NewsCovering Colorado

Actions

Colorado health plans cover LGBTQ specific procedures and medications

Posted at 6:52 PM, Dec 11, 2018

DENVER – There are several new health plans available in our state specifically for members of the LGBTQ community. As the deadline to purchase health insurance next year through the state exchange approaches, the advocacy group One Colorado has released a trio of shopping guides to help their constituents see what is and isn’t covered in the various plans.

Executive Director Daniel Ramos explained that prior to the passage of the Affordable Care Act, many treatments and procedures sought by transgendered individuals were not covered because being transgendered was considered a pre-existing condition.

“And so, transgender people could be denied care by a provider or by an insurance simply because of who they are.”

He said that all changed in 2013 when the Colorado Division of Insurance codified prohibitions against discrimination by insurance companies based on sexual orientation.

The group searched through the various plans announced on the exchange to see how they comply with the non-discrimination mandate.

“We’ve gone through to make sure that insurance companies have removed those exclusions and that they, in fact, are offering comprehensive care which includes access to mental health, access to hormones and also access to gender-affirming surgeries on health plans on the Colorado exchange,” Ramos said.

Average annual premiums for health insurance plans sold on the Connect for Health Colorado insurance exchange will increase 5.6 percent in 2019.

Nick Voss of the Southern Colorado Equality Alliance in Pueblo said the guides are a valuable tool.

“You’re going to want to make sure that you have the plan that’s going to be able to cover you and help you afford your healthcare needs.”

So, what’s covered? According to the One Colorado guide, plans offered by Bright Health, Cigna, Denver Health, Anthem, Kaiser Permanente and Rocky Mountain Health plan all cover mental and behavioral health treatment,
gender-affirming surgeries and hormone therapies. Six of the seven providers also cover puberty blocking prescriptions. However, Rocky Mountain Health Plan does not.

Some doctors will prescribe medications to will delay the onset of puberty to adolescents diagnosed with gender dysphoria in order to give them the option of pursuing other gender modification treatment later in adulthood.

The plans also cover HIV prescriptions and certain drugs known as Pre-exposure Prophylaxis (PrEP) which can reportedly block HIV infection.

To be insured in Colorado on January 1, the deadline to enroll is Saturday, December 15. However, you can still enroll up until January 15 if you don’t mind the two-week gap in coverage.