Transgender Surgery

Transgender or Gender Confirmation Surgery is a covered benefit under the UC Student Health Insurance Plan for eligible enrollees.

Process & Timeline

Your initial step in receiving covered transgender care is to make an appointment with your primary care provider at Student Health. During this appointment, the provider will walk you through the necessary steps and criteria to receive authorization for transgender surgery. Gender Confirmation Surgery is considered an eligible benefit when all of the Clinical Indications for Gender Reassignment Surgery are met.

Benefit

The University of California Student Health Insurance Plan (UC SHIP) provides benefits to insured students for many of the charges incurred for transgender surgery (also known as gender confirmation surgery). Not all charges are eligible and some are only eligible to a limited extent.

Transgender surgery must be performed at a facility designated and approved by the claims administrator for the type of transgender surgery requested and must be authorized prior to being performed.

If there are travel expenses in connection with an authorized transgender surgery performed at a facility which is designated by the claims administrator and approved for the transgender surgery requested, claims can be made for reimbursement (provided the expenses are authorized by the claims administrator) for up to six trips. Travel expenses may include:

a.   Round trip coach airfare to the facility which is designated by the claims administrator and approved for the transgender surgery requested, not to exceed $250 per person per trip.
b.   Hotel accommodations, not to exceed $100 per day for up to 21 days per trip, limited to one room, double occupancy.
c.   Other expenses, such as OTC medical supplies, not to exceed $25 per day for each person, for up to 21 days per trip. Meals are not covered.

Charges for services that are not authorized, or which are provided in a facility other than which the claims administrator has designated and approved for the transgender surgery requested, will not be considered covered expenses. 

Transgender surgery is payable 90% in-network or 60% out-of-network rates. There is no lifetime maximum on the gender confirmation surgery benefits.

keywords: trans, sexual, sexual reassignment surgery