Medicare lifts ban on gender reassignment surgery

By Marie Blake,

Sex reassignment surgery coverage can no longer be automatically denied by Medicare, a federal health department appeals board ruled.

Medical Daily reports that the Department of Health and Human Services Appeals Board shut down the policy which denied these procedures be covered by Medicare.

For 33 years, Medicare patients who wished to have gender reassignment surgery were denied coverage, due to the fact that the procedure was deemed experimental and controversial.

Seventy-four-year-old Army veteran, Denee Mallon, brought his case to the appeals board in 2012. A doctor recommended the operation for Mallon, but Medicare denied coverage.

In the ruling, posted on Scribd, the Department of Health and Human Services Appeals Board stated: "The Board has determined that ... denying Medicare coverage of all transsexual surgery as a treatment for transsexualism is not valid under the reasonableness standard the Board applies."

The Associated Press reports that the new ruling does not mean everyone is eligible to have their surgery covered by the government, however.

Jennifer Levi, lawyer and director of the Transgender Rights Project of Gay & Lesbian Advocates and Defenders in Boston, stated that the new policy only means individuals can submit paperwork from doctors and mental health professionals who recommend the surgery.

Coverage will not be immediately granted for everyone who applies, but the ruling means the government cannot automatically deny patients' claims.

According to the Transgender Law Center in Oakland, California, gender reassignment surgery can range from $7,000 to $50,000.

The new ruling, however, does not apply to Medicaid, in which the state provides health coverage for low-income individuals and families. Some states have different rules regarding whether the operation is an option or regulates what drugs are available.



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