With LGBTQIA+ awareness at the forefront of the national conversation, you may be wondering whether health insurance plans provide inclusive care. Is gender affirmation care covered? At Wellfleet, we place a strong emphasis on keeping our policies and coverages up-to-date to meet the ever-changing nature of inclusive care needs.
In this blog, learn about our coverage and benefits that affirm the health needs of LGBTQIA+ students.
Our approach to inclusive care
Because our health plan focuses on college-aged students, we are experts at providing care that meets the unique needs of this age group. With 5.1% of adults younger than 30 and 2.3% of all U.S. adults identifying as transgender, nonbinary, and gender expansive, providing care that meets all students’ needs is of the utmost importance.1
As an insurer that specializes in student health, we provide coverage at the most pivotal point in the life of a student who is ready to transition and seek gender-affirming care. Our experience sets us apart.
Because Wellfleet is the largest health plan devoted solely to college students, we understand the healthcare needs of different subgroups on campus, including the LGBTQIA+ group.
What is gender-affirming care?
Gender-affirming care is provided for transgender, nonbinary, and gender expansive individuals who feel their biological sex is misaligned with their gender identity.2 Care includes a diverse mix of social, psychological, behavioral, and medical interventions to support a person’s gender identity.3
Gender-affirming healthcare can include:
- Mental healthcare: Therapy and support resources can help individuals feel happy and supported in their gender identity.
- Hormonal treatments: Individuals can take medications that provide hormones aligned with their gender identity.
- Surgical treatments: After individuals have been living as their gender identity for a certain amount of time, they may pursue male-to-female, female-to-male, or gender nullification surgical options, including:
- Top surgery
- Bottom surgery
- Facial feminization or masculinization
- Care management: This service can help students navigate their care and access the resources and specialists who can provide the care that’s right for them.
Coverage of gender-affirming care
At Wellfleet, our commitment to providing inclusive care for LGBTQIA+ students is evident in our student health plans, which include comprehensive coverage for gender-affirming care.
The base plan we offer to our schools includes the following:
- Non-procedural outpatient care (no precertification required), including:
- Behavioral healthcare
- Hormonal treatments
- Laboratory testing
- Speech therapy
- Preventive health
- Tracheal shave (chondrolaryngoplasty)
- Top surgery (precertification required)
- Bottom surgery (precertification required)
Additionally, we offer the option for schools to add coverage for facial feminization surgery if desired. They may also choose to add fertility preservation coverage, where eggs or sperm are collected and stored for future use
What criteria are used for covering gender-affirming care?
When creating Wellfleet’s guidelines for coverage of gender-affirming care, our clinical team conducted thorough research and analysis of the WPATH 8 guidelines, and we have continued to update our guidelines as new recommendations surface. We will continue to stay abreast of changes and new research, striving to be leaders in gender-affirming healthcare.
Artificial insemination coverage
In addition to our gender-affirming benefits, another element of our inclusive care initiative is coverage of artificial insemination. This procedure allows AFAB couples to reproduce using a sperm donor. While we’re happy to offer, this procedure, it will only be covered when a school elects it as part of an enhanced infertility coverage option for all members.
Benefits of choosing Wellfleet for inclusive healthcare coverage
Because Wellfleet deals exclusively with students, we specialize in offering the right care and coverage for the young adult population.
Since most health plans cover a wide range of ages, their care centers around adults and seniors — as your chance of having a chronic condition increases with age.4 Thus, many health plans tend to focus on managing chronic conditions like COPD, cardiovascular disease, diabetes, arthritis, and cancer.
However, at Wellfleet, we focus on caring for the health needs of young adults, including:
- Sports injuries
- Mental health conditions
- Acne and other skin conditions
- Reproductive care
- Gender dysphoria and gender incongruence
- Autoimmune conditions
We strive to be leaders in driving positive change to stay at the forefront of the industry because we understand the ever-changing student healthcare landscape. That’s why we’re committed to fostering innovation and continuously updating our policies to ensure the best possible coverage for our student members.
Learn more about Wellfleet Student
Now that you know more about Wellfleet’s approach to inclusive care, contact our team to learn more about creating a health plan built for your students.
This document is intended for marketing purposes only. The information contained herein is non-binding, may vary by plan, and is subject to change without notice. For a complete listing of covered services or procedures, please contact our Customer Service Department.
1 Brown, A. (2022, June 7). About 5% of young adults in the U.S. say their gender is different from their sex assigned at birth. Pew Research Center. https://www.pewresearch.org/short-reads/2022/06/07/about-5-of-young-adults-in-the-u-s-say-their-gender-is-different-from-their-sex-assigned-at-birth/
2 Gender identity is a person’s internal sense of their gender. It can be the same as the sex assigned at birth (cisgender) or different (transgender).
3 Boyle, P. (2022, April 12). What is gender-affirming care? Your questions answered. AAMC. https://www.aamc.org/news/what-gender-affirming-care-your-questions-answered
4 National Center for Health Statistics. (2015, November 6). Percent of U.S. Adults 55 and Over with Chronic Conditions. CDC. https://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm#:~:text=The%20s ix%20possible%20chronic%20conditions,three%20or%20more%20chronic%20conditions