California Department of Managed Health Care (DMHC) Reminds Insurers Not to Exclude SRS

The Department of Managed Health Care (DMHC) has sent a letter instructing insurers to review their policies and identify and correct any exclusionary language that would prohibit a transgender person from similar procedures available to non transgender persons.

These procedures include transitional costs and Sexual Reassignment surgery. Insurers have 90 days to submit the corrections for review.

Source: Transgender Law Center "The DMHC directive applies to HMOs and PPOs regulated by the Department of Managed Health Care. In 2012, the Department of Insurance issued non-discrimination regulations with similar protections for health insurance regulated by the Department of Insurance. Combined, this means that all California health plans and insurers cannot arbitrarily deny medically necessary services provided to other policy holders or members simply because the patient is transgender.

The newly issued DMHC letter instructs health plans to revise current plan documents to remove exclusions and limitations related to gender transition. For transgender people, how and when they transition is typically a private decision made with their doctor. The American Medical Association, American Psychological Association, American Psychiatric Association, and the American Academy of Family Physicians have all deemed transition-related care to be medically necessary for transgender patients."

Individuals with questions about today’s announcement or other questions about their health coverage should contact the Department of Managed Health Care’s Help Center at 1-888-466-2219 / http://www.HealthHelp.ca.gov.

The California Department of Insurance also offers consumer assistance at 800-927-HELP / http://www.insurance.ca.gov/contact-us/

Transgender Californian’s who experience discrimination or have legal questions should contact Transgender Law Center at 417.865.0176 x306/ http://www.transgenderlawcenter.org

For more information or interview requests please contact Mark Snyder, Communications Manager, 415.865.0176 x310, .mark@transgenderlawcenter.org

Transgender Law Center works to change law, policy, and attitudes so that all people can live safely, authentically, and free from discrimination regardless of their gender identity or expression. http://www.transgenderlawcenter.org


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