Topic: Aetna grows coverage for gender-affirming surgeries for transgender women

[Laura1951]

Aetna grows coverage for gender-affirming surgeries for transgender women


https://www.fiercehealthcare.com/payer/aetna-grows-coverage-for-gender-affirming-surgeries-for-transgender-women

Fierce Healthcare by Paige Minemyer on January 27, 2021

Aetna is expanding coverage for gender-affirming surgeries for transgender women.

The insurer will now cover gender-affirming breast augmentation in most of its commercial plans, the CVS Health subsidiary announced this week. The change came as a result of a collaboration between Aetna, the Transgender Legal Defense & Education Fund (TLDEF), Cohen Milstein Sellers & Toll law firm and several transgender Aetna members.

[JamieH]

we need legislation that insurers don't get to decide what is medically necessary or not and leave that to the doctors.  If a doctor prescribes a treatment it should be covered, period.  Good step by Aetna but not nearly far enough. 

It's like telling people ok we'll put a stent in your arteries that will open them by 20% but the other 80% isn't medically necessary so you have to come out of pocket for a bigger stent if you want to like really not have a heart attack.

The argument that its' too much money and will raise everyone's premiums etc is baloney.  Trans people are what, 0.5% of the population based on best estimates (surely higher but for argument's sake).  Some don't seek any surgery, some only a few, and some full boat.  Paying for trans people's care is barely a rounding error on their books.