Trans PSA: While most US insurance companies cover some TGNC procedures and surgeries, they carve out many as "cosmetic."

Reading BlueCross/BlueShield's policy bulletin reveals that they may cover many things others have deemed "cosmetic."

URL and list of procedures below...

1.) Google: SUR717.001, or
2.) The URL below. It works, but will be automatically redirected the first time. Subsequent uses will connect directly.

http://www.medicalpolicy.hcsc.net/medicalpolicy/activePolicyPage?lid=ju6tnvkw&corpEntCd=IL1

Primary Sexual Characteristic Gender Reassignment Chest and/or Genital Surgeries:

Male-to-Female (MtF) surgical procedures performed as part of gender reassignment services for an individual who has met the above criteria for gender dysphoria may be considered...

medically necessary and include the following:

• Breast modification, including but not limited to breast enlargement, breast augmentation, mastopexy, implant insertion, and silicone injections, and nipple or areola reconstruction;

• Clitoroplasty;

• Clitoroplasty;

...

• Colovaginoplasty;

• Labioplasty;

• Orchiectomy;

• Penectomy;

• Penile skin inversion;

• Repair of introitus;

• Vaginoplasty with construction of vagina with graft; and/or

• Vulvoplasty.

...

Female-to-Male (FtM) surgical procedures performed as part of gender reassignment services for an individual who has met the above criteria for gender dysphoria may be considered medically necessary and include the following:

• Hysterectomy;

• Metoidioplasty;

...

• Phalloplasty;

• Placement of an implantable erectile prostheses;

• Placement of testicular prostheses;

• Salpingo-oophorectomy;

• Scrotoplasty;

• Subcutaneous mastectomy, including nipple or areola reconstruction;

• Vaginectomy (colpectomy);

...

• Urethromeatoplasty.

Secondary Sexual Characteristic (Masculinizing or Feminizing) Gender Reassignment Surgeries and Related Services:

Procedures or services to create and maintain gender specific characteristics (masculinization or feminization) as part of the overall ...

desired gender reassignment services treatment plan may be considered medically necessary for the treatment of gender dysphoria ONLY. These procedures may include the following:

• Abdominoplasty;

• Blepharoplasty;

• Brow lift;

• Calf implants;

• Cheek implants;

...

• Chin or nose implants;

• External penile prosthesis (vacuum erection devices);

• Face lift (rhytidectomy);

• Facial bone reconstruction/sculpturing/reduction, includes jaw shortening;

• Forehead lift or conturing;

...

• Hair removal (may include donor skin sites) or hair transplantation (electrolysis or hairplasty);

• Laryngoplasty;

• Lip reduction or lip enhancement;

• Liposuction/lipofilling or body contouring or modeling of waist, buttocks, hips, and thighs reduction;

...

• Neck tightening;

• Pectoral implants;

• Reduction thyroid chondroplasty or trachea shaving (reduction of Adam’s apple);

• Redundant/excessive skin removal;

• Rhinoplasty (nose correction);

• Skin resurfacing;

• Testicular expanders;

...

• Voice modification surgery; and/or

• Voice (speech) therapy or voice lessons

NOTE 3: Preparatory or ancillary procedures (such as anesthesia, tissue harvesting for skin, fat, nerve or muscle grafting, etc.) and supplies or equipment

...

(such as stents, prosthesis, implants, etc.) that are required for the procedures listed above are considered an integral part of the MtF or FtM transition process.

NOTE 4: Surgical repairs or revisions related to MtF or FtM procedures may be required, such as removal and ...

replacement of prostheses.

...

Additional information is available about Gender Reassignment Surgery and Related Services for Children and Adolescents.