Industry moves against transgender discrimination

Aetna will provide benefits for gender reassignment surgery next year for federal employees in its customer base, The Washington Post reported. While health insurance benefits have not historically been available for this surgery, Aetna's announcement is one of several signs that what's been considered transgender discrimination in health insurance is making a gradual exit.

Insurance regulators in eight states prohibit discrimination against transgender patients and treatments for gender reassignment, and mainstream medicine has recognized gender identity disorder as a diagnosable condition. The U.S. State Department announced it would drop the coverage exclusion from its largest health plan, which covers about 31 percent of its workforce, The Post noted. Medicare reversed its ban on coverage for gender reassignment surgery earlier this year in response to a lawsuit. Then in June, the federal government said it would no longer prohibit its health plans from covering gender reassignment. While this wasn't a benefits mandate, it created an opening for insurers.

"Aetna has long been supportive of the LGBT community. Moving to include transgender reassignment surgery in our plans is consistent with other changes we have made to better serve their needs," said Wayne Rawlins, M.D., M.B.A., Aetna's national medical director for thought leadership, in an email to FierceHealthPayer.

Rawlins went on to point out that in early 2009, Aetna became the first major health benefits company to add gender reassignment surgery as a benefit for its employees and any contracted companies choosing to add it to their benefits package.

Costs of gender reassignment vary depending on the extent of intervention. While hormone therapy costs hundreds of dollars annually, surgery can run in the tens of thousands of dollars, The Post reported. Yet employer groups who added gender transition-related coverage to their plans report low levels of claims experience, the newspaper noted.

Aetna has about 250,000 federal employees nationwide in 33 health plans, a corporate representative told FierceHealthPayer in an email. The insurer also plans to include transgender surgery benefits in many of its fully-insured commercial products going forward, pending state regulatory approval.

For more:
- here's The Washington Post article