MMC Benefits Handbook
Gender Reassignment Surgery
Does the Plan cover transgender surgery?
Transgender surgery is covered for persons that meet all of the following conditions:
  • You are at least 18 years old
  • Receive a written psychological assessment from at least one (for breast surgery) or two (for genital surgery) qualified behavioral health provider experienced in treating Gender Dysphoria.
    • Assessment must document that member meets specific criteria set by UHC, including persistent, well-documented Gender Dysphoria
  • Prior Authorization is required. Contact the Claims Administrator for specific details.
What transgender surgery benefits will the Plan pay?
The Plan will provide medically necessary benefits in connection with transgender surgery.
Call the Claims Administrator at the number on the back of your ID card for specifics on what is covered and excluded by the Plan.