In March of last year, Colorado’s Division of Insurance issued a bulletin stating that state anti-discrimination laws extend to people with transgender status in regards to healthcare. This means that insurance carriers may not charge higher rates to people based on transgender status, they may not consider transgender status a pre-existing condition, nor can they deny, exclude, or limit coverage for any medically necessary services that would be provided to another individual. This bulletin was a huge step forward for the transgender community in Colorado, as these individuals often struggle to find appropriate care and face a lack of sufficient health coverage solely because of their transgender status.
Colorado HealthOp, followed by Kaiser Permanente, were the first insurance carriers in Colorado to embrace the bulletin and announced that they will cover health services for transgender Coloradans.
In December 2013, the Colorado Association of Health Plans (CAHP) was the first trade group in the country to release a statement that their members will cover medically necessary services for transgender individuals. CAHP has a membership of eleven health insurance carriers that provide coverage for over 3 million Coloradans. CAHP’s members are Anthem BlueCross BlueShield, Cigna, Colorado HealthOp, Colorado Access, Colorado Choice Health Plans, Denver Health Medical Plan, Humana, Kaiser Permanente, Rocky Mountain Health Plans, SeeChange, and UnitedHealthcare In the press release, CAHP Executive Director Ben Price stated that,
“We would like all consumers to know that they can shop for health insurance coverage with confidence. All CAHP member carriers are conducting a thorough review of their coverage and processes to ensure they will cover medically necessary services for transgender individuals to the same extent that those services are covered for non-transgender individuals enrolled in the same benefit plan.”
We were excited to see CAHP publicly announce that its members will provide the same eligibility rules, premiums, and benefits to all individuals regardless of gender identity or sexual orientation. However, carriers are not required to provide certain procedures or treatments; as long as they are excluded for every policyholder, carriers can legally choose to exclude certain services from their plans. Therefore, when shopping for coverage, check the details of the plan’s Evidence of Coverage (EOC) or Summary of Benefits and Coverage (SBC) to ensure that the plan will provide the coverage you need before you buy it.
Gender identity exclusions may still be listed on insurance plans’ EOCs, as many of them were written before the rule clarifications were issued. Just because the exclusions are written into the policies does not necessarily mean they are still in effect, as carriers are working toward ensuring that they are following state anti-discrimination laws and removing the exclusions from future EOCs. To check if the EOC is up to date, contact the insurance carrier.
CCHI will continue to work towards expanded access to health coverage for all Coloradans, regardless of sexual orientation or gender identity.