“Benefits Equity for Transgender Employees” session is now available online:


The 2014 St. Louis Transgender Inclusive Health Insurance Summit is supported by the WUSTL School of Medicine, Institute for Public Health, WUSTL Olin School of Business Weston Career Center, BALSA Group, and WUSTL OUTgrads.

TRANSCRIPTION OF PRESENTATION (PDF FORMAT)


The Transgender Insurance: Coding, Guidelines, and Getting Coverage for Your Client recording will be made available soon. Email transgenderinclusionSTL@gmail.com for more info.


Important News since the 2014 Transgender Inclusive Health Insurance Summit:

  • Sept 2015
    • Jersey City, NJ announces that effective January 1 2016, municipal employee health benefits will be trans-inclusive. Jersey City is the first city in New Jersey to commit to offering inclusive benefits for municipal employees. (link)
    • US Dept of Health & Human Services (HHS) issues a proposed rule that would prohibit categorical exclusions on care related to medical transition. Under this rule, individuals must also be treated consistent with their gender identity, including in access to facilities. (link)The rule, when final, would apply to health insurance plans sold on state or federal health care exchanges, Medicaid, CHIP (Children’s Health Insurance Program), Medicare, the Indian Health Service, and any health care provider that accepts federal funds (such as hospitals and doctors’ offices that accept Medicare or Medicaid). Some private health insurance plans outside the Marketplaces may not be covered if they are offered by issuers who do not also offer Marketplace plans or receive other federal funds. The rule does not address non-HHS federal health programs such as veterans’ and military health care.
  • Aug 2015
    • Chicago, Il announces plan to lift ban on transition-related care from city health care benefits; the change will be implemented for all non-union employees, and is working with labor partners to also remove exclusions for union members. Change goes into effect Oct 1 2015. (link)
  • July 2015
    • US Dept of Health & Human Services (HHS) Office for Civil Rights (OCR) issues statement regarding a voluntary resolution agreement with Brooklyn Hospital Center, affirming that HHS interprets Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of sex, to incorporate claims on the basis of “gender identity, gender expression, and non-conformity with gender stereotypes” (link)
    • New York State Department of Health issues guidance  clarifying NY State Medicaid coverage to ensure that “medically necessary procedures affecting appearance” are covered (including those associated with medical transition) (link)
  • June 2015
    • Office of Personnel Management (OPM) issues guidance effective Jan 1 2016, insurers in the Federal Employment Health Benefits (FEHB) Program may not exclude transition-related coverage (link)
    • Nevada State Division of Insurance issues bulletin on transgender inclusive health coverage (link)
  • May 2015
    • US Dept Health & Human Services (HHS) issues guidance that under the Affordable Care Act, all insurance companies must cover sex-specific preventive care, including mammograms and pap smears, for transgender people, and that that care must be provided without regard to “sex assigned at birth, gender identity, or recorded sex.” (link)
  • March 2015
    • New York State Medicaid lifts ban on transition-related care (link)
    • Connecticut  State Medicaid lifts ban on transition-related care (link)
    • Federal court confirms that the Affordable Care Act (ACA) prohibits discrimination against transgender people by any health care provider accepting federal funds and that under Section 1557 transgender people have the right to sue for gender identity-based discrimination. (link)
  • Dec 2014
    • New York State Dept of Financial Services, which regulates the NY insurance industry, issued guidance stating that the law requires health insurance companies to cover transgender health care on the same terms as other care. (Does not apply to NY State Medicaid nor to self-funded plans because those plans are not regulated by the NY State Dept of Financial Services.) (link)