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.