Beginning
in 2011 (Carrier letter 2011-12), OPM emphasized that transgender individuals
should be provided appropriate preventive services in accordance with their
individual medical status. For example, an individual who transitions
from female to male may still need pap smears if they have not undergone a
hysterectomy.
Effective
January 1, 2016, no carrier participating in the Federal Employees Health
Benefits Program may have a general exclusion of services, drugs or supplies
related to gender transition or “sex transformations.”
All
plans complied with the OPM directive to remove blanket exclusions. There are plans in every state that will
offer mental health services, hormone therapy, and gender re-assignment
surgery.
Plans
differ in their covered services and procedures. Members seeking specific services should consult
plan brochures posted by state at www.opm.gov/insure.