Transgender Legal Defense and Education Fund and Cohen Millstein Sellers & Toll, a national civil rights law firm, announced a deal with health insurance provider Aetna to expand the insurance carrier’s medical coverage of transition-related care for transgender women.
On its website, Aetna announced it had “expanded coverage of gender-affirming surgery to include breast augmentation for transfeminine members of most of its commercial plans” and included the caveat, “subject to plan terms and other requirements.”
TLDEF wrote in its press release, “According to a national study, more than half (55%) of transgender people who sought coverage for transition-related surgery in the past year were denied.”
Aetna describes the announcement as “a collaboration between Aetna, TLDEF, Cohen Milstein, and several transgender beneficiaries.” The company wrote in its press release that four trans women “brought access-to-care issues to Aetna’s attention after being denied coverage for breast augmentation as part of their gender-affirming treatment.”
Brought those issues to the company’s attention? Threatened a lawsuit? Both sides are being much more polite than that. Aetna thanks the attorneys for being so collaborative and TLDEF thanks Aetna for updating its policies.
“Our decision to update our clinical policy bulletin is consistent with many changes we have made over the years to better serve the needs of the LGBTQ community,” said Dr. Jordan Pritzker, senior director of clinical solutions for Aetna. “We appreciate the collaborative nature of this process, which allowed us to make an evidence-based change to our coverage policies regarding important care for members of the LGBTQ community.”
“Aetna has been an industry leader in providing access to medically-necessary, transgender-related health care coverage, and we commend them for continuing to lead by example,” said TLDEF Executive Director Andy Marra. “Eliminating this exclusion is a vital step towards providing comprehensive and medically-necessary care that all transgender people deserve to ensure their health and wellbeing.”
While all sides are talking about expanded access to breast augmentation for trans women as part of Aetna’s coverage, we’ll see if Aetna comes up with “other requirements” to deny coverage. Oh, wait. An insurance company would never do that. They only want what’s best for their clients.
— David Taffet
