Doc ImpossibleDec 20, 2022

Umm... This is kind of a big deal.

If this ruling stands, it'd mean that basically every health insurance plans in America (because of the health insurance marketplace) would be required to cover everything WPATH SoC8 deems medically necessary.

Which is... *everything*.

Holy crap.

https://www.lambdalegal.org/news/cp_wa_20221219_court-rules-that-bcbs-cannot-administer-health-plans-with-gender-affirming-exclusions

VICTORY: Court Rules that Blue Cross Blue Shield of Illinois Cannot Administer Health Plans with Gender-Affirming Care Exclusions

“Third-party administrators that accept federal funds cannot discriminate when administering employer-sponsored health plans.”

Lambda Legal
Show threadDoc ImpossibleDec 20, 2022

So uhh, let's break this down.

The ruling is based directly on Bostock's sex protections. It means that even plans which are fully paid by the employer would be bound by this, as long as whichever company runs the processing takes even one red cent of federal money.

The ruling will definitely be appealed to the SC. But unless Roberts and Gorsuch reverse their positions in Bostock, I think this one stands.

Show threadDoc ImpossibleDec 20, 2022

Overwhelmingly, fully funded insurance plans are administered by big corps, like BCBS or Aetna. All of those companies take federal $.

All of them. Because of the Health Insurance Marketplace.

And once the standard is on medical necessity, the definitive worldwide standards is WPATH SoC8. Which, if you want to check coverage, I did a write up a few months ago (https://stainedglasswoman.substack.com/p/what-do-wpath-standards-of-care-8).

Or you can check this list. **Everything's** on it.

What do WPATH Standards of Care 8 actually say?

From The Blue Bird App

Stained Glass Woman
Show threadEmily 🏳️‍⚧️Dec 20, 2022
@Impossible_PhD Oh heck it covers laser and electrolysis. I wonder if I can file a claim for the laser I started months ago. I don't think Milan has any insurance handling arm though.
Show threadEri ⟭⟬ 💜⟬⟭
@EmilyGB20 @Impossible_PhD they won’t bill insurance directly. You get approved for the service with your insurer. The. You get the service. You keep your detailed receipts and submit to your insurance for reimbursement. It actually requires folks to at least have the first part of the payment upfront before reimbursement but it’s something
Dec 21, 2022 at 1:16pmWeb
Show threadDoc ImpossibleDec 21, 2022
@MKE_BTS @EmilyGB20 Or you can submit the itemized receipts after service for reimbursement.
Show threadEri ⟭⟬ 💜⟬⟭Dec 21, 2022
@Impossible_PhD @EmilyGB20 in our experience the hair removal places both Milan and small businesses would not do the service without upfront payment even with insurance approval. Had to get reimbursement after.
Show threadEri ⟭⟬ 💜⟬⟭Dec 21, 2022
@Impossible_PhD @EmilyGB20 thinking about this playing forward, perhaps that would change with this insurance ruling knowing that services must be covered 🤔