Announcing Expanded Gender Affirming Care Insurance!
Gender Affirming Care
The CSU is one of 37 university associations across Canada to have added these new coverage options offered through Studentcare for 2023/2024. The coverage has been Developed by GreenShield Canada in collaboration with student focus groups, the Canadian Professional Association for Transgender Health (CPATH), and the Social Collective.
Who is Eligible for Gender Affirming Care Coverage?
The Gender Affirming Care Coverage will be available through the Dental Care plan so that international students can opt-in to receive it.
All undergraduate students whether domestic or international are eligible for this coverage.
Domestic students enrolled in more than three credits will be automatically enrolled in the CSU Health and Dental Insurance plans and therefore will have automatic access to the gender affirming care coverage.
International Students regardless of credit amount and domestic undergraduate students registered for less than three credits are eligible for the gender affirming care coverage but will need to opt-in to the plan during the Change of Coverage Period.
The Change-of-Coverage Period is the period at the beginning of each new term when you can opt-in to the Health and/or Dental plans if you are eligible but not automatically enrolled. This period is also the time when you can register your spouse and/or dependent(s) for the Health and/or Dental plans.
To opt-in to the gender affirming care plan, please register for the Dental Care plan during the change-of-coverage period.
If you are enrolled in the Fall Term, your Change-of-Coverage Period is from Sept. 5 – 25, 2023. The Winter Change-of-Coverage Period (for new Winter Term students only) is from Jan. 22 – Feb. 7, 2024.
During these dates you can self-enrol through the Studentcare My Coverage Manager online portal
Where to find more information:
Because the Gender Affirming Care coverage is new as of September 1st, 2023 the CSU is currently working to create additional support resources to provide information and services to help you navigate the process of accessing this coverage. These resources should be up and running by the end of October 2023.
While we work to make new services and resources available to you please consult the CSU instagram and the Centre for Gender Advocacy Website for the latest up-to-date information on gender affirming care insurance and the upcoming Gender Health Hub. Further information from Studentcare can be found at the LGBTQIA2S+ support page for the CSU Health and Dental Plan.
For any questions, please contact the CSU front desk at contactus@csu.qc.ca, (514) 848-7474 ext. 8914.
What gender affirming care was already covered under the health and dental plan?
Did you know that the health and dental insurance plans offered through the CSU have pre-existing coverage that you can use for gender affirming care costs? For domestic students registered with the CSU Health plan, HRT medications and PrEP are both covered through the prescription medication coverage. The health plan also offers coverage for Nursing care to an amount of $25,000 per insured person each period of 3 consecutive coverage periods, provided it is prescribed by a physician and approved by Desjardins Insurance. With proof of a prescription for nursing care this coverage may be used for care during recovery from a gender affirming care related procedure.
What is the new Gender Affirming Care Coverage?
The Gender Affirming Care Coverage program offered by Studentcare is designed to supplement gender affirming care coverage available for domestic students through public provincial and territorial health insurance. It is also intended to provide gender affirming care coverage for international students.
This coverage is meant to provide financial support for transition-related care procedures or services that are not covered by your provincial health insurance. It is also meant to provide coverage in cases where provincial health insurance has rejected your eligibility for public coverage for a procedure. This means that in cases where a surgery or procedure would be covered by a province only when certain conditions are met, you can become eligible for coverage through the Studentcare gender affirming care insurance by providing documentation that you have not been deemed eligible for provincial or territorial coverage.
The full range of eligible procedures includes:
- Penectomy
- Orchiectomy
- Vaginoplasty
- Breast Augmentation,
- Labiaplasty
- Clitoroplasty
- Vaginectomy
- Hysterectomy
- Salpingo-Oophorectomy
- Metoidioplasty
- Phalloplasty
- Mastectomy
- Scrotoplasty
- Erectile and Testicular Implant
- Clitoral Release
- Facial Feminization
- Tracheal Shave
- Laser/Electrolysis Hair Removal
- Vaginal Dilators
- Vocal Surgery
These are the eligible procedures for this 2023-2024 coverage year, but we are hoping to negotiate for the addition of other procedures not listed here to the plan for future years. Please contact us by emailing contactus@csu.qc.ca if there is a procedure not listed here that you would like to see covered so that we can add it to our list of desired additions for future plan years.
The coverage offers up to $5,000 per procedure with a lifetime maximum of $10,000.We understand that many gender affirming care procedures significantly exceed the amount of $5,000 in cost and are hoping to negotiate higher coverage amounts for future years. In the meantime, all money claimed through gender affirming care insurance will provide weight to future negotiations for higher coverage amounts.
Navigating provincial and territorial coverage:
Provincial and territorial coverage for gender affirming care varies greatly from province to province. Coverage eligibility for specific gender affirming care procedures through Studentcare will therefore vary from student to student depending on the provincial or territorial insurance that you have.
This infographic created by Studentcare breaks down coverage across provinces in relation to the procedures currently covered by the Gender Affirming Care Insurance. Please note that Laser/Electrolysis Hair Removal does not have to be performed by a physician to be eligible for coverage.
You can also seek help navigating this directly through Studentcare by filling out a Studentcare support form.
If there is coverage for a gender affirming care procedure available to you through your provincial or territorial insurance, we recommend students try to access this coverage prior to attempting to use the coverage available through Studentcare. When a province or territory covers a procedure, the public insurance provides greater cost coverage than is currently available through Studentcare.
If your province or territory does not offer coverage for a gender affirming care procedure, then you will be eligible for coverage for that procedure through Studentcare. If you have been denied coverage from your province or territory, then you will be eligible for coverage through Studentcare with documentation of your rejection for public coverage.
RAMQ:
RAMQ covers gender affirming care procedures including: Penectomy, Orchiectomy, Vaginoplasty, Breast Augmentation, Labiaplasty, Clitoroplasty, Vaginectomy, Hysterectomy, Salpingo-Oophorectomy, Metoidioplasty, Phalloplasty, Mastectomy, Scrotoplasty, Erectile and Testicular Implant and Clitoral Release. The insurance available through the Studentcare Dental Plan will therefore offer eligible coverage for Facial Feminization, Tracheal Shave, Laser/Electrolysis Hair Removal, Vaginal Dilators, and Vocal Surgery to students covered by RAMQ. If you are rejected by RAMQ for coverage for a gender affirming procedure that is normally covered by the province, you can become eligible for coverage for that procedure through Studentcare by providing documentation that RAMQ will not approve coverage for you.
*RAMQ covers hair removal if prescribed by a doctor, but this can be very difficult to access, therefore Studentcare has opted to make laser/electrolysis hair removal covered through the gender affirming care insurance for students with RAMQ.
International Students:
The international students’ Blue Cross health plan is meant to provide relatively equivalent coverage to RAMQ for international students; however, as the CSU is not responsible for the Blue Cross plan we are currently unsure of how Blue Cross might cover gender affirming care procedures. We will be following up with this to update this information as soon as possible. Please contact the International Students Office for more information, and if you are unable to receive the help you need from them, then please be in touch with the CSU reception at contactus@csu.qc.ca and we will contact the international students office on your behalf to advocate for you.
What kinds of services and supports can you expect from the CSU and partner organisations to assist you in accessing this coverage?
The Centre for Gender Advocacy is working to develop programming to assist trans students with navigating the bureaucratic process of accessing gender affirming care, navigating insurance coverage with both provincial and CSU health plans, and accessing the medical care to get the necessary documentation for insurance eligibility.
Through Studentcare, the Gender Affirming Care Program also includes access to support from a lawyer for students who would like assistance with any legal aspects of their gender transition journey (e.g. updating government-issued identification documents).To access legal assistance, please fill out the online Support Form available on the Studentcare CSU site, and select Gender Affirmation Care as the reason for your request. A legal partner will respond to you shortly.
Through Studentcare, the mental health resource EmpowerMe is designed with LGBTQIA2S+ students in mind. It gives students the opportunity to enter a chosen name and specify their gender identity (the legal name is only required during registration) and can provide referrals to clinics for anyone experiencing gender dysphoria or medically transitioning.
Studentcare, the CSU, and the Centre for Gender Advocacy are working on compiling a list of gender affirming care providers who can provide diagnoses and documentation necessary to access the gender affirming care insurance. This list will be intended to help mitigate the barriers to accessing care from helpful and supporting practitioners that will make claiming gender affirming care insurance possible.
In the case of any transphobia resulting from the announcement of this expanded coverage, the CSU will stand with and support trans students. CSU policy mandates the support for trans students through CSU position 11.2.:
“the CSU stands in solidarity with trans, nonbinary and gender-non-conforming folks. The CSU strongly opposes transphobia in all its forms and rejects all structures, behaviours and laws that perpetuate systemic transphobia. The CSU recognizes the gender binary as a social construct that must be dismantled. Further, the CSU recognizes that there is no one step or set of steps to undergo in order to have one’s gender identity be affirmed and respected. People must have the right to change the sex designation on their birth certificate and other documents if it does not represent their gender identity without having to undergo surgery. As such, the CSU strongly denounces Bill 2, project de loi no. 2, which would effectively further discriminate against and harm trans people. Trans, nonbinary and gender-non-conforming folks must have the right to safety and security on their own terms.” [Adopted during the Fall By-Election, 2021]
How can you access the new Gender Affirming Care Coverage and what barriers to access can you expect?
The documentation requirements needed to be eligible for coverage are set by GreenShield Canada, the insurance company providing the coverage offered through Studentcare. As a result, the CSU is not currently able to remove these documentation requirements and the barriers to access that they represent. We hope that these requirements may change to be easier in the future. The CSU, Studentcare, and the Centre for Gender Advocacy are working to develop supports to help trans students navigate these barriers to accessing insurance coverage as easily and quickly as possible.
Diagnosis Requirement:
In order to claim the gender affirming care insurance coverage, students must first receive a letter from a physician or nurse practitioner that confirms that they have a diagnosis of gender dysphoria. This diagnosis letter needs to be given to the student directly, who then can submit the documentation directly to GreenShield via the online portal before or at the same time as submitting receipts for reimbursement. We therefore recommend that you seek a diagnosis from a doctor or nurse practitioner as soon as possible during your studies to ensure that you will be able to take advantage of this coverage.
You can find a list of Queer and Trans Friendly Resources and Services including lists of doctors that provide HRT through Project 10’s Trans Health Network. Project 10 is a Montreal based advocacy centre for 2LGBTQ+ youth. Because the availability of care and doctors that provide HRT and diagnosis documentation changes frequently, The CSU, Studentcare, and the Centre for Gender Advocacy are developing an updated list of trans affirming practitioners so that we can connect you to practitioners who will be able to provide diagnosis documentation to enable access to the insurance coverage. This list will be available as soon as possible through the CSU website, the Studentcare website and the Centre for Gender Advocacy website.
In the wider Montreal community, the Action Santé Travesti(e)s et Transexuel(le)s du Québec (ASTT(e)Q) program run by CACTUS Montréal is a resource available to trans people that can help connect you to trans-affirming healthcare.
Current lack of Pay-Direct coverage:
Pay-Direct service is unfortunately currently unavailable for this coverage, meaning that trans students must pay for a procedure out-of-pocket first and then submit a claim for reimbursement. We understand that this is a significant barrier to accessing gender affirming care. Studentcare has informed the CSU that GreenShield has committed to working with Studentcare to establish the Pay-Direct service for Gender Affirmation Care coverage in the future. We are therefore hoping that Pay-Direct will be offered as soon as possible and will provide updates on this as they become available.
How can you claim coverage for Gender Affirming Care?
It is possible to receive pre-approval for gender affirming care coverage for a particular procedure by submitting your documentation to GreenShield prior to the procedure. While pre-approval is not required, we highly recommend applying for pre-approval for coverage for a gender affirming care procedure, particularly for surgical procedures to ensure that out of pocket costs will be reimbursed as soon as possible.
For up-to-date information on the claims process please visit the Studentcare website CSU LGBTQIA2S+ Support page. For any questions, concerns, or problems with the claims process please contact the CSU reception at contactus@csu.qc.ca or fill out a support form to speak directly with someone from Studentcare.
Please note that because gender affirming care insurance is offered by GreenShield, claims for gender affirming care cannot be made through Desjardins in the same way that they would be for other health and dental insurance claims. They must be made through GreenShield to receive reimbursement.