As part of NCTE’s federal aging policy agenda, we are releasing this guide on navigating Medicare for transgender beneficiaries. Transgender people often face confusion around what is covered in their Medicare benefits, both for transition-related care and for routine preventive care.
This guide makes clear that Medicare does cover:
1) Routine preventive care regardless of gender markers, and
2) Medically necessary hormone therapy.
Medicare has instituted a special billing code to end denials of coverage based on apparent gender discrepancies. Now doctors and hospitals can use this code to override Medicare’s computer systems to ignore gender discrepancies on a person’s record. Unfortunately, Medicare still does not cover medically necessary sex reassignment surgery.
This document goes into detail about what is covered, appealing denials of coverage, and reporting instances of disrespect, discrimination and harassment related to your gender identity or transgender status.
Read the full guide below.
National Center for Transgender Equality's Blog 
Don’t misunderstand me; I appreciate every step forward we get and all the hard work everyone puts in to get it.
But basic care and hormones is what my insurance company has been covering for years. And they have knowingly been discriminating against trans-people since forever. It’s a band-aid and they know it. I hope that before I die of old age. I will see and end to my own government’s discrimination against me. Hearing we kinda, sorta, maybe, think we may almost acknowledge you and heres a 13.00 prescription of estrogen still isn’t being treated equally or properly.
We can help every other country on the planet but refuse to support and help our own people who are in real need.
Sincerly
Jill Edwards
I have a conversation with a Medicare Ombudsman recorded that NCTE might find interesting. She told me to avoid suicide due to lack of surgery coverage with bowling and movies until Medicare covers surgery….which said said would NEVER happen. She was very patronizing in response to my obvious distress.
Please try not to use SCRIBD – it makes it a pain to download documents and spams your facebook contact list when you sign up. A simple PDF or webpage is more open and a lot more friendly.
Likewise, their document viewer is extremely difficult to use for those who are blind or have visual impairments. These people already face other barriers to care – adding another one only hurts, not helps.
This kind of Information should be accessable to all.
@catherinecc – Vincent here at NCTE. My sincerest apologies for not making our documents more accessible. In the future, I will do better with including pdf links into the page. Here is a pdf link where the document can be viewed:
http://www.transequality.org/Resources/MedicareBenefitsAndTransPeople_Aug2011_FINAL.pdf.
Please note that all NCTE resources are also available on our main website here: http://www.transequality.org/Resources/index.html.
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Medicare Has You Covered | National Center for Transgender Equality’s Blog