Transgender healthcare coverage: Prevalence, recent trends, and considerations for payers

The post originally ran on Milliman, Inc. on July 28, 2016.
Recently, the concept of gender identity and what it means from a health insurance coverage perspective has been receiving increased attention. This paper lays out recent trends, including recent federal and state laws affecting health insurance benefits for transgender individuals. We also examine health insurance clinical coverage policies related to gender reassignment surgery as well as prevalence estimates. Finally, we provide future considerations for healthcare payers, including appropriately capturing data relevant to the healthcare needs of the transgender population.
According to the U.S. Department of Health and Human Services (HHS), the term “gender identity” is defined as:
…an individual’s internal sense of gender, which may be different from an individual’s sex assigned at birth. The way an individual expresses gender identity is frequently called ‘‘gender expression,’’ and may or may not conform to social stereotypes associated with a particular gender. Gender may be expressed through, for example, dress, grooming, mannerisms, speech patterns, and social interactions…an individual has a transgender identity when the individual’s gender identity is different from the sex assigned to that person at birth; an individual with a transgender identity is referred to in this part as a transgender individual.1
In most cases, to qualify for gender reassignment surgery, a patient...

Source: Disruptive Women in Health Care - September 9, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Transgender Healthcare Uncategorized Source Type: blogs