HB 2405 Summary

• Prohibits health insurers, mutual benefit societies, and health maintenance organizations from applying categorical cosmetic or blanket exclusions to gender affirming treatments and procedures when determined medically necessary.

• Requires insurers to cover gender affirming treatments (including hormone therapy, surgeries, vocal training, and hair removal) under the same terms as non-gender-related versions of those same services.

• Mandates that appeals of denied claims for gender affirming treatment be decided in consultation with a healthcare provider experienced in prescribing or delivering gender affirming treatment.

• Requires insurers to provide applicants and insured persons with clear information about coverage of gender transition services and the process for appealing medical necessity denials.

• Establishes that copayments, deductibles, and coinsurance for gender affirming services must be no less favorable than those for other covered medical services.