What gender-affirming care does TRICARE cover?
Quick Answer
TRICARE covers some gender-affirming care including mental health services and hormone therapy. Surgical coverage has specific criteria.
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Key Takeaways
- Mental health covered
- Hormone therapy covered
- Surgery has criteria
- Authorization often needed
Detailed Answer
Gender-affirming care coverage has evolved over time.
Currently Covered
- Mental health counseling
- Hormone therapy
- Some surgical procedures
- Ongoing medical care
Requirements
- Diagnosis of gender dysphoria
- Treatment plan
- Provider qualifications
- Authorization may be needed
Mental Health
- Assessment and diagnosis
- Ongoing therapy
- Support services
- Family counseling
Medical Treatment
- Hormone therapy covered
- Monitoring and labs
- Related medications
Surgical Options
- Specific criteria must be met
- Prior authorization required
- Provider requirements
- Evolving coverage policies
Related Questions
What services require prior authorization?
Prior authorization is needed for many inpatient stays, some surgeries, specialty services, DME, and certain high-cost procedures regardless of plan.
What mental health services does TRICARE cover?
TRICARE covers outpatient therapy, psychiatry, inpatient treatment, intensive outpatient programs, substance abuse treatment, and crisis intervention.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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