Will Insurance Cover My Top Surgery?
Massachusetts is widely considered more up-to-date on insurance coverage for transgender patients than other places within the United States, so if you have insurance from a company licensed by the Massachusetts Division of Insurance, your insurance may cover part or all of your gender affirming procedures.
In 2014, Massachusetts reformed health coverage policies to ensure transgender patients receive full access to all medically necessary care, including gender affirming medications and procedures. Participants in Massachusetts’ MassHealth program (the Massachusetts Medicaid program) cannot be discriminated against with denials of insurance coverage for transgender medical care. Private health care providers licensed in Massachusetts are similarly barred from excluding coverage for transgender medical care. For participants in a self-insured plan, where the employer or union assumes the risk of paying healthcare claims, the regulations do not apply. Large employers or unions deciding their own coverage policies are not mandated to cover transgender affirmation medical care, so if you’re unsure if your plan is self-insured or not, check with your HR or union representative for more information.
Aligning your body’s appearance with who you know you are is a complex undertaking with many steps to reach your ultimate goal of living authentically. In most cases, gender affirming procedures performed at Longwood Plastic Surgery are partially or fully covered by Massachusetts insurance providers, giving many of our trans patients the peace of mind needed to become who they were always meant to be.
Am I a Good Candidate?
If you’re grappling with the incongruity of your body appearing as the gender with which you don’t identify mentally, top surgery may be something to consider. Ideal candidates are those who would benefit physically or mentally from top surgery, who don’t smoke, and who enjoy otherwise good health. A comprehensive consultation with Longwood Plastic Surgery physicians is a great place to begin.