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TLDEF's Trans Health Project

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Health Insurance Medical Policies

Medicaid

In many states, Medicaid plans are administered through Medicaid managed care plans, which each have their own clinical criteria. However, managed care plans must still comply with federal and state laws, meaning that if some procedures are listed as not covered, such exclusions can be challenged.

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Type in the name of the issuer you are seeking.

Aetna

  • Endometrial Ablation
  • Gender Affirming Surgery
  • Gonadotropin-Releasing Hormone Analogs and Antagonists
  • Implantable Hormone Pellets

AllWays Health Partners

  • Assisted Reproductive Services/Infertility Services
  • Gender Affirming Procedures

Alliant Health Services

  • Alliant Gender Reassignment Surgery

Ambetter Peach State Health Plan (Centene Corporation)

  • Gender Affirming Surgery

Ambetter from Buckeye Health Plan (Centene Corporation)

  • Endometrial Ablation
  • Leuprolide Acetate (Eligard, Lupaneta Pack, Lupron Depot, Lupron Depot-Ped)

AmeriHealth Caritas of Louisiana

  • Gender Dysphoria
  • Implantable Testosterone Pellets

AmeriHealth Caritas of New Hampshire

  • Gender-Conforming Facial Surgery

Amerigroup

  • Endometrial Ablation

Amerigroup (Anthem)

  • Gender Affirming Surgery

Amida Care

  • Clinical Guidelines and Coverage Criteria for the Treatment of Gender Dysphoria

BlueChoice Healthplan of South Carolina

  • Gender Affirming Surgery

Boston Medical Center HealthNet Plan / Well Sense

  • Gender Affirmation Surgeries
  • GnRH Agents

CareSource

  • Gender Dysphoria (Georgia Medicaid)
  • Gender Dysphoria (Indiana Medicaid)
  • Gender Dysphoria (Ohio Medicaid)

Fallon Health

  • Gender Affirmation Services

Gateway Health

  • Gender Transition Services

Geisinger Health Plan

  • Gender Dysphoria and Gender Confirmation Treatment

Health Net

  • Gender Affirming Procedures

Healthy Blue (Louisiana Medicaid)

  • Endometrial Ablation
  • Gender Reassignment Surgery

Husky Health Connecticut (Medicaid)

  • Gender Reassignment Services

Louisiana Healthcare Connections (Centene Corporation - Medicaid)

  • Gender-Affirming Procedures

Medi-Cal

  • Transgender Services

Minnesota Health Care Programs

  • Gender-Confirming Surgery

Neighborhood Health Plan of Rhode Island

  • Gender Dysphoria Treatment

Oregon Health Authority (Oregon Health Plan)

  • Prioritized List of Health Services - Gender Dysphoria/Transsexualism

Prestige

  • Gender-Conforming Facial Surgery

Prestige Health Choice

  • Gender Dysphoria
  • Implantable Testosterone Pellets

Priority Health

  • Gender Reassignment Surgery

Select Health of South Carolina

  • Implantable Testosterone Pellets

Tufts Health Plan

  • Transgender Surgical Procedures

UPMC Health Plan

  • Gender Affirmation Surgery

UnitedHealthcare

  • Gender Dysphoria Treatment (Community Plan)
  • Subcutaneous Implantable Hormone Pellets (Louisiana)
  • Testosterone Replacement or Supplementation Therapy (Community Plan)

Univera Healthcare

  • Gender Reassignment/Gender Affirming Surgery and Treatments for Medicaid Managed Care Plan (MMCP) and Health and Recovery Plan (HARP) Members

WellCare

  • Gender Reassignment Surgery

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