Access to Health Care

Equality Virginia believes everyone should have proper access to healthcare, regardless of sexual orientation or gender identity and expression, in a manner the aligns with their needs and identity.

Current Status

The Affordable Care Act provides multiple protections for the LGBT community in Virginia. However, transgender Virginians often face discrimination from health care or insurance providers.

FAQs on the Affordable Care Act ►
The Affordable Care Act (ACA) was signed into law in 2010 by President Obama with the goal of increasing the quality and affordability of health insurance in the United States. The ACA contains several sections which provide protections for LGBT individuals seeking healthcare.

Can I enroll in family coverage with my same-sex spouse or partner?

Yes. In March 2014, the federal government clarified that health insurance providers cannot refuse to offer coverage to a same-sex spouse if they offer coverage to an opposite-sex spouse.

  1. What protections exist against discrimination towards LGBT individuals?

The Affordable Care Act prohibits discrimination against LGBT individuals by anyone who works with the Marketplaces, including employees and insurance companies offering plans for sale.

Insurers are not allowed to offer plans that discriminate against individuals based on their sex, gender identity, sexual orientation, or health condition.

  1. What protections exist specifically for transgender individuals?

Under the Affordable Care Act, it is illegal for any health program or organization that is funded or administered by the federal government to discriminate against you because you are transgender. The following places or programs may be covered by this law: hospitals, physicians’ offices, nursing homes, etc.

  1. What medical services will be covered?

If you are a transgender individual, you have the right to expect that your plan will cover the services you need, so long as they are covered for other people on your plan. Depending on the plan, these services may or may not include surgical procedures related to gender transition.

Always read the full explanation of which services are covered or excluded before choosing a health insurance plan.

  1. What protections exist for hospitals?

Joint Commission hospital accreditation standards require hospitals to have internal policies prohibiting discrimination based on gender identity and sexual orientation.

  1. How do I file a complaint of discrimination based on sexual orientation or gender identity?

If you believe that you have been discriminated against, you may file a complaint with the Department of Health and Human Services’ Office for Civil Rights (OCR) within 180 days of when you knew the discriminatory action occurred. The person making the complaint does not have to be the person who experienced discrimination; someone else, like a friend or family member, may file a claim on your behalf.

Complaints with HHS’s Office of Civil Rights must be filed in writing, either by mail, fax, or email.

  1. How do I file a complaint against a hospital?

If you have encountered discrimination based on gender identity or sexual orientation by a hospital, you may also file a complaint with the Joint Commission, which accredits most hospitals. You can submit a complaint online at http://www.jointcommission.org.

  1. What services will Medicare provide?

Medicare covers routine preventive care for all eligible individuals. Additionally, Medicare covers medically necessary hormone therapy.

In May 2014, Medicare changed its policy to allow coverage decision for transition-related surgeries to be made individually on the basis of medical need, similar to other services under Medicare.[1]

  1. How do I file a complaint or appeal with Medicare?

Information about filing a complaint or appeal with Medicare can be found on Medicare’s website at https://www.medicare.gov/claims-and-appeals/index.html.

[1] http://www.hhs.gov/dab/decisions/dabdecisions/dab2576.pdf

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