Transgender Hair Transplant Cost – Will Insurance Cover It?

Even with the continued growth in procedures related to gender transition, sex reassignment surgery and other medical care related to gender transition has not been covered by most health insurance providers. Even though gender-affirming surgeries are now associated with positive mental health benefits, these procedures have long been viewed as being cosmetic in nature by health insurance companies. Thankfully, this attitude towards gender-affirming surgeries is changing as some transgender surgeries are now covered in part, or completely, by insurance (including Medicaid and Medicare). While transgender patients are now able to get access to the healthcare services they need more than ever before, many of our potential transgender patients are still not sure if their health insurance will cover a transgender hair transplant.

Does health insurance cover transgender hair transplant

Transgender Hair Transplant and Insurance – Examples Revealed

Our practice has had discussions with doctors across the country and around the globe regarding this topic. For example, one of my colleagues has a patient who works for a hospital center in Pittsburgh. This hospital center covers some of the transition cost, but a hair transplant has not been included in their coverage. This hair transplant surgeon provided a letter requesting that the hair transplant be part of the covered costs, and, after a few months of negotiations, the request was approved.

Insurance and Transgender Hair Transplant

Another of my hair transplant colleagues reported that some of his transgender patients had their surgeries paid for by insurance using the same method described in the above paragraph. He shared that writing a letter with the diagnosis of gender dysphoria as well as the procedure code for skin grafting (which is what a hair transplant is) and the treatment cost is often enough to persuade insurance companies to pay for the hair transplant. According to this source, gender dysphoria is normally the diagnosis that patients have received that allowed them to have previous procedures covered by their insurance company.

Yes, the two examples above both had happy outcomes but that is not always the case when transgender patients deal with their insurance providers. Our office has treated many transgender patients over the years, and we know how difficult it can sometimes be for them to complete their sex reassignment procedures. There are times when they have to take out big loans or put their life savings towards their procedures.

Transsexualism – The Condition Explained

Many transsexual people often view their sex reassignment process as the main goal in their life and they do not want to stop until they are able to accomplish this mission. Their transgender journey would certainly be easier if the medical community could convince insurance providers to cover some portion of the cost.

It should be noted that transsexualism is not a mental condition as some members of the public believe. Instead, it is a condition characterized by a person being born in the body of the other sex. Because of this aspect of the condition, our position on the issue is that health insurance companies should pay for its cost much like other sex reassignment procedures.

Transgender Hair Transplants and Insurance Companies – Guidelines Patients Should Know

It is important to know that any healthcare plan that excludes all care related to gender transition is illegal. Having said that, here are some other rules that patients should know about as they start the process of undergoing a transgender hair transplant.

Since not every insurance plan covers all medical procedures, patients should refer to their medical policy and handbook to review the type of coverage they have for transgender care. If a person has Medicare or Medicaid, they started to provide some coverage for transgender healthcare back in 2014 but these decisions are still made according to the details of the specific case. Plus, many insurance policies and states have strict guidelines regarding what is considered to be a medically necessary procedure.

There are many medical professionals and medical groups that have publicly acknowledged the need for care related to the sex transition process. Unfortunately, some insurance companies are still able to bypass legal regulations which makes it vitally important for a person to know their legal rights in case their claim is illegally denied.

In order to get a better idea about what their insurance company will cover, patients can file for preauthorization which asks the insurance provider to approve the claim before the procedure is performed. The act of asking for preauthorization also gives the person a better idea about their level of financial responsibility and helps them budget for the treatment. The medical team handling the surgery can help with this process as most insurance plans require a letter that explains the treatment plan and why it is a medically necessary surgery. In addition, some insurance plans do not offer preauthorization so the patient would need to file for reimbursement after the procedure.

If the medical claim is denied, patients should talk to their medical team and get a proper letter or documentation about their procedure to help them with the appeal process. Transgender patients have rights and options. However, they might need to take extra steps to get the insurance approval they require in order to have a transgender hair transplant.