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Vermont Requires Insurers To Cover Transgender Healthcare Needs

Last week, the Vermont Department of Financial Regulation, Division of Insurance issued a bulletin clarifying key protections for transgender Vermonters in health insurance. The bulletin clarifies that Vermont law prohibits gender identity discrimination in health coverage, including through the use of exclusions limiting benefits for medically necessary services provided to transgender people.

The bulletin prohibits health insurers doing business in Vermont from unfairly excluding coverage for the care that transgender people need. The bulletin specifically states that:

  • Medical necessity remains the fundamental standard of care and legal requirement for treatment provided to transgender people.
  • Insurers cannot exclude coverage for medically necessary health care services for transgender people, including transition-related surgeries and other care provided for gender dysphoria and related conditions.
  • Plans offered through Vermont’s Health Benefits Exchange are covered by the bulletin.

The bulletin also recognizes that the Affordable Care Act prohibits discrimination on the basis of gender identity in any health program receiving federal funds or by an entity established under the ACA, including Health Insurance Marketplaces.

Vermont joins a growing number of states, Including California, Colorado, Oregon, and the District of Columbia, in recognizing that removing unfair discrimination from health insurance does not raise costs, and is invaluable in helping transgender people lead healthy and authentic lives. Similar antidiscrimination policies are supported by expert medical bodies who say that the care provided to transgender people, including transition-related health care, is medically necessary for many patients.

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Read the full bulletin and the FAQ.