HHS rules Medicare must provide gender affirmation surgery

Posted on 01 Feb 2016 at 1:47pm
Official portrait of the Secretary of Health & Human Services Sylvia Mathews Burwell

HHS Secretary Sylvia Mathews Burwell

The Department of Health and Human Services ruled that a private insurance company that provides coverage under the Medicare Advantage program must cover a transgender person’s gender affirmation surgery. Charlene Lauderdale, a 55-year-old Texan covered by United Healthcare through Medicare Advantage, filed the lawsuit.

HHS lifted a ban on transition-related coverage in May 2014, but didn’t specify how that would apply to gender-affirming surgery.

HRC Legal Director Sarah Warbelow called it “a tremendously important step towards helping ensure that transgender people who rely on Medicare are no longer denied access to the basic, yet crucial, medical care they need.”

In September, HHS issued rules that insurers couldn’t deny coverage for trans-related healthcare. This ruling, however, is the most specific interpretation the department has issued.

Lauderdale is a former airport operations officer for the Houston aviation department, according to her Facebook page.

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