Your state Medicaid plan should provide coverage for the care that you need. It is illegal for Medicaid plans to deny coverage for medically necessary transition-related care.
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To understand how to get access to the care that you need under your private insurance plan, check out NCTE’s Health Coverage Guide.ĭoes Medicaid cover transition-related care? However, many transgender people continue to face discriminatory denials. Your private insurance plan should provide coverage for the care that you need. It is illegal for most private insurance plans to deny coverage for medically necessary transition-related care. If you do not yet have health insurance, you can visit our friends at Out2Enroll to understand your options.ĭoes private health insurance cover transition-related care? What should I do to get coverage for transition-related care?Ĭheck out NCTE’s Health Coverage Guide for more information on getting the care that you need covered by your health plan. If her provider recommends gynecological care, coverage can’t be denied simply because she was identified as male at birth. For example, if a transgender woman’s health care provider decides she needs a prostate exam, an insurance company can’t deny it because she is listed as female in her records.
For example, an insurance company can’t automatically exclude a specific type of procedure if it covers that procedure for non-transgender people. An insurance company can’t place limits on coverage for transition-related care if those limits are discriminatory.For example, a health plan should not categorically exclude all coverage for facial feminization surgery or impose arbitrary age limits that contradict medical standards of care.
Excluding from coverage specific medically necessary procedures that some transgender people need is discrimination. Health plans can’t have a categorical exclusion of a specific transition-related procedure.For example, a health plan that says that all care related to gender transition is excluded violates the law. Health plans can’t have automatic or categorical exclusions of transition-related care.Here are some examples of illegal discrimination in insurance: This means, with few exceptions, that it is illegal discrimination for your health insurance plan to refuse to cover medically necessary transition-related care. Understanding Transgender People: The Basicsįederal and state law prohibits most public and private health plans from discriminating against you because you are transgender.Video: An Introduction to Transgender People.
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