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OPM.gov / Frequently Asked Questions / Domestic Partner Benefits FAQ / Insurance Benefits

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Insurance Benefits

Questions and answers

Carriers must have an exceptions process, which should be applied on a case-by-case basis, for coverage of excluded services for enrollees who are mid-treatment within a surgical and/or hormonal regimen for diagnosed gender dysphoria. Individuals under age 19 are not eligible for exceptions related to services for ongoing surgical or hormonal treatment for diagnosed gender dysphoria.
Consult your Carrier’s plan brochure for further information at Healthcare: Plan Information - OPM.gov and Postal Service Health Benefits (PSHB) Plan Brochures.

Control Panel

Insurance Benefits

Questions and answers

Is there an exceptions process for those enrollees who may be mid-treatment for a surgical and/or hormonal regimen for diagnosed gender dysphoria such that they are able to finish their treatment?