University includes additional health plan coverage for transgender members

Monday, April 22, 2019 - 6:18pm

All University of Michigan health plans will cover facial feminization surgery, permanent hair removal and Adam's apple reduction for transgender health plan members.

All University of Michigan health plans will cover facial feminization surgery, permanent hair removal and Adam's apple reduction for transgender health plan members. Buy this photo
Max Kuang/Daily

Effective July 1, all University of Michigan health plans will cover facial feminization surgery, permanent hair removal and Adam’s apple reduction for transgender health plan members.

Rackham student Monica Lewis, chair of the Graduate Employees’ Organization Trans Health Caucus, wrote in an email statement to The Daily that the coverage of FFS is an incredible step forward in the fight for trans health equity. Various transgender surgeries and medical procedures have long been considered cosmetic by many insurance plans. However, the University is taking steps to recognize the necessity of these procedures as more than cosmetic.

“I am also deeply thankful to GEO’s allies who have stuck with us throughout this difficult and emotionally charged campaign,” Lewis wrote. “I could not be happier to hear that U-M and Blue Cross Blue Shield (sic) have finally come around to see our perspective. Transition is not cosmetic, and it makes me very hopeful to see people’s minds change so much on this matter.”

When reached for comment, University Public Affairs directed The Daily to a University Record article regarding the expansion of coverage. According to the article, the University decided to identify the additional services as medically necessary after a recommendation from University clinicians and policy experts. These experts considered medical evidence and benefits at peer institutions and corporate employers in a recent review of coverage for gender-affirming services.

Health plan members must use in-network providers and meet medical-necessity criteria to be covered for the services. The coverage will exist up to a $30,000 lifetime limit, which refers to the total dollar amount providers would spend on benefits while enrolled in the plan. The addition of facial feminization surgery to the plan includes forehead contouring and reconstruction, mandible contouring and reconstruction, rhinoplasty, genioplasty, blepharoplasty and lip lift via alar base excision. University health plans already cover mastectomy in female-to-male transition, genital surgery, hormone therapy and counseling when medically necessary.

In January, GEO representatives met with Human Resources representatives and the MHealthy Advisory Committee to discuss the coverage of gender-affirming surgeries. Lewis said the committee collectively put in hundreds of hours researching and advocating for the procedures. Lewis said seeing the work pay off means a lot to the committee.

“We did everything in our power to force trans voices into a conversation that was initially reluctant to hear them,” Lewis wrote. “Our meeting between members of the trans community and the University’s Medical Benefits Advisory Committee is the most prominent example of bringing in trans voices. I honestly believe that minds were changed, and it makes me so happy to know that a point of mutual understanding was reached about why the ‘cosmetic’ label formerly used to justify the exclusion from coverage was wrong.”

According to Lewis, two items brought forward in the discussion — speech therapy and breast augmentation surgery — are still not covered by the University health plan. Lewis said GEO does not believe their work is finished and will continue to advocate for trans coverage until the procedures are also covered.