Gender Care Access Project

Rainbow Health knows that when it comes to getting gender-affirming care covered by insurance, there can be many obstacles and it’s important to have an advocate on your side. Our staff has years of experience in navigating the intricacies of plans from Medical Assistance/MinnesotaCare, Medicare, large-employer plans, small-employer/individual plans, public-employee plans, and more, and have dealt with most of the big insurers in Minnesota in one way or another.

The people who come to us have generally either already been denied, or expect to be denied, coverage for their medically-necessary care—our basic message is: don’t assume “no” is the final answer! While we can’t necessarily resolve every problem, Rainbow Health is a recognized leader in this area because we take the time to review a person’s insurance plan documents, denial notices, and medical records to determine whether there is a path to getting your care covered, and then travel that path with you as far as we can take it. Our vision is of a Minnesota where access to gender-affirming care is routine and efficient, and each success along the way brings us a bit closer to that goal. In 2023, the Minnesota Department of Health issued a report identifying additional ways to address barriers facing those seeking gender-affirming care.

Do you have an insurance situation you’d like to discuss with us? Great! Drop us a note at [email protected] to get started. Here are some of the questions you would likely be asked, so having as much of this information ahead of time will help the discussion:

• What services are you trying to get covered?
• What reason(s) are you being given for coverage being denied?
• What insurance company or government agency is involved?
• How do you come to have coverage through that company or agency?
• If your coverage comes through an employer, about how many employees does it have? Is it a religious employer? A unit of State or local government?

Documents that would be very helpful to have from you include:

• Copy of your Summary Plan Description (private plans only)
• Denial notices
• Letters of support from your providers for the services you’re seeking