Insurance Coverage for Gender Dysphoria?

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  • Insurance Coverage for Gender Dysphoria?
  • Posted by on January 6, 2015

There has recently been increased media coverage regarding issues of “gender dysphoria”. Now, it appears that there may be insurance coverage for the condition as well. Gender dysphoria, or gender identity disorder, is a condition where persons experience discomfort with the gender or gender roles assigned by their biological sex. The causes are many, including hormonal, chromosomal and psychiatric. Whatever the cause, the condition often results in the need for medical treatment on the part of the dysphoric. When medical treatment is required, and medical insurance is mandated, will medical insurance cover gender dysphoria treatment? In New York, the answer is “yes.”

The New York Department of Financial Services has informed health insurers that medically necessary treatment for gender dysphoria may not be denied. DFS superintendent Benjamin M. Lawsky was quoted: “We hope this action sends a powerful message that discrimination against transgender people will not be tolerated. Transgender New Yorkers deserve the same access to essential health care as every other New Yorker.” Insurance carriers may still review gender dysphoria treatment to determine medical necessity, but may not discriminate. Insureds whose treatments are reviewed and denied are guaranteed the full range of appeal rights under New York Insurance Law and Public Health Law.

Each state has different rules and regulations, but this looks like the beginning of a nationwide trend.

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