Transgender individuals have health care needs and human needs, such as the need for respect, love and access to care. Aetna®. standard plans provide access to medically necessary transgender-related health care. Plan documents outline the member’s specific coverage.
Hormone therapy
The pharmacy benefit usually covers testosterone or estrogen therapies. Clinical Policy Bulletins #510 Progestins and #501 Gonadotropin-Releasing Hormone Analogs outline the coverage of relevant medications.
Surgical transition
Our Clinical Policy Bulletin #615 Gender-Affirming Surgery outlines what surgeries are covered by standard Aetna plans. Also, find out more about gender affirmation surgery precertification (PDF).
To find a breast surgeon in the network, gender reassignment surgery designated surgeons (PDF)
Behavioral health services
Individuals considering a surgical transition will need:
Reproductive services
Some Aetna® plans may cover fertility preservation. These services need precertification. Check the ;benefits plan documents for coverage details.
Ongoing health and wellness
Discuss the risks of alcohol and tobacco while undergoing hormone therapy and preparing for surgery.
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Health benefits and health insurance plans contain exclusions and limitations.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
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Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
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Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
