Medicaid Coverage Exclusions for Transgender RI'ers Removed

The state Department of Health and Human Services announced last week that the state’s Medicaid program has removed coverage exclusions for transgender Rhode Islanders.

The changes “will allow many people to get the care they need. It’s an important step towards addressing the healthcare disparities that impact trans* Rhode Islanders,” said Ethan Huckel of TGI Network, an organization that advocates on behalf of transgender, gender-variant and intersex people. “We applaud HHS Secretary Elizabeth Roberts and Governor Gina Raimondo for their leadership in bringing our Medicaid policy up to date and ensuring that every Rhode Islander has the potential to live a happy, healthy, and productive life.”

The changes do not require private health insurance companies to provide the same coverage as Medicaid and most private plans still do not include coverage for transgender people seeking sex reassignment surgery, hormone therapy or behavioral health services.

But GLAD and TGI said that the Medicaid changes are a step in the right direction.

““The guidance will be life-saving for transgender Rhode Islanders on Medicaid,” said Jennifer Levi, director of the Transgender Rights Project for Gay & Lesbian Advocates & Defenders (GLAD). “Unfortunately, all too often transgender people cannot get insurance programs to cover essential medical services. This guidance should change that.”

Under the new coverage guidelines, members over 18 will be covered for behavioral health, hormonal therapy, lab testing and a variety of surgical procedures after prior authorization.

Rhode Island is the 10th state in the union to update its Medicaid policy to better serve transgender Medicaid members.