Recognizing the difficulties transgender members may face, Tufts Health Plan has worked with community providers to enhance service and support for transgender members, at any stage of their journey.
Our servicing program comprises integrated care management teams involving our clinical and behavioral health teams and call center staff. This integrated team has specialized training in transgender health issues and in cultural competency skills and a comprehensive understanding of available coverage options.
Transgender health services offered to many of our members include coverage for gender affirming surgery, hormone therapy and behavioral health services related to the member’s gender identity. These services may require prior authorization and are subject to the member’s cost share, as defined by the member’s plan design. Self-funded employer sponsored plans may have non-standard coverage or not currently cover certain services; please check your benefit document or call the number on your member ID card to confirm your coverage.
With respect to gender affirming surgery, our medical necessity guidelines provide up-to-date information on which surgeries or procedures are considered medically necessary.
External transgender support resources
Recognizing that support services are important in a member’s journey, the links below provide information members may find useful. Tufts Health Plan is not responsible for content: