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Are transgender-inclusive health insurance benefits expensive?

Transgender-inclusive health insurance benefits are not expensive, particularly for large employers. Early studies led benefits experts to believe otherwise.

Although some treatments, including particular surgical procedures, can add up to costs in the tens of thousands of dollars, these treatments generally represent a very small additional cost for insurance plans that cover large employers.

Making an insurance plane inclusive is generally inexpensive because:

  • Only a small percentage of people undergo transgender-specific medical treatment
  • Significant costs for surgical procedures are one-time costs that, again, apply to a small percentage of people
  • The total costs of transgender-specific care for one person are often estimated between $25,000-$75,000; these costs are minimal compared to other expensive procedures such as defibrillator implants ($68,000 – 102,000) or colon cancer drugs ($250,000 per patient)
  • Transgender people often present other medical issues as a result of being unable to transition; people who transition lead happy, healthier lives

When the City and County of San Francisco made its employee insurance plans transgender-inclusive in 2001, it set up an additional per-employee per-month surcharge to offset the expected additional expenditures. By 2006, it had only spent $386,417 of the $5.6 million it had collected from this surcharge. It ended the surcharge completely:

"Despite actuarial fears of over-utilization and a potentially expensive benefit, the Transgender Health Benefit Program has proven to be appropriately accessed and undeniably more affordable than other, often routinely covered, procedures."
— 2006 letter from San Francisco's Human Rights Commission

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