California Department of Managed Health Care Letter on Nondiscrimination Based on Gender, Gender Identity, or Gender Expression

This April 2013 letter from the California Department of Managed Health Care affirms the department’s implementation of Assembly Bill 1586, prohibiting health insurance plans from discrimination based on gender, gender identity, or gender expression.

Significantly, the letter affirms that California law requires health plans “to provide transgender individuals with the same contracts and coverage benefits that are available to non-transgender individuals.”

Managed care health plans in California are now required to review and remove all current benefit and coverage exclusions and limitations related to gender transition services within 90 days, and no later than July 9, 2013.

Thanks to the Transgender Law Center for making the letter available.

This entry was posted in Lesbian, Gay, Bisexual and Transgender Health. Bookmark the permalink.

2 Responses to California Department of Managed Health Care Letter on Nondiscrimination Based on Gender, Gender Identity, or Gender Expression

  1. rma1202 says:

    So does this law prohibit insurance plans from denying coverage for gender reassignment surgery?

    Sent from my iPad

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  2. Ignatius Bau says:

    Eventually it will, but there is still some resistance to the fact that gender-conforming surgery would be “medically necessary” for some transgender individuals, even though the American Medical Association, American Psychological Association, American Psychiatric Association, American Academy of Family Physicians, American Congress of Obstetricians and Gynecologists, Endocrine Society, National Association of Social Workers, and World Professional Association for Transgender Health have all concluded that such surgery would be medically necessary for those transgender individuals. So individuals may still have to make the case, or appeal their specific denials, with their health plans on this medical necessity justification. However, the new guidance prohibits blanket denials for all transgender health services.

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