Does New York Medicaid cover gender reassignment surgery?

Transgender Related Care and Services Update

Does NY Medicaid cover HRT?

If I live in New York and I am a Medicaid recipient, what transition-related care will be covered? In New York, coverage is available for hormone therapy (including cross-sex hormones and pubertal suppressants), surgeries, and other procedures.

Does NY Medicaid cover top surgery?

It is important for you to be aware that transition-related surgery will be covered by New York’s Medicaid program ONLY if your health care provider has given you a diagnosis of “gender dysphoria.” … These procedures include genital surgery, top surgery, body sculpting, and facial feminization surgery.

What are the requirements for gender reassignment surgery?

Gender Affirming Surgery

  • Two referral letters from qualified mental health professionals, one in a purely evaluative role (see appendix); and.
  • Persistent, well-documented gender dysphoria (see Appendix); and.
  • Capacity to make a fully informed decision and to consent for treatment; and.
  • Age 18 years or older; and.

Is gender reassignment surgery considered elective?

We consider (gender reassignment surgeries) as elective,” said a spokeswoman for the American College of Surgeons, an association which has advised U.S. surgeons to reschedule elective surgeries to deal with an influx of COVID-19 patients.

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How old do you have to be to start HRT in New York?

The existing regulation provides coverage for hormone therapy only for individuals 18 years of age or older.

Can you get surgery with Medicaid?

Even Medicare and Medicaid pay for elective surgery. The catch is that most health plans will only pay for an elective surgery that’s medically necessary, and your health insurer’s opinion of what’s medically necessary may differ from your surgeon’s opinion.

How much does top surgery cost?

The average range for cost of FTM and FTN top surgery is currently between $3,000 and $10,000. The average cost range for MTF and MTN top surgery varies greatly depending on factors such as body size, body shape, and desired breast size. The average cost range for this surgery is between $5,000 and $10,000.

How do you get diagnosed with gender dysphoria?

To be diagnosed with gender dysphoria as a teenager or adult, you must have experienced significant distress for at least six months due to at least two of the following: marked incongruence between your experienced and expressed gender and your primary or secondary sex characteristics.

How much is a gender reassignment surgery?

Gender reassignment surgeries are expensive. Bottom surgeries can cost about $25,000 and top (breast surgeries) from $7,800 to $10,000. Facial and body contouring are also costly.

How long do you have to wait for gender reassignment surgery?

Gender reassignment surgery (GRS) cannot be provided until you have lived in a social role appropriate to your gender identity for at least twelve months. At some point, you will want to tell other people about your transition.

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