I like to say that the insurance companies favorite word is “No” and you usually have to appeal their verdict and sometimes you have to file a complaint with state insurance commissions.
In LGBTQ rights, the New England states lead the way in protections and other states are catching up.
APG Media of WisconsinBy Riley VetterkindJune 30, 2020Health insurance providers can no longer discriminate against Wisconsin transgender patients following a directive issued by the state’s chief insurance regulator.Wisconsin Insurance Commissioner Mark Afable issued a memo to health insurers Monday clarifying that discrimination by health insurance companies based on sex, gender identity or a gender dysphoria diagnosis is illegal.The department’s stance bars health insurers from banning or limiting health care coverage for transgender individuals for medical procedures that are otherwise covered, such as mastectomies for transgender men or breast enhancement for transgender women.To enforce the decision, the Office of the Commissioner of Insurance will not approve health insurance policies for consumers that contain exclusions or limitations on benefits that are based on a person’s gender identity.
You know that the insurance companies will try to weasel out of it anyway they can and they use the tried true NO! I imagine that Wisconsin insurance companies will also say no and hope they person doesn’t know the law.
Here in Connecticut our insurance commissioner issued in December 19, 2013 bulletin IC-37 that said the same thing as the Wisconsin regulators did. The bulletin said anything that is covered for cis-gender people must be covered for trans people, but even with that the insurance companies still said “no” for what they said was cosmetic procedures.
Then last November the Commission on Human Rights and Opportunities (CHRO) issued a DECLARATORY RULING ON PETITION REGARDING HEALTH INSURERS’ CATEGORIZATION OF CERTAIN GENDER-CONFIRMING PROCEDURES AS COSMETIC.
As the Executive Director of the Connecticut TransAdvoacy Coalition we applied for intervenor status, and was granted permission to appear and file a brief as amicus curiae. The declaratory ruling required insurance companies to cover what is normally cosmetic surgeries if a doctor says it is medically necessary.
But keep in mind that even with Bulletin-37 it took a ruling by the CHRO.
Diana, do you know the current status of trans health coverage under Medicare? Even if my supplemental policy may be subject to individual state rules for coverage, it is only 20% of the total. Although I feel that my state laws would protect me from Trump's recent attempt to erase my rights for care, they do not protect from elimination of certain trans-related coverage restrictions imposed by Medicare rules. Even under what's left of the ACA, I'm not sure what to expect, should I seek any medical assistance for transition.
ReplyDeleteIf you know, I'm sure that there are many other older readers of your blog who are as concerned as I am, and would appreciate any information you could provide.