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TRANSGENDER HEALTH: KNOW YOUR RIGHTS
The Affordable Care Act (“Obamacare”) provides better health security by implementing comprehensive health insurance reforms that serve to enhance the quality of care.
Additionally, California’s Department of Health Care Services (DHCS) assures residents that all Medi-Cal beneficiaries can access transgender services, including hormone therapy, labs, and non-cosmetic gender confirmation surgeries.
If you have problems with your insurance carrier, talk to one of our trans navigators for help with resolving the issue. For assistance call 760-800-8736.
What Laws Protect Me?
Federal Protections
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The Affordable Care Act (ACA) prohibits sex discrimination, including anti-transgender discrimination, by most health providers and insurance companies, as well as discrimination based on race, national origin, age, and disability. Under the ACA, it is illegal for most insurance companies to have exclusions of transition-related care, and it is illegal for most health providers to discriminate against transgender people, like by turning someone away or refusing to treat them according to their gender identity.
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The Health Insurance Portability and Accountability Act (HIPAA) protects patients’ privacy when it comes to certain health information, including information related to a person’s transgender status and transition. It also gives patients the right to access, inspect, and copy their protected health information held by hospitals, clinics, and health plans.
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Medicare and Medicaid regulations protect the right of hospital patients to choose their own visitors and medical decision-makers regardless of their legal relationship to the patient. This means that hospitals cannot discriminate against LGBT people or their families in visitation and in recognizing a patient’s designated decision-maker.
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Joint Commission hospital accreditation standards require hospitals to have internal policies prohibiting discrimination based on gender identity and sexual orientation.
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The Nursing Home Reform Act establishes a set of nursing home residents’ rights that include the right to privacy, including in visits from friends or loved ones; the right to be free from abuse, mistreatment, and neglect; the right to choose your physician; the right to dignity and self-determination; and the right to file grievances without retaliation.
State Protections
State and local nondiscrimination laws prohibit health care discrimination against transgender people in many circumstances.
A large number of states also have explicit policies that prohibit anti-transgender discrimination in private insurance and Medicaid, like exclusions of transition-related care.
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California: Private Insurance (PPO regulation, HMO general guidelines and HMO guidelines on surgery coverage) and Medi-Cal
Remember: Just because your state isn’t listed here doesn’t mean you’re not protected. Check out NCTE’s Health Coverage Guide for more information about getting coverage for the care that you need.