CHOICE SelectHealth Is Now Offering Coverage to Transgender New Yorkers, Regardless of HIV Status
As a New York State-sponsored HIV Special Needs Plan (SNP), VNSNY CHOICE SelectHealth is best known for providing specialized Medicaid coverage and care management to HIV-positive residents of Brooklyn, the Bronx, Manhattan and Queens. But the New York State Department of Health (DOH) also has the option of adding coverage for other special populations to its SNPs as needed. Earlier this year, DOH exercised this option by extending SNP coverage to transgender Medicaid-eligible individuals, regardless of their HIV status.
The new enrollment rules took effect on November 1st. “Any Medicaid-eligible person in the four covered boroughs who identifies as transgender or gender non-conforming is now eligible for enrollment in SelectHealth,” says Lauren Benyola, one of two SelectHealth product managers along with Candia Richards-Clarke. “To qualify, members either need to obtain a letter from a healthcare provider indicating their transition or an official document reflecting the change in gender designation.”
The reason for including transgender individuals in SelectHealth and the state’s other SNPs, adds Lauren, is similar to why SNPs were originally created for HIV-positive New Yorkers: It ensures access to a health plan that understands their specific needs, with a network of specialized providers who can provide expert medical care in an environment of respect and sensitivity. “According to a 2015 survey by the National Center for Transgender Equality, half of all transgender individuals don’t go to a physician for fear they’ll be discriminated against, while about one-third of those who do see a doctor report having a negative experience,” she explains. “At SelectHealth, our goal is to give these individuals a better experience in the healthcare system.”
New York State’s Medicaid plans have been providing transgender-related benefits and services since 2015, and SelectHealth already has 30 to 40 transgender members enrolled by virtue of their HIV status. With all transgender Medicaid recipients now eligible for enrollment, CHOICE has been retraining its staff at all levels to be sure they are responsive to transgender members’ needs. The training sessions have included discussions with consumers as well as presentations by Shannon Whittington, director of VNSNY Home Care’s Gender Affirmation Surgery program.
“We’ve also done a lot of work revising how we collect gender information and disseminate that to our various delegated vendors that manage the plan’s pharmacy, vision, dental and behavior health benefits,” says Lauren. “It’s estimated there’s more than 6,000 transgender individuals in our coverage area, including many who are served by clinics where SelectHealth has active outreach. We’re looking forward to sharing the various ways that the SelectHealth plan can benefit this group.”
The Take-Away: The population eligible to enroll in CHOICE SelectHealth was recently expanded to include any Medicaid-eligible individual in Brooklyn, the Bronx, Manhattan and Queens who identifies as transgender or gender non-conforming, regardless of their HIV status.
