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August 18, 2017 at 07:04 AM
Health insurers in New York may not discriminate or deny coverage for transgender and gender-nonconforming individuals, the Cuomo administration reminded insurers yesterday.
According to a letter sent to health insurers Wednesday from the state’s Department of Financial Services, it had “come to the attention” of Superintendent Maria Vullo that some health insurers may be denying claims of transgender individuals “because the gender with which the individual identifies does not match the gender of someone to whom those services are typically provided.”
(Related: Transgender Clients and Disability Insurance)
For example, the letter written to insurers by Lisette Johnson—the health bureau chief at the DFS—said a female who identifies as male may be denied coverage for gynecological services because the insured is anatomically male. “Similarly, a male who identifies as a female may be denied a claim for prostate cancer screening because the issuer’s information indicates that the insured is anatomically a female,” Johnson wrote.
The letter reminded insurers that although a health insurer may request additional information regarding a medical service, the insurer may not deny a claim because it does not have sufficient information to pay the claim.
“An issuer should not deny a claim for a health service provided to an individual because the individual is seemingly not of the gender to whom the service is typically or exclusively provided without seeking additional information to determine whether the service was appropriately provided to the individual,” the letter said.
In a statement, Vullo said, “Transgender persons should not be discriminated against and denied health insurance coverage because of their transgender status nor denied treatment simply due to insurance coding issues.”
