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Insurance Company Refused to Pay for Transgender Teen's Health Care

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A major insurance company is refusing to pay for a trans teenager’s health care

LGBTNation by Molly Sprayregen on December 3, 2020

The family of a transgender teen is suing his insurance company for denying coverage for his gender-affirming care. They charge it is a violation of the Affordable Care Act.

Lawyers for 15-year-old C.P., as he is referred to in court records, filed a complaint in Tacoma, Washington against Blue Cross Blue Shield of Illinois (BCBSIL). The complaint says BCBSIL denied coverage to C.P based on an exclusion in the terms of his health plan, which stated that benefits would not be provided for anything “for, or leading to, gender reassignment surgery.”


Unequal health coverage for transgender youth and adults is problematic.

This is unfortunate and all too common.

All health insurance companies offer many different plans. You must read the plan to see if it covers transgender surgery or not. Blue Cross Blue Shield in my state offers a one time coverage of GCS.

For my edification, does anyone know the current state of WPATH standards as it relates to surgery for underage trans patients?



--- Quote from: sarahc on December 07, 2020, 08:44:58 pm ---For my edification, does anyone know the current state of WPATH standards as it relates to surgery for underage trans patients?


--- End quote ---

I'm unaware of WPATH changing anything in the Standards of Care.

The timing of the request for services and subsequent lawsuit could have been better.  With the pandemic waging throughout the world insurance claims are through the roof.  As access to doctors, emergency rooms and surgery facilities have been dramatically curtailed people have been putting off getting treated and conditions that could have been treated for a couple of hundred dollars end up costing an insurance company 10s of thousands of dollars instead.  Many insurance companies are likely to pay out more than they take in. Insurance premiums are likely to be increased to cover all the conditions they currently cover to make up for their losses.

For every elimination of an exclusion 1000s of people would line up to take advantage of the increased coverage.  Lifting an exclusion could cost an insurance company tens of miliion dollars a year.  No one including those asking for exclusions want their premiums raised so that everyone can get all the care they want.  I support increased transgender coverage but unsure how it can be accomplished. It will be interesting how the lawyers proceed and what positive or negative outcomes it may have on the transgender community.

This is a touchy case.  Slowly but surely our community is garnering limited support inside the insurance companies, other businesses, governments and our neighbors.  Real support will likely require many more years.  Transgender advocacy could exponentially increase that support if done with great care. Unfortunately there is no unity amongst us so the public will get a scattershot of advocacy attempts. Some might further our cause but most will likely fall flat and we might actually loose some supporters as a consequence.


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