Health Plan Coverage and Information for Gender-Affirming Services

Gender-Affirming Care

All U-M Health Plans cover a variety of medically necessary gender-affirming treatments for members diagnosed with gender 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 Medicine provides gender affirming services and can assist with coordinating your care through the Comprehensive Gender Services Program. Additional in-network providers can be found using the provider search tool specific to the health plan you are enrolled, or by calling the customer services number on the back of your health plan ID card.

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:

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.