If you want to maximize your benefits for gender affirming care and receive the information you need, follow these steps to insure a successful care experience:
Schedule an appointment with a Student Health Primary Care Provider at (858) 822-5926 or (858) 534-3300. They provide primary care (including initial hormones, hormone replacement therapy/HRT and hormone adjustment), x-rays, labs, and pharmacy services, and can make a referral.
Get a referral from this Primary Care Provider for the appropriate next level of care from a specialist, such as; surgery, endocrinology, vocal training, psychology or psychiatry, hair removal options, etc. Referrals are written for 365 days, as long as the patient is still participating in the SHIP insurance offering.
Secure an Anthem Case Manager to assist you in finding a specialist provider and facility that you are comfortable with, including UC San Diego Health Specialists (see below). Case Managers assist you in interpreting your benefits and navigating the precertification process successfully. Anthem Case Managers should be secured by calling: (855) 484-4930.
UC San Diego Health Specialists provide you at the highest level of UC SHIP coverage, and have low out-of-pocket costs. Your Anthem Case Manager can help you to make an appointment or research providers, and you may also call 1-800-926-8273 to request a UC San Diego Health patient care navigator that can assist you in making an appointment appropriate for the care you have been referred for.
Make an appointment with a specialist when you are ready. Your referral from your Student Health Primary Care Provider is valid for one year or 12 visits, as long as you remain covered by UC SHIP, other referrals & precertification may be necessary.
More information: Anthem Clinical Guidelines, although written for health care providers and not patients, provides detailed information on coverage.
GENDER AFFIRMING BENEFIT HIGHLIGHTS (PDF)
UCSHIP GENDER AFFIRMING SURGERY RESOURCE GUIDE (DOC)
Transgender and Nonbinary Insurance Benefits
Most areascovered medical expenses
Feminizing hormone therapy
Blocking male sex hormone (androgen) receptors, then taking estrogen to decrease testosterone production and induce feminization. Estrogen can be taken in a variety of methods, including as a pill, by injection or in skin preparations, such as a cream, gel, spray or patch.
Masculinizing hormone therapy
Taking testosterone, either by injection, or by a patch or gel applied to the skin.
“Bottom” surgical procedures
Hysterectomy (removal of uterus), vaginectomy (removal of the vagina and closing of the vaginal opening), salpingo-oophorectomy (removal of ovaries and fallopian tubes), ovariectomy (removal of ovaries), penectomy (removal of penis), orchiectomy (removal of testicles), metoidioplasty (work with your existing genital tissue to form a new penis), phalloplasty (multi-staged procedures to create a new penis), vaginoplasty (multi-staged procedures to create a new vagina), clitoroplasty (surgical creation of a clitoris), labiaplasty (surgical creation of labia), scrotoplasty (surgical creation of a scrotum), urethroplasty (surgical reconstruction or replacement of the urethra), or placement of testicular prostheses.
“Top” surgical procedures
Subcutaneous mastectomy (removal of breast tissue, excess skin, and the inframammary fold. Reduction and repositioning of the nipple-areolar complex).
Facial Gender Conforming Surgery--transfeminine surgeries
Brow lift, forehead contouring, malar (cheek) implants, jaw and/or chin re-shaping, lip shortening, scalp (hairline) advancement, and rhinoplasty (changing shape of nose).
Facial Gender Conforming Surgery--transmasculine surgeries
Augmentation thyroid chondroplastychin implant
Non-Surgical Procedures
Vocal training, fertility preservation (eggs/sperm), hair removal procedures (by electrolysis or laser treatment).
Transportation and hotel costs
Up to $250 for round trip coach airfare; up to $100 per day, for up to 21 days per trip for hotels.
UCSHIP Gender Reassignment/Affirming Surgery Check List (PDF)
UCSHIP Gender Affirming Surgeons (PDF)
Additional info on transgender care can be found at Student Health Services.
UC San Diego Student Health and Well-Being is proud to partner with:
- UC San Diego LGBT Resource Center
- UC San Diego Health Transgender Provider information (search for “transgendercare”)
