Medicare Can Now Cover Sex-Change Surgery, Report
Medicare Can Now Cover Sex-Change Surgery, Report

Medicare Can Now Cover Sex-Change Surgery, Report

Medicare will now cover sex-change operations for transgender people, the U.S. Department of Health and Services announced Friday.

The unprecedented decision overturns a 30-year ban that prevented Medicare, which offers health care to the elderly and disabled, from paying for sex reassignment surgeries. The department’s Appeals Board, which lifted the ban, ruled that sex reassignment surgeries are medically necessary for those who do not identify with their original sex, the Associated Press reported.

The ruling means that individuals can petition Medicare to cover their sex-change operations using documentation from physicians and mental health professionals. It does not mean the program will automatically cover the procedures.

“The national policy barring Medicare from covering gender transition surgery has been invalidated by HHS’s Departmental Appeals Board. As with all such determinations, CMS will carry out this independent board’s ruling through Medicare Administrative Contractors, who manage Medicare claims payment systems,” said Aaron Albright, spokesman for the Centers for Medicare and Medicaid Services. “These contractors may cover this care case-by-case or under a local coverage determination based on clinical evidence to determine medical appropriateness.”

Advocates hope the decision will place pressure on private health insurance companies and Medicaid programs to cover the surgeries as a matter of course.


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