Gender Identity and Insurance Providers

[Imaginary Spiders]

I was wondering if someone could tell me if Fidelis covers gender identity and if so to what extent. I've been trying to find some information online, but can't seem to find their policies concerning transgenderism. In particular I want to know if they cover HRT and gender therapists costs. Also it would be helpful if someone could post a list of insurance providers that cover gender identity. Thanks.

[Ravin]

Any given insurance provider will have multiple plans, some of which may have transgender exclusions, and some which won't.

[VickySGV]

I have never heard of that insurance company before and would have to do some web work to find out and even then would likely get it wrong. It is going to be an almost individual thing from any insurance system. The first problem is who you have the insurance through, your job, state medical assistance (Medicaid), a private policy, a union, or _______. If it is your job or union, then their insurance desk / site is going to have your answer linked to this company. If it is a private policy, then it will be your insurance agent who can help you. The state will have its own information on it's websites. Some of what the insurance will cover also depends on your state to begin with. Each state has its own Department Of Insurance and an elected State Insurance Commissioner who regulates and licenses insurance companies to operate in their state. If your state requires an insurance company to provide full or partial insurance for Trans* people, the company will have the coverage, otherwise, it is very doubtful that they will, or it will be a battle to get it that more and more Trans* folk are winning over time.

My suggestion to you is simply call the company directly and with your policy number in hand, ask them what your policy may cover. It's a bite the bullet thing. You say you are in New York, and the state has gotten pretty good about TG things. In NY you will get what the state requires them to provide at a reasonable price. If you were in Oklahoma or South Dakota the same insurance company would not do that for you.

[Imaginary Spiders]

Thanks for your helpful advice. I did some research based upon you information. New York's policy is that insurance providers are required to cover all transgender services which are deemed medically necessary. This seemed hopeful. then I was able to find information for the insurance plan in question. I found a list of what they cover. It does not list gender identity or anything like that. It seems that the answer to my question is no sadly, but I need to contact someone to confirm this.

[VickySGV]

Don't rely solely on the booklet you were given. If the policy was sold in New York. you may have a booklet that is handed to people in Ohio which is less than friendly to TG people. See if you can get an appointment with a plan Behavioral Health person without mentioning the TG until you are talking to a therapist in person. They can get their billing staff to pay their bill, and may be qualified for your actual gender therapy or know someone who is. Once they determine things are medically necessary in your case, then the insurance company is in a different position. Gender issues being as small a part of the big picture as they are, you will probably have the coverage, but the IC is not advertising it.

[Imaginary Spiders]

The information I looked at wasn't state specific, so you could be right about that. I hope you are. I just basically wanted to make sure my new insurance provider covers HRT and gender therapists for when I get to that point if I do. Thanks for your advice.

[Carolyn Marie]

One thing about insurance plans; they probably list all the things they don't cover, but will rarely list everything they do cover. If New York requires that they cover it, and you don't see an exclusion for it, then they likely do cover it. What will be important is what they require to determine "medical necessity." That varies from one company to another. At minimum, you will likely need a letter from a doctor and/or a psychologist.

Good luck, hon.

Carolyn Marie