Reply To: Top surgery

[Dana Munson]

Plunking around on the Web, I recently found Medicare’s policy memo regarding coverage for transgender medical services. So far as surgeries go, Medicare has no “national” policy at present. The regional Medicare admin centers (MACs) are left to decide coverage of transgender surgical procedures “case by case.”  Translation: some MACs may be more trans leaning than others and there may be no discernible rhyme or reason why one MAC typically approves a given procedure and another MAC typically doesn’t.  The one seemingly consistent position nationally is that the trans-related surgery sought has be “medically necessary” to the well-being of the patient. Meaning detailed letters from treating medical & mental health  professionals supporting the “necessity” in a particular case. Merely cosmetic procedures probably are not going to fare well in this environment. For instance, I am lining up a tracheal shave for early next year. Chances of Medicare covering it: zero.