Medically reviewed by Paul Gonzales on March 13, 2024.
Navigating insurance coverage for gender affirmation surgery can be complex, but many insurance providers now recognize these forms of healthcare for transgender individuals as medically necessary and thereby deserving of coverage. This guide aims to simplify the process of finding and applying for insurance coverage for gender-affirmative surgery, also known as gender confirmation surgery.
Below you can find a list of insurance providers for which our team has successfully obtained approval for top surgery procedures from here. If you don’t see your insurance listed here or are unsure, you can schedule a free, virtual consultation so our team can verify this information for you. Unfortunately, Medicare does not cover any of our procedures at this time.
Successful Insurance Approvals* |
Challenging Insurance Approvals |
AETNA – AET07 ALL SAVERS – AME46 ANTHEM BLUE CROSS – ANT05 ANTHEM MEDI-CAL – BXLA BIND UHC – BIND BLUE SHIELD OF CALIFORNIA – BLU14 BROWN AND TOLAND MEDICAL GROUP – BRO01 EMBLEM HEALTH – NEW17 GEHA – GEHA1 GEHA STANDARD OPTION – GHE01 HEALTHCOMP INC – HEA44 HMA – HMA MERITAIN HEALTH – NOR07 MERITAIN HEALTH MINNEAPOLIS – MER01 NIPPON LIFE INSURANCE COMPANY – NIP01 OXFORD HEALTH PLANS – OXF01 STUDENT INSURANCE – STU01 UHC ONE – UHCONE UMR – UNI34 UNITED HEALTH CARE SS – MID14 UNITED HEALTHCARE – UNI20 UNITED HEATLH CARE SHARED SVC – UHCSS WESTERN GROWERS INSURANCE COMPANY – WES03 WESTERN HEALTH ADVANTAGE – WHA |
AETNA BETTER HEALTH – AETB ALAMEDA ALLIANCE – ALA04 ALLIED BENEFIT SYSTEM – ALL01 ALLIED PHYSICIANS MEDICAL GROUP – ALL09 AMIDA CARE – AMI01 ARIZONA HEALTH CARE COST CONT – AHCCC BEAVER MEDICAL GROUP – BEA03 BENEFIT ADMINISTRATIVE SYSTEMS – BEN10 BLUE SHIELD PROMISE – BSPROM BOON CHAPMAN ADMINISTRATORS – BOO01 CAL OPTIMA – CAL01 CALIFORNIA BLUE SHIELD – CAL02 CALIFORNIA HEALTH AND WELLNESS – CAHW CALIFORNIA MEDICAL – CAL03 CENCAL HEALTH – CENCA CENTRAL COAST ALLIANCE FOR HEALTH – CEN05 CHCN – CHCN CHILDRENS FIRST MEDICAL GROUP – CHI03 CIGNA PPO – CIG09 CONTRA COSTA HEALTH PLAN – CCHP EXCLUSIVE SURGERY SOLUTIONS – ESURG FACEY MEDICAL FOUNDATION – FACEY FIRST CHOICE HEALTH NETWORK – FIR12 FIRST CHOICE MEDICAL GROUP – FIR01 GOLD COAST HEALTH PLAN – GOL03 HEALTH NET CC – HNCC HEALTH NET MCAL – HNMC HEALTH PARTNERS – HEA81 HEALTH PLAN OF SAN JOAQUIN – HEA50 HEALTH PLAN OF SAN MATEO – HEA57 HEALTH PLANS – HEA18 HEALTHCARE PARTNERS – HEA60 HEALTHSCOPE BENEFITS – HEA90 HILL PHYSICIANS MEDICAL GROUP – HIL01 HOMETOWN HEALTH – HOME1 INLAND EMPIRE HEALTH PLAN – INL01 LA CARE HEALTH PLAN – LAC02 LASALLE MEDICAL ASSOCIATES – LAS01 LIFEWISE – LIFE01 MEDICA – MEDICA MODA HEALTH PLAN – MODA MOLINA HEALTHCARE – MOL02 MOLINA HEALTHCARE OF CALIFORNIA – MOL01 OSCAR – OSCAR PACIFIC SOURCE COMMUNITY SOLUTIONS – PAC06 PACIFIC SOURCE HEALTH PLANS – PAC07 PARTNERSHIP HEALTH PLAN – PAR05 PRESBYTERIAN HEALTH PLAN – PRE23 PRIORITY HEALTH OF MICHIGAN – PRI20 PROVIDENCE HEALTH PLAN – PRO15 RIVER CITY MEDICAL GROUP – RCMG SAN FRANCISCO HEALTH PLAN – SFHP SANTA CLARA FAMILY HEALTH PLAN – SAN04 SANTE COMMUNITY PHYSICIANS – SAN02 SELECTHEALTH – SEL10 SHARP HEALTH PLAN – SHAR1 TRUSTMARK HEALTH BENEFITS – TRU01 TUFTS HEALTH PLANS – TUF01 UC DAVIS – UCDAV UHC COMMUNITY PLAN OF NY – UHCCP US NETWORKS AND ADMIN SVCS – USN01 VALLEY HEALTH PLAN – VAL05 VANTAGE MEDICAL GROUP – VAN04 |
* This list does not guarantee insurance coverage for top surgery and successful approvals may vary on a number of factors, such as the type of plan for each insurance company.
The following information is meant to give you an overview of all the components you will need to take into consideration in finding an insurance plan that will cover your gender-affirming surgery.
If you live in the United States, here’s a list of resources to help you identify insurance providers offering coverage for gender-affirming surgery:
The National Center for Transgender Equality created a guide to help navigate getting your insurance to cover gender-affirming care. This process can be summarized in 3 steps below:
Navigating this process can be challenging but our Insurance Advocacy team works directly with your insurance for each step of this process until the insurance company reaches a decision for the preauthorization request. This service is provided free of charge for our patients to ensure the best chance of success in getting their surgery covered.
The Affordable Care Act prohibits discrimination based on gender identity, which can be leveraged when seeking coverage for gender-affirming surgery. Despite this, many still face challenges with access or coverage of medically necessary transition related care. Recently, these states have limited protections for transgender youth after passing laws banning their access to gender-affirming care.
Navigating insurance coverage for gender-affirming surgery can be challenging, but our Insurance Advocacy team is dedicated to ensuring access to care for our patients. The National Center for Transgender Equality and Transgender Legal Defense and Education Fund also provides a comprehensive list of resources to help patients find and get insurance coverage for gender-affirming care.
The virtual consultation will be billed to your insurance company. We will accept the insurance reimbursement as payment in full.