September 10, 2024
Three transgender women sued Aetna Life Insurance Co. Tuesday for allegedly denying them coverage for medically necessary gender-affirming facial reconstruction surgeries.
Aetna’s categorical exclusion on the treatments constitutes discrimination on the basis of sex in a federally funded health-care program in violation of Section 1557 of the Affordable Care Act, a proposed class action complaint filed in the US District Court for the District of Connecticut said. Aetna generally provides payment for facial reconstruction surgery for diagnoses other than gender dysphoria, and also covers other gender-affirming care, such as chest reconstruction, the plaintiffs said.
. . .
Medical professional groups have deemed facial reconstruction surgeries medically necessary for trans people and distinguished them from cosmetic procedures because they’re meant “solely to align a person’s facial characteristics with their gender identity, and not to ‘improve’ appearance,” the plaintiffs said. The surgery is “an essential component of their gender transition,” they said.
Aetna’s policy is facially discriminatory because it treats transgender people differently from cisgender people, for whom it covers facial reconstruction surgery to treat other medical conditions, the plaintiffs said.
. . .
Wardenski PC, Transgender Legal Defense & Education Fund Inc., and Cohen Milstein Sellers & Toll PLLC represent the plaintiffs.
Read Aetna Hit With Class Action Over Gender-Affirming Care Pay.