California has laws that ban discrimination and guarantee access to health care without regard to a person’s sexual orientation or gender identity. However, that doesn’t mean it’s always easy to get the health care we need, when we need it. Add on top of that the efforts at the federal level to undermine access to health care, and you may be feeling lost about the current state of health care rights.
The following are common questions and answers about accessing health care for LGBTQ Californians.
Will insurance companies or doctors be able to discriminate against LGBTQ patients?
No. California law bans health insurers and providers – both private and public – from discriminating against individuals based on sexual orientation or gender identity. LGBT Californians cannot be denied coverage or care because of their sexual orientation or gender identity.[i] These protections are based in state law and will stand regardless of what happens at the federal level.
Federal regulations currently protect Americans from denials or limitations on health coverage based on gender identity [ii] and guarantee the rights for patients to designate their visitors at hospitals that receive federal funding regardless of sexual orientation, gender identity, or legal relationship status. [iii]
Will I be able to access transition-related health care?
If you have insurance, California regulators require health insurers to provide coverage for all medically necessary health care procedures for transgender people that are otherwise covered for cisgender people. [iv] If you lose insurance, you would likely have to pay out of pocket, which could cost tens of thousands of dollars. If your insurer denies your procedure, you have a right to appeal that decision. Call 1-888-466-2219, or visit the Department of Managed Health Care Help Center for more information about filing a complaint.
If you need to sign up for insurance, visit CoveredCA.com to find affordable coverage that fits yours and your family’s needs. Eighty-five percent of Covered California enrollees receive financial assistance to pay for health coverage.
I am HIV-positive. Will I lose access to drugs or other healthcare?
The Ryan White Program, which is an important safety net to guarantee access to life-saving health care for people living with HIV, enjoys broad bipartisan support. That support will be important to ensure that Congress fully funds the Program to fill in the gaps left by the potential loss of coverage for thousands of people living with HIV who are covered by the ACA. [v]
How can I find an LGBTQ-affirming provider in my area?
Finding a provider who affirms LGBTQ patients’ identities and is a good fit for your individual health needs can be challenging. Many people still rely on word-of-mouth and local networks to get recommendations about affirming providers. There are also a number of other places you can look to find an affirming provider:
- Our Resources pages include hundreds of local, state, and national organizations with LGBTQ health expertise
- There are over one hundred Planned Parenthood Health Centers throughout California, which train providers on working with LGBTQ patients, and many offer services such as hormone therapy, mental health services, PrEP, and STI testing.
How long should I have to wait for an appointment with my provider?
California law requires health plans to provide access to care in a timely manner. For urgent health care needs, this mean an appointment within 48 hours. Appointments with primary care providers and mental health providers must be available within 10 days. [vi] If you are having trouble getting an appointment within these windows, you should contact your health insurer. If they are not able to resolve the issue, contact the Department of Managed Health Care Help Center.
What should I do?
- Enroll in coverage: You can enroll during open enrollment periods at the end of the year, or visit CoveredCA.com/ to see if you qualify for special enrollment any time of year due to a life-changing event.
- Get legal documents in order: Now is the time to change gender markers on passports, birth certificates and drivers’ licenses, [vii] make sure that children’s documentation accurately includes both parents’ legal names, and have an up-to-date advance health directive, [viii] living will, and other documents protecting you and your family’s assets.
- Get help if you need it:
Visit our Resources page to find the help you need.
