Montana Clarifies Medicaid Coverage for Transition-Related Care

The Montana Department of Public Health & Human Services (DPHHS) issued a lifesaving Healthcare Program Notice last week, clarifying that their Medicaid benefit plans include services related to gender transition. The notice makes Montana the 14th state, in addition to the District of Columbia, to put out guidance affirmatively stating that transgender people on Medicaid have access to medically necessary transition-related care. Fifteen states continue to maintain exclusions that ignore medical science and violate federal laws, while nearly half of states have no clear policy, often complicating access to care.

The Department’s guidance helps ensure that low-income transgender Montanans using Medicaid benefits have access to medically necessary care related to gender transition. Notices such as this one are necessary because historically many insurance programs deny gender transition services. The Montana Medicaid notice directs providers to determine whether procedures are medically necessary according to criteria outlined by the World Professional Association for Transgender Health Standards of Care.

NCTE worked closely with the Montana Human Rights Network (MHRN) to push for this important guidance, and we congratulate MHRN and DPHHS for their hard work on this incredible victory for transgender Montanans! NCTE continues to partner with state groups to advocate for updated Medicaid policies clarifying coverage of transition-related care.

If you have faced discrimination in health care or health insurance coverage, including Medicaid, check out our Know Your Rights: Healthcare resource or get legal help.

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