Update on Medicaid Coverage of Gender-Affirming Health Services

Appendix A: Survey Questionnaire

In Table G, use the drop-down boxes in the table below to indicate whether, as of July 1, 2021, the various transgender health services were covered for adults aged 21 and older in the traditional Medicaid program, explicitly excluded from coverage, or whether coverage is not explicitly addressed in statute or administrative policy. Describe limits or utilization controls applied by entering text in the space provided and use the drop-down boxes to indicate if coverage policies are aligned across all eligibility groups (i.e., traditional Medicaid, ACA expansion adults, etc.). If not aligned, please describe coverage policy variations in the comment field at the bottom of the table. Please do NOT include services that are provided by managed care plans as value-added benefits (that is, are not a required state benefit).

Transgender Health Services Traditional Medicaid covers as of 7/1/2021? Describe limits or utilization controls Coverage Policies Aligned all Elig. groups?
1. Gender-affirming surgery
2. Gender-affirming hormone therapy
3. Infertility services, such as fertility preservation or IVF, for transgender individuals
4. Mental health counseling and services related to gender-affirming care
5. Voice and Communication Therapy
Comments on Transgender Health Services coverage, including any coverage policy variations across different eligibility pathways (i.e., ACA expansion adults):

Appendix Table B: Detailed Tables

Issue Brief

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