Yale Health extends sex-reassignment coverage to students

The Yale Health Plan will now cover sex-reassignment surgeries for students, joining fellow Ivy League schools Harvard, Brown and the University of Pennsylvania in offering insurance for the procedure.

The extended insurance — which was granted to faculty and staff in 2011 and to unionized workers in January — covers expenses related to a medically necessary sex-reassignment surgery “subject to preauthorization based on widely accepted standards of care.” The coverage change will go into effect Aug. 1 and is part of multiple updates to the student plan announced by Yale Health in a Thursday email to the Yale College community.

Although the surgery is infrequently used, the extended coverage is a significant signal to potential applicants that Yale is committed to providing equal-access health care, said Grace Zimmerly ’13, an advocate for sex-reassignment surgery coverage.

“While Yale was not among the first schools to repeal its coverage exclusion, we hope that this represents a commitment to catch up to our peers in terms of offering transgender students an equitable student life and health care experience,” said Gabriel Murchison ’14, a member of the Resource Alliance for Gender Equity.

Each sex-reassignment case will be approved on an individual basis, but Yale Health will use commonly accepted guidelines, which generally require a mental health assessment and a period of hormonal therapy and/or living in the desired gender role, University spokesman Tom Conroy said.

“This additional student coverage follows a period of several years when similar coverage was provided to Yale employees,” Conroy said. “It made sense, after appropriate study, to bring the student coverage in line with Yale’s belief that, in some circumstances, sex-reassignment surgery is medically necessary and appropriate.”

Murchison said he considers the coverage “reasonably comprehensive,” but added that students considering the surgery must have access to qualified mental health professionals and not be “coerced” into hormone therapy, a typical requirement for sex-reassignment surgery.

In addition to the sex-reassignment change, two revisions to mental health policies will remove a waiting period previously required for inpatient care and will increase mental health coverage for children of students, though outpatient counseling — which includes psychiatry visits, therapy and other services for students not admitted to Yale Health facilities — has not been changed.

The modification of inpatient coverage will allow students admitted to Yale Health facilities for mental health or substance abuse to receive 60 days of continuous treatment, said Michael Rigsby MED ’88, medical director of Yale Health. Previously, students still received 60 days of coverage per year but were required to take a 180-day interim period after the first 30 days.

The number of covered visits related to mental health for children of students enrolled in the Yale Health Plan has also been increased from 16 to 25, Rigsby said.

One sophomore, who requested to remain anonymous because she has used mental health resources, said the mental health policy revisions will have no effect on the mental health services used by most students.

“I think it is a pretty hollow gesture since it is not at all a response to what the real mental health needs are for students,” said the student. “Outpatient care is exclusively what students use.”

In another update to the Yale Health Plan, Rigsby said that students no longer have the option of waiving prescription coverage — which includes partial coverage of pharmacy charges as well as psychiatric and substance abuse services for admitted patients — as it will be combined with the hospitalization and specialty coverage insurance that is required for students who do not purchase outside coverage. The decision to package prescription coverage with hospitalization and specialty coverage was made in part to comply with the Affordable Care Act and because students without prescription coverage potentially face “extremely large” out-of-pocket costs for prescription drugs, he added.

While hospitalization and specialty coverage was priced at $810 and prescription coverage at $180 per term this year, the total plan will cost $1,020 per semester next year.

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