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January 2017

Reminder: Blue Cross expanding coverage of gender transition services, starting Jan. 1

In a November Record article, Blue Cross Blue Shield of Michigan announced that it will extend gender transition benefits to individuals and groups that currently have none or only some of them, starting on Jan. 1, 2017.

Blue Cross already provides gender transition benefits to many of its groups.

New benefits may include:

  • Gender reassignment surgery
  • Hormone therapy
  • Psychotherapy and counseling
  • Mastectomy for female to male transitions

Some surgical procedures will continue to require preauthorization. Always check a member’s eligibility and benefits.

Our benefits for gender transition are changing in response to this year’s final rule under Section 1557 of the Affordable Care Act. The rule prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health care programs or activities that receive federal financial assistance. It requires that gender transition benefits be available in health care plans starting on or after Jan. 1.

Blue Cross MOS groups and individual customers will receive the benefit on Jan. 1, 2017. NASCO Classic groups, with the exception of MESSA, will receive the benefit at the start of their 2017 plan year. MESSA will receive the benefit beginning Jan. 1, 2017.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.