U-M health plans to expand coverage for transgender members

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U-M health plan members who are transgender will soon have coverage for additional medical procedures.

All U-M health plans cover genital surgery, mastectomy in female-to-male transition, hormone therapy and counseling when medically necessary to treat gender dysphoria. As of July 1, the plans will also cover certain facial feminization surgeries, Adam’s apple reduction and facial hair removal.

Gender dysphoria involves a conflict between a person’s gender identity and their gender assigned at birth, causing significant distress.

In a recent review of coverage for gender-affirming services, U-M clinicians and policy experts considered medical evidence as well as benefits at peer institutions and corporate employers. The university accepted their recommendation to identify the additional services as medically necessary.

Coverage for these services will require that members meet medical-necessity criteria and use in-network providers, up to a $30,000 lifetime limit.

Transgender members may also utilize new coverage for fertility preservation if medical or surgical interventions related to their transition could result in infertility. This benefit is available to any U-M health plan member with infertility due to medical treatment or surgery.

U-M’s scope of coverage for gender-affirming services is among the most comprehensive in higher education. Coverage follows standards defined by the World Professional Association for Transgender Health. As WPATH issues new standards over time, the university may re-evaluate coverage and medical necessity criteria as needed.

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Comments

  1. Tina Ronders
    on April 22, 2019 at 6:56 am

    I am pleased to hear this about UM health plans. Many people have gender dysphoria and suffer enough without having to try and afford extremely costly expenses for surgery or other medical provisions to live their live as who they truly are. I believe this benefit is crucial in allowing those who choose to have transition to their true self. Thank you for providing this benefit.

  2. Nia Bozeman
    on April 22, 2019 at 9:07 am

    Wow, this is great news. I love how U of M is being more inclusive.

  3. Betsy Brown
    on April 22, 2019 at 9:33 am

    This is amazing news! Thank you so much for being so supportive of the transgender community. Your services have made a world of difference for our family, and may have saved our daughter’s life. We are forever grateful.

  4. Jessica Smith
    on April 22, 2019 at 9:38 am

    This is a lovely and concrete example of U-M not just talking the talk on its commitment to diversity, equity, and inclusion (as many in higher ed are accused of), but actually in policy and dollars, walking the walk — investing in the health and well-being of its diverse workforce, many of whom are marginalized in the rokplace, healthcare, and in our society overall. I would like to see U-M continue to lead higher ed by speaking up and dedicating resources to improve the lives of all those who struggle against social bias and discrimination. Good move!

    • Jessica Smith
      on April 22, 2019 at 9:39 am

      And that’s Jessica Rohr BTW

  5. Kimberly Schlegel
    on April 22, 2019 at 11:43 am

    This is wonderful news and a significant step forward in terms of equity. Facial hair removal alone can cost several thousands of dollars over the course of treatment, since it takes years to complete the entire process. Truly this is game-changing, since many people affected by gender dysphoria cannot afford such expensive treatments on their own.

  6. Erica Hefner
    on April 22, 2019 at 6:01 pm

    As a U of M employee who identifies as transgender, I cannot express how grateful I am that these procedures are now covered in my health plan. Thank you, thank you, thank you!!! 🙂

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