Jan 21, 2014
LGBT Health Care: What are the Options?
Many of us in the LGBT community have long been left out when it comes to health insurance. It has been too hard to find coverage that treats our families fairly, that covers the care we need, and that doesn’t break the bank. For the first time, under the Affordable Care Act, there are new affordable options, protections against discrimination based on sexual orientation and gender identity, and coverage even if you have a preexisting medical condition.
BREAKING: As of Monday, February 3, 2014, Blue Cross Blue Shield of North Carolina Will Provide Family Coverage for Same-Sex Couples and All Domestic Partners in ACA Plans. Learn more >>>
But the law's not perfect. So what are our options?
Check out the helpful discussion of local and national experts during Equality NC's January 20, 2014, Twitter Town Hall, "LGBT Health Care in the New Marketplace: What are Your Options?" Click here: http://storify.com/EqualityNC/nclgbthealth-twitter-town-hall.
TOP Three Marketplace FAQs for LGBT North Carolinians:
1. How does the Affordable Care Act's new marketplace help LGBT North Carolinians?
The law has been touted to help LGBT Americans, including North Carolinians, in the following ways:
AFFORDABLE HEALTH CARE. The ACA makes sure that affordable health insurance is available in every state to individuals and families who cannot afford expensive care. In general, fewer families with parents who are LGBT have health insurance than families in the general population because many employers do not offer coverage for same-sex partners or their children. It can be very costly for parents who are LGBT to insure their entire families. Thanks to the ACA, many more children with parents who are LGBT will be able to access the coverage that they need.
NONDISCRIMINATION. The ACA bans Health Insurance Marketplaces and the plans sold in them from discriminating on the basis of sexual orientation and gender identity. Families with parents who are LGBT will enjoy comprehensive coverage without being discriminated against based on whom they love or what their families look like. Transgender people will also have increased access to coverage without being denied based on their gender identity or expression.
PRE-EXISTING CONDITIONS. The ACA prohibits insurance companies from discriminating against people with pre-existing conditions such as cancer and HIV. Before the ACA, transgender people or people living with HIV could be dropped from or denied coverage. After January 1, 2014, people living with HIV will be able to get health coverage that includes their treatment plan, and being transgender will no longer be considered a pre-existing condition.
2. Can I enroll in family coverage with my same-sex spouse or partner?
As you know, laws vary from state to state on recognition of marriage equality and the marriages of same-sex couples. Similarly, there is no single standard for defining a “family” under Obamacare. As a result, states have different rules about family coverage, and insurance companies may have discretion in how they define “family” for their plans.
As a North Carolinian comparing plans through your Marketplace, you can look for plans that cover you and your spouse or partner together. This will depend on the way that the plan defines “family.” You can usually find this information by looking at the detailed plan documents available on your Marketplace website (these are often called a “Certificate of Coverage” or an “Evidence of Coverage”). If the plan won’t cover you and your spouse or partner together, you may be able to enroll as individuals.
3. What do I then look for when searching for health care coverage for myself or my family?
This is the tough part. Once you’ve completed your application and learned whether you are eligible for financial assistance, you’ll be able to make side-by-side comparisons of different health insurance plans.
But how do you know what you need? Strong Families – and 17 other organizations – have compiled a great guide called Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans. The guide provides a broad overview of factors to consider when shopping for coverage and questions to ask a navigator, certified assistance counselor, or insurance agent/broker. The questions will help you understand what is covered under a specific healthcare plan, and what it will cost. Questions address LGBT-specific healthcare needs, as well as more general healthcare questions.
Want to learn more? Visit at Out2Enroll.org.
OTHER RESOURCES
Family Equality Council
Family Equality Council connects, supports, and represents the three million parents who are lesbian, gay, bisexual, and transgender in this country and their six million children. The organization provides a guide meant to help couples and parents who are lesbian, gay, bisexual, and transgender, or LGBT, understand how the ACA benefits LGBT people and their families. The guide provides a basic overview of the Affordable Care Act, a review of how the act helps you and your family, and an explanation of how you and your family can access affordable health insurance.
Healthcare.gov
The much-talked-about Affordable Care Act website that features comparisons of health care plans and options, as well as an application and new enrollment options.
HHS.gov/HealthCare
Kathleen Sebelius, Secretary of Health and Human Services, outlines the real impact of Obamcare on LGBT health, including her department's 2013 White House Briefing on "Obamacare and the LGBT Community."
Out2Enroll
Coalition of organizations who want to help lesbian, gay, bisexual, and transgender people stay healthy by making sure that one of the major benefits of the Affordable Care Act – access to affordable, comprehensive health insurance coverage – reaches LGBT communities. Working with national, state, regional, and local partners to get the word out, help LGBT community members separate fact from fiction, and provide tools to help LGBT people make well-informed decisions and enroll in coverage that works for them.
Strong Families
In their fight for rights for diverse families, Strong Families has partner with 17 organizations to compiled a great guide called Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans. The guide provides a broad overview of factors to consider when shopping for coverage and questions to ask a navigator, certified assistance counselor, or insurance agent/broker. The questions will help you understand what is covered under a specific healthcare plan, and what it will cost. Questions address LGBT-specific healthcare needs, as well as more general healthcare questions.
ALSO RELATED
(BLOG) BREAKING: A Huge Victory for Our North Carolina Families
We did it! Blue Cross Blue Shield of North Carolina has reversed course and will now offer family coverage to same-sex couples under the Affordable Care Act.
(BLOG) It's Not Just About Health Care: How it Feels to Have Your Insurance Canceled for Being Gay and Married
Thomas Hafke and Chad Higby -- a married, same-sex couple from Moore County, NC -- made headlines last week when Thomas's insurance provider canceled their joint health care coverage upon learning his spouse was of the same gender. This is their story.