Insurance Plans to Cover Gender Reassignment Surgery

Tamsen Butler
Surgery

Insurance plans to cover gender reassignment surgery should also cover all the other inevitable medical procedures that come along with making a full transition from one gender to another. Not all insurance companies will cover these procedures and those that do typically require a large amount of proof that this surgery is not cosmetic but is instead medically necessary.

Medically Necessary versus Cosmetic

While many people assume that gender reassignment surgery is frivolous or purely cosmetic in nature, the truth is that Gender Identity Disorder is a serious mental disorder that can lead to depression or suicide if not properly addressed and treated. For people with Gender Identity Disorder, gender reassignment surgery can essentially be a lifesaving procedure. Insurance companies are still reluctant to pay for the procedures related to gender reassignment because the total cost can be quite expensive and also because Gender Identity Disorder is so misunderstood.

Many insurance companies still classify these procedures as elective and cosmetic. On the other hand, people with Gender Identity Disorder--along with the physicians and psychotherapists who treat them--consider the procedures to be medically necessary.

Find Insurance Plans to Cover Gender Reassignment Surgery

Finding insurance plans to cover gender reassignment surgery can be complicated, but it is not impossible.

Employer Provided Coverage

Health benefits provided by an employer may not cover these expenses or may only cover portions of the total procedures necessary. Gender reassignment is more than one simple surgery; many procedures precede the surgery and come afterwards, including mental health evaluations and hormone therapy.

Some people find that their employer requests to include gender reassignment surgery as a health care coverage option only to have the procedure denied by the insurance company. Even if the employer includes these procedures within the total health benefits coverage benefits provided to employees, the insurance company can still deny coverage if the procedure is deemed elective for the individual. For this reason, it is important to not only review the information provided by an employer, but also to review information directly from the insurance company.

State Provided Coverage

If deemed medically necessary by a physician, some state-offered medical assistance will cover the cost of gender reassignment surgery. Notably, California's Medi-Cal system has covered gender reassignment surgery, related hormone treatments, and other necessary procedures related to gender reassignment in the past.

Visit the Department of Health Care Services for your state to find out if you can obtain partial or full cover for gender reassignment surgery. You can expect to provide proof that you have undergone mental health counseling that resulted in a diagnosis of Gender Identity Disorder and the procedure has been deemed medically necessary. Keep in mind that coverage from a state program is generally only available to residents who already qualify for routine medical coverage through the program. If you already have insurance coverage, or if you do not meet the income requirements of the program, you will not be able to obtain coverage for gender reassignment surgery through a state program.

Additional Coverage

People who purchase short-term health insurance coverage specifically for gender reassignment procedures will discover that short-term policies for this specific procedure are difficult to find. In fact, Gender Identity Disorder can be considered a preexisting condition and therefore would not be covered under the umbrella of coverage provided by a short-term policy.

When purchasing an insurance policy, look for a company that presents clear willingness to cover gender reassignment surgery when deemed medically necessary. An example of one of these health insurance companies includes Cigna.

Coverage for Travel

Traveling to another country for gender reassignment surgery is a preferred method for some people who cannot afford to pay for the procedure stateside. In these instances, it is a good idea to research options for insurance for medical travel. While this special type of travel insurance will not cover the cost of the procedures, it may cover unexpected expenses that may occur when traveling overseas.

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Insurance Plans to Cover Gender Reassignment Surgery