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. Denying coverage for care typically associated with one gender: It’s illegal for an insurance company to deny you coverage for treatments typically associated with one gender based on the gender listed in the insurance company’s records or the sex you were assigned at birth.Refusing to enroll you in a plan, cancelling your coverage, or charging higher rates because of your transgender status: An insurance company can’t treat you differently, refuse to enroll you, or limit coverage for any services because you are transgender.For example, if a plan covers breast reconstruction for cancer treatment, or hormones to treat post-menopause symptoms, it cannot exclude these procedures to treat gender dysphoria. 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:
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This means, with few exceptions, that it is illegal discrimination for your health insurance plan to refuse to cover medically necessary transition-related care.
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Video: An Introduction to Transgender People.