Skip to main content

Caring for transgender individuals 

 

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:

 

  • One letter from a mental health care ;provider for breast (top) surgery
  • Two letters from a mental health care provider for genital (bottom) surgery

 

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

  • Benefits for preventive health services (such as cancer screening) are based on the individual’s birth anatomy (cervix, breast, prostate).
  • Discuss safe sex practices and screenings for sexually transmitted infections.

Discuss the risks of alcohol and tobacco while undergoing hormone therapy and preparing for surgery.

Legal notices

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).

Health benefits and health insurance plans contain exclusions and limitations.