Colorado expanded its essential health benefit (EHB) benchmark plan to enhance coverage for those seeking gender-affirming care. EHB benchmarks contain services that must be covered by individually-purchased health insurance and plans in small-group markets both inside and outside of health insurance marketplaces.
Colorado’s new EHB benchmark plan discourages a “one size fits all” approach to health care and will provide coverage for a wider range of services for transgender individuals, including eye and lid modifications, face tightening, facial bone remodeling for facial feminization, breast/chest construction and reductions, and laser hair removal. Further, the EHBs will include mental wellness and coverage for 14 more prescription drug classes. Changes will take effect January 2023.
Notably, Colorado’s EHB expansion is the first of its kind to be approved by the Centers for Medicare & Medicaid Services (CMS).
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.