Feds Order Insurance Companies to Provide Mammogram Coverage for Men Who Have Undergone Sex Change Ops
[Editor’s note: the following fair-use excerpt is from ultra-liberal Thinkprogress.org] Transgender people face two prominent hurdles to equitable health care: coverage of procedures related to their actual gender transition (hormones, surgery, etc.) and coverage of sex-specific procedures that are as important for transgender people as for others, like mammograms, prostate exams, and cervical Pap tests. New guidance issued this week from the Departments of Health and Human Services, Labor, and the Treasury affirms that insurance companies must provide the services in this second category without discriminating on the basis of gender identity.
When a doctor or other health care provider determines that an exam is medically appropriate for a patient, the guidance instructs, “the plan or issuer must provide coverage for the recommended preventive service, without cost sharing, regardless of sex assigned at birth, gender identity, or gender of the individual otherwise recorded by the plan or issuer.” A talking point memo accompanying the guidance offers, “This means, for example, that a transgender man with an intact cervix can get coverage without cost sharing for a pap smear, if recommended by his provider. . .”
In the 2011 National Transgender Discrimination Survey, a full 50 percent of respondents reported that they had postponed pursuing preventive care services because they could not afford it. This included a transgender man who was told by Blue Cross of California, “Unfortunately we are unable to process claims for one member under both genders,” and thus he could not be covered for procedures related to his anatomy. One 55-year-old transgender man was denied coverage for a bone density scan because according to the insurer’s policies, only women could qualify as “at-risk” for osteoporosis. Another transgender man sought treatment for an infection from an LGBT-friendly health provider; when he asked for additional preventive services, he was told that because his documents identify him as male, it wasn’t possible to submit a claim for a Pap test without compromising coverage for the other tests and treatments he received related to the infection. (Read more from “Feds Order Insurance Companies to Provide Mammogram Coverage for Men Who Have Undergone Sex Change Operations” HERE)
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