On June 20, 2014 the Massachusetts Division of Insurance (DOI) issued a bulletin to insurers related to a law that went into effect July 1, 2012 that protects "gender identity" or "gender dysphoria" against discrimination.
In its bulletin, the DOI notes that discrimination on the basis of gender identity or gender dysphoria is prohibited. The DOI also acknowledged that the law did not specifically amend health insurance laws; however, the Division has concluded that insurers may not exclude transgender benefits such as medically necessary gender reassignment surgery.
How is Blue Cross Addressing This?
Our health plans already cover many services related to gender identity or gender dysphoria, including behavioral health services with a focus on gender identity and related issues, as well as hormone therapy. In addition, we are in the process of amending all of our insured health plans to remove the current benefit exclusion for a service or supply that is related to gender reassignment surgery.
This change will be effective immediately for all fully insured commercial plans, including Medex and Medicare Advantage.
We also intend to provide the benefit for our standard self-insured plans beginning January 1, 2015 on the anniversary date. If a self-funded account wishes to opt out of this benefit change and continue to exclude these services, we would recommend a careful consideration of this decision and consultation with their legal counsel.