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Kaiser Permanente Washington Agrees To Cover Transitioning-Related Care

Kaiser Permanente Washington must now cover breast augmentation, better known as implants, for trans women who have been prescribed them for gender dysphoria, after the company was hit with three official complaints.

The Washington State Office of the Insurance Commissioner (OIC) has announced an agreement with the insurer in the wake of an investigation over the company’s denial of medically-necessary care for trans people.

“People who are transgender should not be barred from medical treatments because of their gender identity,” said Insurance Commissioner Mike Kreidler, in a statement. “I’m glad the companies ultimately did the right thing to ensure they are treating their transgender enrollees fairly.”

Four years ago, Kriedler issued a letter to insurers laying out anti-discrimination protections for trans policyholders and reminding insurers that “denial of a medically necessary service on the basis of gender identity is prohibited under Washington state law.”

OIC lists breast augmentation among procedures that insurance companies are required to cover as part of a transition.

In January, transgender advocacy organization Gender Justice League (GJL) shepherded three complaints through the OIC. At the time, GJL reported that Kaiser said it offered the same coverage for trans women that it did for cisgender women. But advocates pointed out that Kaiser missed the mark because cisgender women didn’t need treatment for gender dysphoria.

GJL took Kaiser Washington to task over the denials on its Facebook page.

“The field of transgender medicine has been rapidly evolving over the last several years and so too does our approach, which will match the market in coverage,” Kaiser commented back. “We honor the feedback of our patients and members, are committed to reexamining our medical policy and to moving toward matching coverage that is market standard.”

According to the OIC, an investigation found that the company did not treat transgender customers as individuals but instead issued blanket denials.

The July 27 agreement between and Kaiser the OIC mandates that Kaiser Foundation Health Plan of Washington and the Kaiser Foundation Health Plan of Washington Options review all of their trans-related breast augmentation denials dating back to January 2016 no later than October 28.

GJL Executive Director Danni Askini celebrated the agreement in a public Facebook post.

“This is long overdue and a huge win against trans misogyny in trans health insurance policies,” she wrote on her page.

In a statement released to INTO, Kaiser said the company sees itself a nationally-recognized leader in LGBTQ healthcare.

“We are committed to continually improving the care and coverage we provide and will evolve our approach as the field of transgender medicine continues to evolve, informed by the Standards of the World Professional Association for Transgender Health, other published guidelines, and the needs of patients,” the company said. “Our goal is always to continually improve the equitable, compassionate, and high-quality care we provide for our transgender and non-binary members.”


Kate Sosin 

Kate Sosin is a trans news and features reporter and former associate editor of Chicago’s Windy City Times.

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