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Code · Vermont · Title 8 — Banking and Insurance · Chapter 107

§ 4071.

209 words·~1 min read·/vt/title-8/chapter-107/4071

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§ 4071. Gender-affirming health care services
(a)As used in this section, “gender-affirming health care services” has the same meaning as in 1 V.S.A. § 150.
(b)(1) A health insurance plan shall provide coverage for gender-affirming health care services that:
(A)are medically necessary and clinically appropriate for the individual’s diagnosis or health condition; and
(B)are included in the State’s essential health benefits benchmark plan.
(2)Nothing in this section shall prohibit a health insurance plan from providing greater coverage for gender-affirming health care services than is required under this section.
(c)Cost sharing. A health insurance plan shall not impose greater coinsurance, co-payment, deductible, or other cost-sharing requirements for coverage of gender-affirming health care services than apply to the diagnosis and treatment of any other physical or mental condition under the plan.
(d)This section shall apply to Medicaid and any other public health care assistance program offered or administered by the State or by any subdivision or instrumentality of the State. The coverage provided pursuant to this section by Medicaid and other public health care assistance programs shall comply with any requirements imposed on such coverage by the Centers for Medicare and Medicaid Services. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)
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