Members

Gender Affirmation Services, including Sex-Trait Modification Services

We’re committed to providing equitable and affordable health care for all. We're here to support you on your health care journey.
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Most Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plans provide coverage1 for individuals whose gender identity differs from sex assigned at birth.

Specified sex-trait modification procedures in our plans

The following services may be covered as part of an overall treatment plan for gender dysphoria:2

  • Hormone therapy or pubertal delay
  • Gender-affirming surgeries, including genital and chest procedures
  • Voice therapy
  • Some electrolysis or laser hair removal procedures2

Hormone therapy

Hormone therapy may be covered when it is part of your benefit plan3 and when it is medically necessary for the treatment of gender dysphoria.

Gender affirmation surgery

Gender affirmation surgery may be covered when it is part of your benefit plan3 and when it is medically necessary for the treatment of gender dysphoria. This may include:

  • Vaginoplasty
  • Phalloplasty
  • Hysterectomy
  • Mastectomy
  • Breast reconstruction, including augmentation with implants
  • Certain facial procedures for feminization or masculinization2

Specific gender affirmation services are still covered on all plans and include:

  • Mental health support
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How coverage works

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For individual members under 65
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Most Blue Cross NC individual and family plan4 cover gender affirmation services, including sex-trait modification services as outlined in our coverage policy. Services may require prior approval.

Learn more about the services covered3 in our individual and family medical policy and in your Benefit Booklet.

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For Medicare members 65 and up
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Coverage for Medicare Advantage members is based on guidance from the Centers for Medicare & Medicaid Services⁠ (CMS).
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Supporting you on your health care journey

Our customer service team can connect you with a nurse case manager for gender services who has specialized knowledge to help you:

  • Understand your benefits
  • Navigate gender affirmation surgery and hormone therapy
  • Learn more about gender affirmation services, including sex-trait modification services
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You can learn more about your coverage by reviewing your Benefit Booklet in your member portal or by contacting us.
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Contact us
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Additional resources

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Submit a claim
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Prior review and authorization
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Preventive care
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Mental health support
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Frequently asked questions

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