Health Care

CMS approves Colorado’s plan to require coverage of gender-affirming care

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Colorado’s marketplace health plans must cover a wide range gender-affirming services for transgender individuals beginning Jan. 1, 2023, the federal government announced Tuesday.

It’s the first time the Centers for Medicare and Medicaid Services has signed off on such a requirement. The cost of related medical treatments can add up to more than $100,000, according to some accounts.

“I am proud to stand with Colorado to remove barriers that have historically made it difficult for transgender people to access health coverage and medical care,” Secretary of the Health and Human Services Department Xavier Becerra said in a statement.

The approval means all plans sold on Colorado’s individual and small group health insurance markets will have to cover services experts say are medically necessary for transgender individuals but that have been deemed as “cosmetic” by some insurance companies.

The plans will have to cover eye and lid modifications, face tightening, facial bone remodeling for facial feminization, breast/chest construction and reductions and laser hair removal, according to CMS.

Currently, marketplace plans in Colorado must cover hormone therapy and some surgeries for treatment of gender dysphoria.


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