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What does the new COVID-19 special enrollment period mean for me?

The pandemic has highlighted the importance of each of us having affordable, high-quality health insurance. To help ensure that everyone can enroll in coverage, the Biden administration announced a COVID-19 special enrollment period. Even though the open enrollment period for 2021 ended on December 15, you have another chance to enroll in coverage from February 15, 2021 to August 15, 2021. You can enroll if you are uninsured, or if you’re already insured but want to change your plan.

This is a HUGE opportunity for our community to enroll in coverage that we need. But, if you miss the deadline, you could be locked out of health insurance until 2022 AND forced to pay 100% of your medical bills. It’s not worth the risk, especially when financial help is available: last year, 2 out of 3 customers could find a plan with a monthly premium of $10 or less.

Does the Affordable Care Act protect LGBTQ people from discrimination?

Yes. The Affordable Care Act is the first federal law to prohibit discrimination based on sex, including against LGBTQ people, in the health system. The law protects LGB and transgender, gender nonconforming, non-binary, and intersex individuals. This includes most types of health insurance coverage and most types of health care providers. Learn more here.

But we all need to pitch in to make sure that these protections are being honored. If you face discrimination at any point during the enrollment process, please let us know at If your coverage is denied, appeal with your health insurer – learn how here. If you face discrimination by an insurer or health provider, contact a legal organization here.

Read about Section 1557 of the Affordable Care Act to learn more about nondiscrimination protections.


What if my plan refuses to cover benefits and services related to gender transition?

You have rights. The coverage of transition-related care continues to vary by insurer and state. But you have the right to expect that your plan will cover the services you need as long as those services are covered for other people on your plan. These services may include preventive screenings such as mammograms, Pap tests, and prostate exams; hormone therapy; mental health services; and surgical procedures related to gender transition.

To help you understand your options, we’ve created new state-specific Transgender Health Insurance Guides and encourage you to make an appointment with an LGBT-friendly expert who can help you enroll for free. If your transition-related care is denied, learn how to appeal with your health insurer here. If you face discrimination by an insurer or health provider, contact a legal organization here.

Read about Section 1557 of the Affordable Care Act to learn more about nondiscrimination protections.

If you want more information on what your insurance company might cover, check out these medical policies from Transcend Legal – but make sure you look at your own policy too since that’s what will really determine what services are covered.

What if my plan refuses to cover the services that I need?

If your plan refuses to cover medically necessary services that are recommended by your doctor, you have the right to appeal this decision and have it reviewed by an independent third party.

You have the right to:

  • Ask the insurer to reconsider its decision.
  • Know why an insurer denied your claim or ended your coverage.
  • Know how to challenge the insurer’s decision.

Typically, you must first go through a process called the “internal appeals process” where you appeal directly to your insurer. If you are unhappy with the result from the internal appeal, you can then request an “external review” from an independent third party.

We recommend going through this process because many denials are overturned during the appeals process. If you need help filing an internal appeal or external review, contact your state’s consumer assistance program or insurance department.

If you are denied coverage for transition-related care or discriminated against at any point in this process, contact a legal organization here. Read more about your rights here and here.

What if my plan doesn’t carry the prescription drug that I need?

Every plan sold in the Marketplace must provide a link to its drug formulary (the list of drugs that are covered). If you need a certain drug, you can use this formulary to find out if your drug is covered before you sign up for coverage. If you have a specific health need, we encourage you to take advantage of free help (either in-person or by phone) from a trained assister to help you consider your options.

If your doctor prescribes a drug for you but your insurer doesn’t cover the drug, you may be able to appeal for an exception to get the drug covered. To do so, contact your insurer. If you want help with your appeal, contact your state’s consumer assistance program or insurance department.

Can I visit my partner or spouse in the hospital or nursing home?

Yes, you have the right to visit your partner in the hospital, nursing home, and most other types of health care facilities. If you face discrimination, you have new rights. If you experience any form of discrimination, you should contact a legal organization here and let us know at

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