LGBT Task Force Examining Transgender Insurance Coverage
Posted September, 30 2015 by Hannah Lupien
Guest post: Lois Uttley, Director, Raising Women’s Voices – NY
The NYS Department of Financial Services issued a Circular Letter in December 2014 requiring private health insurance plans in our state to cover all medically-necessary care for treatment of gender dysphoria. With the one-year anniversary of this policy approaching, the LGBT Task Force of Health Care for All New York (HCFANY) is determining whether private health insurance plans are complying with this policy.
The LGBT Task Force is inviting transgender individuals, as well as their clinicians and advocates, to share their experiences with us and with state officials at “listening sessions” to be held this fall in three locations: New York City, Albany and Rochester. The goal of these sessions is to identify systemic problems with insurer compliance with the transgender coverage policy, so that we can work with state officials and insurers to address the problems. The sessions will be invitation-only and will not be open to the public or media for confidentiality purposes. We are taking special steps to ensure the comfort of transgender individuals who are willing to testify.
The listening sessions are planned to highlight the wide range of challenges transgender individuals experience when trying to use their private health coverage to obtain needed care. For example, such problems might include difficultly obtaining pre-certification approval, denials of coverage for surgical procedures and lengthy appeal processes.
If you have a recent story about how you, your client or your patient has had difficulty obtaining approvals for private health insurance coverage of transgender care, please fill out the form at https://www.surveymonkey.com/r/NYTransHealth, and a Task Force member will get in touch shortly. Please note that these experiences must have taken place since December 2014, when the new policy was issued, and must concern private insurance coverage, not Medicaid coverage (which we will analyze in a later stage of this process). Please direct all Medicaid stories to the email NYtransSurvey@gmail.com, and Task Force members will reach out to you in the next phase of this project.