Did you know that there are no health insurance options for non-binary people in the U.S.? Whenever you apply for health insurance, the application asks for your gender/sex, and every application only has male/female options.

When I corrected my birth certificate to state that I’m “non-binary,” I called my health insurance provider to update my account. They said they could not do the update because their insurance plans are specifically and only for males and females.

Health Insurance Broker Claims They Could Help

In the summer of 2022, I received an email from the State Bar of Arizona with information about its health insurance exchange. I snarkily responded that I cannot get health insurance because I’m non-binary. The rep for the program sent me a response that said they were “confident” that they could find me a health insurance plan because federal law prohibits discrimination based on gender.

My thoughts were dripping with sarcasm. I thought they were coming from a good place, but I didn’t think they knew what they were talking about.

Wait – The Rep Found Me Non-binary Health Insurance?

A few months later, when open enrollment started, the rep from the health insurance exchange sent me an email saying they’d found me some options for health insurance.

Really?! I figured, if they even bothered writing me back, that they would saying they couldn’t find any options for non-binary people.

Intrigued, I clicked on the link to the options they found. My curiosity quickly shifted to anger when I saw that the rep classified me as “female.”

What the fuck, dude! (I thought it. I didn’t say it.)

I sent them an annoyed, but respectful, response that I explicitly told them months ago that I’m non-binary, not female. (This is the issue I’ve been dealing with for years.)

The rep responded that every health insurance option requires the applicant to declare themselves as “male” or “female.” I messaged them back with something like, “Welcome to my non-binary life.” I refuse to declare a gender that’s a lie.

Obnoxious Emails from HealthCare.gov

Open enrollment also meant the beginning of a slew of emails from HealthCare.gov about researching and applying for health insurance under the Affordable Care Act. Every time one of these messages arrived, I became more and more prickly.

I finally replied to one of these emails with “I can’t get health insurance because I’m non-binary.” Less than a minute later, a response arrived:

“The email is not monitored.”

Damn it!  

I Called the Government

When HealthCare.gov did not provide an option to email the government for help, I picked up the phone and called them. I clicked through their menu of options to get to a human, a polite man with a southern accent.

I explained to him that I’m non-binary and there are no health insurance options for people like me on their site. His response: “Let me put you on hold and ask my manager.”

When he came back on the line, the rep said a trans person can claim their new gender, male or female, when applying for health insurance. I told him again that I’m non-binary, not male or female, and that’s what’s on my birth certificate, driver’s license, and passport.

“Birth certificate?”

“Correct.”

“Let me put you on hold and ask my manager again.”

When he got back on the line, he was apologetic, but said that every health insurance plan requires you to state that you’re male or female.

I knew this would be the answer. The point of making the call was to spread awareness about this issue, and I was curious to see how long it would take them to realize that non-binary people can’t get health insurance without lying about who they are. Before hanging up, I asked the rep to please let his manager know that this is a problem impacting all non-binary Americans.

I also set my email up to automatically send all future emails from HealthCare.gov to spam.

Why I Keep My Current Health Insurance

I need health insurance to cover my medications and to be there if something catastrophic happens. If I didn’t, I’d approach an organization like Lambda Legal or the ACLU about teaming up, giving up my incorrect health insurance plan, paying the penalty on my federal taxes, and suing the government and/or health insurance providers for gender discrimination for not providing a health insurance option for non-binary people.

Hope on the Horizon

The Social Security Administration is expected to add the X gender option sometime in 2023. Hopefully, this is the last year we have to identify as something we’re not in order to get health insurance. (Trans men and women were recently given the ability to update their social security records without needing a doctor’s letter.)

I think social security is the last piece of the puzzle. Once someone has “non-binary” on every document across the board, I don’t think health insurance providers can get away with not having non-binary health insurance options or an option that doesn’t require the applicant to disclose their gender.

Perhaps a non-gendered option will have a questionnaire that will ask about what body parts we have as well as what types of medical treatment or procedures we’ve had to date.  That seems fair and reasonable to design coverage based on your current health care needs. If you don’t have a prostate, you don’t need coverage that includes prostate cancer. Likewise, if you can’t get pregnant, you don’t need coverage for prenatal care or delivery.

Get Ruth & Consequences in Your Inbox

If you like reading my rants and raves, please add yourself to the Ruth & Consequences newsletter. Every other Sunday, I send you something interesting to read as you sip your morning coffee – tidbits about legal news, lessons I’ve learned as an entrepreneur, and exclusive content written for people like me who couldn’t be normal even if they tried.