With Medicare lifting its 33-year ban for gender-reassignment coverage this past May, the transgender population is hoping to see similar landmark changes in other federal insurance policies.
Although Medicare is the first coverage of its kind to include sex changes, the procedure was previously embraced by several private and public university insurance plans, including CU’s Gold Plan.
Joining about 50 other U.S. universities, CU has included gender-reassignment surgery in their insurance policy for the past three years. The transgender population makes up about 0.3 percent of the U.S.
“We have tried to be ahead of the curve,” said Alexis Cook, CU’s student insurance coordinator. “Our plan has been Affordable Care Act-compliant since before the bill was enacted, and this lift of the Medicare ban has been positive in this area, [lending] support to the benefit of our plan.”
Considered a recognized treatment for gender-identity disorder, the Gold Plan covers $10,000 per year for surgical expenses and has hormone and mental health therapy covered under separate medical policies.
To be eligible, an applicant would have to abide to the World Professional Association for Transgender Health guidelines, which is required by AIG, CU’s current insurance provider.
WPATH standards include two letters from mental-health providers, taking hormones for up to two years prior and living as the desired gender for at least a year before the surgery. Before an applicant receives the green light, CU sends this information to the insurance company for pre-determination.
The length of the process depends on how familiar the student is with these requirements.
“Some students come and they are very aware of standards, have documentation, have been taking hormones, are ready to go,” said Cook. “In that scenario they could usually have their surgery in the next three or four months.”
Other students are less knowledgeable, coming with questions about pricing, standards and the overall process, so there are several levels of interaction between a student and the Gold Plan prior to any decisions.
“We facilitate the process — we aren’t their surgeon or the insurance company, so we work in an advocacy role more than anything else,” said Cook. “We make sure everything gets done properly.”
CU’s inclusion of same-sex surgery preceded a federally-funded insurance program by three years. But there are still some internal problems.
Katherine Alex Matthews, an 18-year-old international affairs major, explains how the initial eligibility process can be conflicting.
“It’s so great they cover this, but there is still the issue of gatekeepers,” she said. “If someone decides that you aren’t trans, then what do you do?”
The price of the plan could also compromise a student’s decision. At $1,695 a semester, only 6,048 people out of CU’s 31,702 students subscribe to the Gold Insurance Plan.
“CU Gold is really out of reach for students in general,” said Matthews. “Students seeking this surgery are more likely unemployed, making this policy even more out of reach for them.”
Matthews touches on the fact that the transgender unemployment rate is on average double the population’s as a whole (14 percent compared to 7 percent nationally), making those who would most benefit from the policy less likely to be able to afford it.
Despite its flaws, CU worked to include gender-reassignment surgery not out of necessity but by choice.
“There was no regulation or requirement that this benefit needed to be apart of the plan at the time, but was something we added in the interest of our students,” said Cook. “Our interest is in providing the benefits that our students need and want, and making sure the plan stays viable in affordability.”
Contact CU Independent Staff Writer Jenna Smith at jenna.smith@colorado.edu
