Gender-Affirming Care
All U-M Health Plansgender dysphoria
Gender Dysphoria
A condition classified as emotional discomfort or distress caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth.
Gender affirming care may include:
- Non-surgical treatments:
- Hormone treatment (covered under the UM pharmacy benefit)
- Counseling and psychiatric services
- Voice and communication services through the speech therapy benefit
- Facial hair removal (face and neck)
- Surgical treatments:
- Genitalia reconstruction
- Mastectomy (surgical removal of the breast)
- Augmentation mammoplasty (implants)
- Thyroid reduction chondroplasty (tracheal shave)
- Facial feminization
- Facial masculinization
For services to be covered the member must meet medical necessity criteria as determined by health plan’s medical policy. Some services require prior authorization. Applicable co-pays, deductibles and coinsurance are based on the member's plan selection. Please contact the health plan for detailed benefit information.
Exclusions include but are not limited to:
- Reversal of physical or functional outcomes due to gender affirming services
- Reversal of surgical procedures performed for gender affirming services
- Procedures that are primarily cosmetic and not reconstructive and/or not medically necessary as defined by the health plan’s Medical Policy
- Rhytidectomy (face lift)
- Otoplasty (ear procedures)
- Lip enhancement (filler, vermillion augmentation)
- Hair transplantation/hairline repositioning
- Dermabrasion /chemical peel
- Collagen/injectable dermal fillers
- Liposuction
- Abdominoplasty
Access to Providers
Michigan Medicinegender affirming services
Standards of Care
The university’s coverage of gender-affirming services follows the health plan's medical policy, which incorporates standards of care defined by the World Professional Association for Transgender Health (WPATH) and other professional organizations. As standards change over time, the health plan may re-evaluate coverage and update medical necessity criteria, as needed.
Fertility Preservation
Transgender members have access to coverage for fertility preservation if medical or surgical interventions related to their transition could result in infertility. Fertility preservation services are covered only when received at the Michigan Medicine Center for Reproductive Medicine.
Facial Hair Removal
Information regarding facial feminization hair removal for BCBS and BCN members: Facial hair removal can be performed by laser or electrolysis. Laser hair removal can be performed at many in-network dermatology offices. Providers will bill for services using their standard billing practices.
There are no in-network participating electrolysis providers. If you choose to use a non-participating electrolysis provider, you must follow the BCBS or BCN authorization process. Failure to follow the process will result in denied reimbursement.
View the processes below for facial feminization electrolysis or laser hair removal by non-participating providers:
- If you're a member of a Blue Cross Blue Shield of Michigan (BCBSM) plan
- If you're a member of a Blue Cross Network (BCN) plan
Workplace Transition Guide
Creating a welcoming environment for all identities includes awareness of our policies and procedures, education and training, and supporting our faculty and staff. For more information, view U-M's Workplace Gender Transition guide.
Questions About Your Benefits?
Submit your questions to the SSC Contact Center. You can also call the SSC at 5-2000 from the Ann Arbor campus, (734) 615-2000 locally, or (866) 647-7657 toll free, Monday through Friday from 8 a.m. to 1 p.m. and 2 p.m. to 5 p.m..
Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend, or terminate them. Every effort has been made to ensure the accuracy of the benefits information in this site. However, if any provision on the benefits plans is unclear or ambiguous, the Benefits Office reserves the right to interpret the plan and resolve the problem. If any inconsistency exists between this site and the written plans or contracts, the actual provisions of each benefit plan will govern.
