Friday, December 27, 2013

CT Insurance Commissioner Requires Coverage For Us.

Connecticut now joins California, Colorado, Oregon, Vermont and the District of Columbia to require health insurance coverage for trans-people. That means our health care for transition and hormones will now be covered under certain conditions. If you are insured by a Connecticut company you now get all your medical expenses covered, including hormones and Gender Conforming Surgery. However, if you employer is an ERISA (Employee Retirement Insurance and Security Act) then you may not be covered because they are under federal law, not state law. From what I understand if you have Medicaid I believe that you also would be covered, but not if you are covered by Medicare because Medicaid is a state plan while Medicare is a federal plan.

    State Requiring Heath Insurers To Cover Gender Transition
    Hartford Courant
    By DANIELA ALTIMARI
    December 26, 2013

    HARTFORD – The Connecticut Insurance Department is directing all health insurance companies operating in the state to provide coverage of mental health counseling, hormone therapy, surgery and other treatments related to a patient's gender transition.

    Joining a handful of other states, the department issued a bulletin to insurance companies last week which seeks to ensure that "individuals with gender dysphoria … are not denied access to medically necessary care because of the individual's gender identity or gender expression."

    Deputy insurance Commissioner Anne Melissa Dowling said the state wanted to "go out and affirmatively make [the policy] very clear."

    "As we were turning the corner into the new year, we just wanted to make sure every constituency was clearly heard,'' she said.
P.S. Don't read the comments, all the wackos are out.

Update 12/28.12:
The actual bulletin from the Insurance Commission is here

There is a note at the end of the bulletin...
Important Note: Although a blanket policy exclusion for gender transition and related services is prohibited, a health insurer, HMO or other entity, with respect to the coverages subject to sections 38a-488a [Individual and Group Mental Health Parity Statute - individual health insurance] and 38a-514 [Individual and Group Mental Health Parity Statute - group health insurance ] of the Connecticut General Statutes, may still perform medical necessity determinations on a case by case basis with respect to an insured's request for transgender services. However, if the request is denied on the basis the services are not medically necessary, the insured has the right to an independent review through the Department's External Review Program. .

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