Consumer Driven Health Plan

Gender Affirming Care

This plan recognizes that gender diverse members require health care delivered by healthcare providers experienced in gender affirming health. This page will help members navigate our gender affirmation surgical benefits.

Gender affirmation surgical benefits are limited to the following:

Note: Your provider must submit a treatment plan including all surgeries planned and the estimated date each will be performed. A new prior approval must be obtained if the treatment plan is approved and your provider later modifies the plan.

Note: Benefits for gender affirmation surgery are limited to once per covered procedure, per lifetime. Benefits are not available for repeat or revision procedures when benefits were provided for the initial procedure. Benefits are not available for gender affirmation surgery for any condition other than gender dysphoria.

Note: We only cover procedures outlined in Table 1 of Cigna's Medical Coverage Policy for Gender Dysphoria Treatment.

Gender affirmation surgery on an inpatient or outpatient basis is subject to the pre-surgical requirements listed below. The patient must meet all requirements.