LGBTQ health insurance tips

Various segments of the LGBTQ Community face health care expenses and health circumstances most Americans (and employers) never consider - and as a result we have to start to shop smarter for our health care. And the considerations the “community” has are as diverse as the people in it. Here are a few examples:

LGBT Couples & Families

New protections under the Affordable Care Act (think “Obamacare”) and the end of DOMA eliminate discrimination against LGBT individuals and their families, which means that families with LGBT parents can no longer be charged higher rates for insurance. As long as you have been legally married, insurance companies must offer the same coverage they offer opposite-sex spouses, regardless of which state you live in or where the insurance company is located. More info about this here.

As a couple, you also have access to premium tax credits to help pay for insurance. Just make sure to file your taxes jointly in order to receive these discounts.

Transgender Persons

Thanks to recent policy changes, transgender individuals now have access to health insurance, no matter their identity when buying a plan or how their identity changes over time.

If you’re a transgender person looking for surgical help along your path, you’ll want to make sure you choose coverage that makes reassignment procedures economically feasible, and stay on top of pre-approval requirements. Some insurance companies require a diagnosis of Gender Identity Disorder before covering a transition, and others deem that the Affordable Care Act’s mandate to cover behavioral- and mental- health related treatment doesn’t include gender reassignment procedures... We recommend anyone who is pre- OR post-transition consult with one of our support specialists who can help you find a plan that covers your transition.

Please note: The Affordable Care Act and insurance carriers alike ignore the gender reality of transgender or intersex people on their application forms, even as the ACA itself prohibits such discrimination. We don’t think this is right, but we’re committed to helping you figure out how to apply for the best coverage despite the discrimination - although to get prices for your insurance we are still forced to identify an applicant as “male” or female.”

Bisexual Men and Women

According to HRC, male and female bisexuals are more likely to be victims of domestic violence or rape than similar humans who happen to be gay, lesbian, or straight. While not addressed by the same study, the incidence of abuse of transgender people is likely even higher. Escaping any abusive situation is challenging for a number of reasons, and the government tries to help by giving you special concessions if you’ve suffered abuse; this usually includes buying a new, personal health plan. You’ll need an affidavit (a signed and dated letter in your own voice) to get some of those concessions.

Fortunately, our customer experience team has had great success getting people’s affidavits accepted as qualifying documentation - which means uncomfortable or demoralizing visits to the police station won’t be required to help you get health care while you’re trying to heal and get back on your feet. Email our support team if you need help.

Also remember that treatment for mental health disorders like depression (which bisexuals experience at higher rates than homosexual or heterosexual populations) should be covered by any qualified health plan, by law.

Is Your Employer’s Plan Helping? Or is yours?

There are a lot of ways employer group plans can be good for LGBTQ patients. For example, many group plans cover gender reassignment treatments ONLY IF your employer specifically negotiates for it. But if you don’t have faith in your employer’s devotion to getting you coverage for your transition or your HIV-prevention or treatment regime, consider switching to an individual plan. Sometimes, by choosing moreefficient coverage, you can spend less on a “cheaper” plan outside of your employment, but still get the coverage you need - this is where those data scientists I mentioned come in. Our team has built our recommendation engine to help you see what your health insurance reality is with a personalized recommendation that takes your personalized drugs, doctors, and conditions into account - AND lets you specify a same-sex spouse.

Bottom Line

LGBTQ, intersex, and/or gender nonconforming people have to be smarter about healthcare, because insurance plan designs aren’t meant to serve you well. Let’s be smarter together.

Author’s note: If you’ve suffered abuse - as far too many of our LGBTQ, intersex, and/or gender nonconforming compatriots do - please contact us at support@stridehealth.com and let us help you demonstrate that your exceptional circumstances qualify you for new coverage and perhaps a federal subsidy.

Photo cred: torbakhopper