Surprised this hasn't been posted yet!
I have been searching and searching for the past few weeks for any updates on the OPM website, but they are so slow in updating. 

However, a quick google search led me to the following article:
http://www.washingtonpost.com/blogs/federal-eye/wp/2014/10/13/state-department-ends-transgender-exclusion-from-health-plan/

For year 2015, the transgender exclusion has been REMOVED for those eligible for the Foreign Service Benefit plan offered by American Foreign Service Protective Association (AFSPA).

Employees from the following agencies will be eligible to choose from this plan:

1. Department of State
2. Department of Defense
3. Agency for International Development
4. Foreign Commercial Service
5. Foreign Agricultural Service
6. Department of Homeland Security
7. Central Intelligence Agency
8. National Security Agency
9. Office of Director of National Intelligence (ODNI)
10. Executive Branch civilian employees assigned overseas or to U.S. possessions and territories; and the direct hire domestic employees assigned to support those activities. 

Note: Executive Branch includes all Federal civilian employees except those working for the Legislative (Congress) or Judicial (Courts) Branches of the Federal government. Direct hire employees and Executive Branch civilian employees must enroll in the Foreign Service Benefit Plan when actively employed to retain or choose the Plan in retirement. Only annuitants who are eligible under the Foreign Service Retirement System may enroll in this Plan as annuitants. 


Here is a link to the American Foreign Service Protective Association website:
https://www.afspa.org/

Here is a link to the 2015 FEHB plan brochure from AFSPA:
https://www.afspa.org/home/pdfs/2015-FSBP-Brochure.pdf

So EXCITING!  Hope other insurance providers follow suit!  I myself am with the Dept. of Defense and will definitely be switching my insurance plan this coming open season!!!

Thanks, this is great information, being a federal employee I wasn't happy with what my current provider covered and was looking to make a change during the next open season. I will have to look into this!

I'm not allowed to release the chart comparing all the plans we have examined so far (grumble, grumble).  But I can point out that only some federal employees are eligible for the Foreign Service Benefit plan.  Since it is tailored for people who spend a lot of time overseas, those who tend to stay in the US may wish to consider other plans.  They might want to take a look at the plans offered by Aetna. 

Depending on where they are located, they may also want to look at some of the plans offered to their own local areas.  That is not limited to states that have mandated trans* inclusive coverage. 

Hope that's helpful. 

There were a couple posts back when it was announced last Summer, but news has been quiet about it since then.

Unfortunately the OPM has only removed the exclusion and is encouraging FEHB insurers to cover transition costs (likely limited to GRS, hormones, and counseling).  That means that each plan by region can choose to provide the coverage or not.  Non-USFPW Federal health plan brochures are supposed to be available for review, during the first week of November, with Open Season starting November 10.  Usually plans are available for review sooner, so I was checking every day until the OPM health plan announcement.  I'm not certain how it works for Federal Postal Workers or some others.

In 2014 Kaiser NorCal and SoCal Kaiser were the only Federal plans that covered transition costs, perhaps because Kaiser is a California based insurer and may have determined they were required to follow the state's DMHC ruling.

Hopefully we'll all have some good plan options available to us for 2015 and onward.

Freya

Quote from: Freya on October 16, 2014, 11:52:15 PM
There were a couple posts back when it was announced last Summer, but news has been quiet about it since then.

Unfortunately the OPM has only removed the exclusion and is encouraging FEHB insurers to cover transition costs (likely limited to GRS, hormones, and counseling).  That means that each plan by region can choose to provide the coverage or not.  Non-USFPW Federal health plan brochures are supposed to be available for review, during the first week of November, with Open Season starting November 10.  Usually plans are available for review sooner, so I was checking every day until the OPM health plan announcement.  I'm not certain how it works for Federal Postal Workers or some others.

The American Postal Workers Union Plan is one of the ones I reviewed personally.  It still contains the exclusion.  There is still a possibility of last minute plan changes, but that information was current as of October 11, 2014. 

By the way, I'm free to answer questions like this to the extent that we have info.  I am not free to share the entire chart because (1) it's not complete yet and (2) the president of one of the organizations involved is very concerned about having one of his people review the chart personally for errors for fear that his organization would be held accountable for possible errors. 

Quote
In 2014 Kaiser NorCal and SoCal Kaiser were the only Federal plans that covered transition costs, perhaps because Kaiser is a California based insurer and may have determined they were required to follow the state's DMHC ruling.

For 2014, OPM actually required insurers to include the trans* exclusion.  Kaiser requested, and received, an exemption from that requirement.  I don't recall the details of why they made that request.  I think it may have been that they wanted to offer consistent coverage throughout the state of California.  In that case, no, they were not required to comply with the state law when there was a conflicting federal requirement.  Federal law always trumps state law.  But they may have wanted to avoid issues like, for example, having two apply two different sets of requirements depending on whether the healthcare policy was a federal plan or anyone else's. 

Quote
Hopefully we'll all have some good plan options available to us for 2015 and onward.

Freya

Overall, the results are looking pretty disappointing so far.  Since OPM made the exclusion optional, insurers are free to say "thanks, but we'd rather exclude trans* people."  Most of them have done exactly that.  After all, insurers stay in business by covering what they must by law or to be competitive in the marketplace.  But they don't usually want to cover things they don't have to. 

The way to get the coverage is to get your agency and have them ask the insurers who cover their agencies to provide it.  It's basic business at that point.  Companies stay in business by providing what their customers want to buy.  That's true of insurers just as it is if anyone else.

I don't want to be publicly posting movement strategy on a message board.  But if you want to talk about how you can work with your agency LGBT groups to make that happen, please feel free to PM me.

Yes, overall the results do look pretty disappointing so far.  I have also reviewed a bunch of different insurance providers changes and plan brochures for 2015 and of the ones available currently to look at online, the Foreign Service Benefit plan was the only one that had removed the exclusion.  However, it remains to be seen what the remaining providers will do...I'm definitely still holding out hope, but who knows.

As ThePhoenix had already stated, by OPM giving insurers the option to remove the clause (or not to) most of them will find it much easier to keep the exclusion in their plans as they have done so for the past however many years.

Quote from: ThePhoenix on October 16, 2014, 08:35:15 PM
I'm not allowed to release the chart comparing all the plans we have examined so far (grumble, grumble).  But I can point out that only some federal employees are eligible for the Foreign Service Benefit plan.  Since it is tailored for people who spend a lot of time overseas, those who tend to stay in the US may wish to consider other plans.  They might want to take a look at the plans offered by Aetna. 

Depending on where they are located, they may also want to look at some of the plans offered to their own local areas.  That is not limited to states that have mandated trans* inclusive coverage. 

Hope that's helpful. 

The Foreign Service benefit plan does sound like it is catered more towards federal employees located overseas, however a new change outlined for their 2015 plan states that members will have access to doctors, hospitals, and health care professionals that participate with the Aetna Choice POS II (open access) Network.

Please see the following websites for more info and for a list of healthcare providers who currently participate with Aetna Choice POS II (open access):
http://fsbp.coventryhealthcare.com/member-support/locate-a-provider/index.htm?
http://www.providerlookuponline.com/coventry/po7/Search.aspx

I received a private message from a person about this thread.  Unfortunately I deleted my original forum account some months ago and only resubscribed a few days ago, so the system considers me a newbie.  I am being reminded that I cannot respond to private messages as a result.  So I apologize to that person and suggest that the person contact me at marylandtransunity@gmail.com if they wish to receive a response.

Thanks.

Quote from: Kaley on October 17, 2014, 12:46:43 PM
Yes, overall the results do look pretty disappointing so far.  I have also reviewed a bunch of different insurance providers changes and plan brochures for 2015 and of the ones available currently to look at online, the Foreign Service Benefit plan was the only one that had removed the exclusion.  However, it remains to be seen what the remaining providers will do...I'm definitely still holding out hope, but who knows.

As ThePhoenix had already stated, by OPM giving insurers the option to remove the clause (or not to) most of them will find it much easier to keep the exclusion in their plans as they have done so for the past however many years.

The Foreign Service benefit plan does sound like it is catered more towards federal employees located overseas, however a new change outlined for their 2015 plan states that members will have access to doctors, hospitals, and health care professionals that participate with the Aetna Choice POS II (open access) Network.

Please see the following websites for more info and for a list of healthcare providers who currently participate with Aetna Choice POS II (open access):
http://fsbp.coventryhealthcare.com/member-support/locate-a-provider/index.htm?
http://www.providerlookuponline.com/coventry/po7/Search.aspx

Aetna has always been the underlying insurer.  I don't know the specifics of the Aetna network through which the FSBP plan provided insurance.  It may be that there is a switch from one Aetna network to another.  But it was always Aetna once you drill down beneath AFSPA, Coventry, etc.

Like I said, people who want trans* inclusive care should definitely take a look at Aetna plans for 2015. 

I personally have reviewed the Plan Brochures for Blue Cross Blue Shield and Government Employees Health Association, Inc. Benefit Plans and they both still contain the exclusionary language.  I have a friend who was covered by BCBS of Idaho which contained the exclusionary language but was able to have her surgery covered by appealing the decisions.

I am so disappointed because I thought that 2015 was finally going to be the year where the insurance companies finally relented.   

 

Quote from: ThePhoenix on October 17, 2014, 09:38:51 PM
Aetna has always been the underlying insurer.  I don't know the specifics of the Aetna network through which the FSBP plan provided insurance.  It may be that there is a switch from one Aetna network to another.  But it was always Aetna once you drill down beneath AFSPA, Coventry, etc.

Like I said, people who want trans* inclusive care should definitely take a look at Aetna plans for 2015. 

Ohh, ok, I see.  Did not know Coventry was also using Aetna.  Seemed like they were different, but then again you are much more well informed on the topic then I am so thanks for the heads up!

So anyways, I have reviewed the brochures for the Aetna plans and all the ones available to me have indeed removed the transgender exclusion.  Super good news!!!!  However, I'm really confused as to which plan I should choose if I were to go with Aetna.

For my geographic area Aetna offers me a choice from the following 4 plans:
1. Aetna Value Plan ($77.08 biweekly premium - self only - non postal rate), Deductible of $600
2. Aetna Healthfund HDHP w/ HSA ($56.71 biweekly premium - self only - non postal rate), Deductible of $1500
3. Aetna Healthfund CDHP ($138.50 biweekly premium - self only - non postal rate), Deductible of $1000
4. Aetna Direct ($52.51 biweekly premium - self only - non postal rate), Deductible of $1500

I am really confused about which plan would be my best option.  Seems like they all have pretty high deductibles (ranging from $600 to $1500 for the self only plans).  As it stands currently my main use for the plan would be to get my meds covered as well as periodic exams, blood tests, and to pay for a therapist. Not sure exactly what will fall under the deductible portion of the plan and what won't...guess I need to read a lot more into these plans.  I currently have a prescription for spironolactone that costs me $7 to fill (30 day supply) and I get delestrogen injections administered by a health professional every 2 weeks (paying the out of pocket price of $40-ish every 2 weeks because they don't even want to try to bill my insurance as they say it will be rejected no questions asked).  Blood tests have been periodic and have always been covered in full by my current insurance company.

So confused by these Aetna plans....not even sure which would work the best for me in my current situation.  Also, the thing that worries me about the Aetna value plan is the cost...$77.08 biweekly premium.  It is $25 more every 2 weeks than I am currently paying for health insurance (with NO deductible through HMSA) and is $17 more every 2 weeks than the Foreign Service Benefit Plan (which also has a fairly low deductible of $250).

Gahhhhhhh!!!  Help please!  So confused by all these insurance terms and stipulations! =(

I'm sorry, but that type of dilemma is one that I'm unable to help with.

Quote from: ThePhoenix on October 18, 2014, 10:24:17 PM
I'm sorry, but that type of dilemma is one that I'm unable to help with.

I figured, but just thought I'd ask!  Oh wells, guess I will just need to do a lot more research on the options available to me before the end of next month!  Definitely super excited such options now exist for federal employees...it's been a long time coming!

Quote from: ThePhoenix on October 17, 2014, 09:38:51 PM
Aetna has always been the underlying insurer.  I don't know the specifics of the Aetna network through which the FSBP plan provided insurance.  It may be that there is a switch from one Aetna network to another.  But it was always Aetna once you drill down beneath AFSPA, Coventry, etc.

Like I said, people who want trans* inclusive care should definitely take a look at Aetna plans for 2015. 

Thank you for the heads up! 

Quote from: SarahJ on October 17, 2014, 10:54:24 PM
I personally have reviewed the Plan Brochures for Blue Cross Blue Shield and Government Employees Health Association, Inc. Benefit Plans and they both still contain the exclusionary language.  I have a friend who was covered by BCBS of Idaho which contained the exclusionary language but was able to have her surgery covered by appealing the decisions.

I am so disappointed because I thought that 2015 was finally going to be the year where the insurance companies finally relented.   

I have BC/BS, and they have been great to me as they cover HRT, therapist, and testing even when they list "sex transformation" procedures and medicines as not covered. I called customer service to correct the error with no success.

However, I will have to seriously take a look at options this year as they removed our local hospital from our preferred provider list . Not looking forward to this at all.

I started a new thread in the Political and Legal News section titled "2015 FEHB Plan Brochure Links and Info" to try to gather info into a more organized matter for everyone!  Here is a direct link to the new thread topic if interested: https://www.susans.org/forums/index.php/topic,175560.0.html

Somebody posted about the regular FEHB plan some time ago.

Unfortunately, the new policy comes years too late for me. I wonder if anyone has ever successfully sued the feds for exclusionary policies and gotten a settlement years after the fact. I highly doubt it, but I could sure use the extra money!