Sex-Trait Modification Services
For Plan year 2026, chemical and surgical modification of an individual’s sex traits through medical interventions (including gender transition services) will no longer be covered under the FEHB Program.
We will continue to cover counseling services for diagnosed gender dysphoria. Search our online provider directory for licensed mental health providers.
If you are mid-treatment under our Plan, you are eligible for our continuation of care exception process by meeting the requirements below:
- For surgical services if:
- Preauthorization approval was completed prior to January 1, 2026;
- Treatment or services under approved treatment plan began before January 1, 2026;
- You are enrolled in the same MHBP plan that you were enrolled in 2025; and
- Your attending physician completes and submits the Precertification Information Request Form and the Hair Removal Authorization Form (if applicable) to the Aetna® Precertification Department
- For chemical regimen if:
- Preauthorization approval was completed prior to January 1, 2026;
- The approved chemical regimen was filled prior to January 1, 2026; and
- The exception form (will be available by 12/1/2025) is completed and submitted to the Clinical Team for review. You may mail or fax the exception request to:
- Clinical FFS Team P.O. Box 981114, El Paso, TX 79998-1114
- 1-855-556-7066
Our Gender Affirming Surgery Clinical Policy Bulletin outlines the procedures that are considered medically necessary.
Individuals under age 19 are not eligible for exceptions related to services for ongoing surgical or hormonal treatment for gender dysphoria.
If you disagree with the decision on your exception, please see Section 8 of the Plan brochure for the FEHB Appeals and Disputed Claims Process.