Policy: Treatment of Gender Dysphoria
Policy Number: 7.01.508
Last Update: 2020-10-01
Next Update: 2021-10-01
Issued in: Missouri

Voice Therapy and Surgery:

When non-surgical treatments are not covered. Examples that apply to this exclusion include, but are not limited to: 

• Reproduction services including, but not limited to: sperm preservation in advance of hormone treatment or gender dysphoria surgery, cryopreservation of fertilized embryos, oocyte preservation, surrogate parenting, donor eggs, donor sperm and host uterus. (See the Reproduction exclusion in the member specific benefit plan document.) 
• Drugs* for hair loss or growth. 
• Drugs* for sexual performance for patients that have undergone genital reconstruction.  Drugs* for cosmetic purposes. 
• Hormone therapy except as described in the Covered Services section above. Gender Dysphoria (Gender Identity Disorder) 
• Voice therapy.

Youth Services:

Age of majority in a given country. Note: WPATH guidelines address age of majority in a given country. For the purposes of this guideline, the age of majority is age 18. However, this refers to chronological age not biological age. Where approval or denial of benefits is based solely on the age of the individual a case-by-case medical director review is necessary.