SPRINGFIELD - Health care insurance providers must pay for medical needs of transgender clients, the state of Illinois informed providers Tuesday.
In the announcement, the Illinois Department of Insurance cited Illinois law and the federal Affordable Care Act, notifying private insurers that they must not discriminate and must provide transgenders the same medical treatment available for non-transgender policy holders.
The non-discrimination notice means that in order for insurance companies to be certified and able to sell policies in Illinois, they must cover hormone therapy and regular blood tests for transgenders as they do for post-menopausal women. The providers must also cover breast reconstruction surgery for transgenders as they cover female clients after surgery for breast cancer.
However, the announcement does say that sex change surgery may be "excluded from excepted benefit policies and grandfathered health plans."
And how to handle mental condition treatment is spelled out in the bulletin:
"State providing coverage for hospital or medical treatment and for the treatment of mental ... conditions provide no more restrictive limitations on treatment for mental conditions, such as gender dysphoria or gender identity disorder, than the predominant treatment limitations applied to substantially all hospital and medical benefits covered by the policy and that there are no separate treatment limitations that are applicable only with respect to mental ... condition benefits."
Three Illinois groups, including Lambda Legal Foundation and the Illinois ACLU, applauded the Department of Insurance's public policy statement.
"Denial of healthcare coverage for needed medical treatment is far too common, especially for transgender people," said Owen Daniel-McCarter, Legal Director for the TransLife Center at Chicago House, told the Windy City Times.
"Private insurance companies can no longer deny transgender individuals, often through explicit exclusions written into the policies, the medical and mental health care that is routinely provided to non-transgender policy holders. We applaud the state of Illinois for making clear that such denials are a violation of Illinois law."