrine disorders. Prevenive care services such as pelvic or prosae exams arean imporan par o an overall healh regimen or all individuals, while various surgeriesand reconsrucive procedures are commonly covered or reaing injuries and inersex condiions, or or cancer reamen or prevenion.Moreover, insurers requenly expand such exclusions in pracice o deny ransgenderpeople coverage or basic services ha are unrelaed o gender ransiion. ake heourageous example o a ransgender woman in New Jersey who was denied coverage