Skip to main content

Keyboard Shortcuts

Key Pair Function
Alt S Search Box
Alt T Top of Page
Alt H Home Page
Alt Index Button
Alt Next Button
Alt Prev Button
TLDEF Logo

TLDEF's Trans Health Project

Working for Transgender Equal Rights
Menu
  • Trans Health Insurance Tutorial
    • Choosing a Plan
    • Understanding Your Plan
    • Applying for Coverage
    • Understanding a Denial
    • Appealing a Denial
  • Resources
    • Health Insurance Medical Policies
    • Medical Organization Statements
    • State Health Insurance Laws and Guidance
    • Medicaid Regulations and Guidance
    • Gender Centers
    • Trans Health Care Providers
    • State Employee Health Plans
    • Financial Aid for Transgender Surgeries
  • Tools
    • Legal Analysis
    • Medical Necessity Literature Reviews
    • Reporting Medical Provider Discrimination
    • Training Materials for Advocates
    • Appealing Medical Necessity Denials
    • Provider Medical Necessity Letter Checklists
  • About Us
    • About TLDEF's Trans Health Project
    • Privacy Policy
  • Contact Us
    • Contact TLDEF's Trans Health Project
    • Contact TLDEF
Previous Page
Prev
Home
Home
Up
Up
Next Page
Next
  •  Home
  • Resources
  • Health Insurance Medical Policies
  • Current: ConnectiCare - Gender Reassignment Surgery

Prev Index Gender Dysphoria/Reassignment [70 of 165] Next

ConnectiCare

Gender Affirming/Reassignment Surgery (Commercial)


Policy: Gender Affirming/Reassignment Surgery (Commercial)
Policy Number: MG.MM.SU.28m
Last Update: 2020-05-08
Issued in: Connecticut

Body Contouring:

The following surgery, services and procedures will be reviewed on a case by case basis.

It is expected that the clinical rationale for each requested procedure is specifically documented in the letter of medical necessity from the treating physician:

  • Calf, cheek, chin, nose or pectoral implants Collagen injections
  • Liposuction

Breast Reconstruction:

Breast augmentation is considered medically necessary provided that the member has completed a minimum of 24 months of hormone therapy, during which time breast growth has been negligible; or hormone therapy is medically contraindicated; or the member is otherwise unable to take hormones.

Facial Reconstruction:

The following surgery, services and procedures will be reviewed on a case by case basis.

It is expected that the clinical rationale for each requested procedure is specifically documented in the letter of medical necessity from the treating physician:

  1. Abdominoplasty, blepharoplasty, neck tightening or removal of redundant skin
  2. Breast, brow, face or forehead lifts
  3. Calf, cheek, chin, nose or pectoral implants Collagen injections
  4. Drugs to promote hair growth or loss
  5. Electrolysis (unless required for vaginoplasty or phalloplasty)
  6. Facial bone reconstruction, reduction or sculpturing (including jaw shortening) and rhinoplasty
  7. Hair transplantation
  8. Lip reduction
  9. Liposuction
  10. Thyroid chondroplasty

Permanent Hair Removal:

Genital electrolysis is not considered a surgical procedure, but is performed in conjunction with genital surgery (i.e., when required for vaginoplasty or phalloplasty)

The following surgery, services and procedures will be reviewed on a case by case basis.

It is expected that the clinical rationale for each requested procedure is specifically documented in the letter of medical necessity from the treating physician:

  • Electrolysis (unless required for vaginoplasty or phalloplasty)

Voice Therapy and Surgery:

The following surgery, services and procedures will be reviewed on a case by case basis.

It is expected that the clinical rationale for each requested procedure is specifically documented in the letter of medical necessity from the treating physician:

  • Voice therapy, voice lessons or voice modification surgery

Youth Services:

Requests for gender reassignment surgery for members less than 18 years will be reviewed on a case-by-case basis.

Back to top

Updated on Nov 6, 2020

Donate Now - Secure donations through Network for Good Donate Now

Join Our Mailing List

Facebook Button Twitter Button
 Keyboard Shortcuts
 Privacy Policy
 TLDEF Website

Copyright © 2021 Transgender Legal Defense & Education Fund, Inc.  |  520 8th Avenue, Suite 2204, New York, NY 10018   Tel: 646.862.9396   Fax: 646.993.1684