Coverage expanded: IVF treatments and gender reassignment surgery services

We have recently announced expanded coverage for the following services.

Infertility (IVF) treatments

Effective July 1, 2016, we will expand our infertility medical policy to cover in vitro fertilization (IVF) treatments for members who are not married. This change allows us to provide more members with coverage for IVF treatments and applies to individual, small group, and large group fully insured members.

Gender reassignment surgery services

Effective December 3, 2015, we updated our Gender Reassignment Surgery policy to cover gender confirmation surgery as a benefit under existing medical plans, for all fully insured members.

This benefit change accommodates new guidance from the Office of the Health Insurance Commissioner (OHIC) regarding the prohibition of discrimination on the basis of gender identity and expression. It also addresses Affordable Care Act (ACA) regulations prohibiting discrimination on the basis of sexual orientation in healthcare programs.

Additional information

See the policies linked to above for details. While these changes are currently in effect, they will not be reflected in members’ Subscriber Agreements until 2017. Members should direct any questions to customer service.

It is important to note that a letter will be sent to self-funded customers to explain these medical policy changes and how they can opt out of making them.