In NYS, More Medicaid Coverage for Transgender Services

Dec 8, 2016

Increased coverage for transgender medical care and services are taking effect for Medicaid plans in New York.

The Department of Health has established that young people, under the age of 18, will now receive coverage for hormone therapy deemed medically necessary, according to the notice filed in the NYS Register.

“Sometimes individuals under the age of 18 require medications in order to bring their mind and their body into alignment with each other,” says Dr. Katherine Blumoff Greenberg, director of the Gender Health Services clinic at the University of Rochester Medical Center.

One in four transgender people experience problems with accessing health care services, according to a new report released by the National Center for Transgender Equality.

Greenberg says insurance coverage for hormones and surgery has been markedly improving over the four years that she has been providing health care to transgender patients.

“However, there were still holes in which of the managed care plans would pay for hormones in patients under the age of 18. This will bring everybody into alignment with our standard of care,” she adds.

The Department of Health also changed Medicaid benefits to include coverage for gender reassignment surgery, for people over the age of 18, who meet certain criteria.  But insurance coverage for surgery doesn’t necessarily equal access.

“Access to surgeons will still be problematic. There are relatively few providers doing these surgeries in the country and no one currently -- although there are plans to have surgeons come on line -- in the New York state system,” Greenberg  says.

These coverage benefits are set to take effect immediately.