Maryland: Expanded Medicaid coverage of gender-affirming treatments

As of Jan. 1, 2024, aligning with state guidelines, we now cover certain gender-affirming treatments for Maryland Medicaid members.

Gender-affirming treatments are considered medically necessary treatments that are consistent with current clinical standards of care prescribed by a licensed health care provider for the treatment of a condition related to the individual’s gender identity.

Covered services

Gender-affirming treatments covered for Medicaid members include:

• Hormone therapy, including hormone blockers and puberty blockers
• Hair alteration for secondary sex characteristics and surgical site preparation
• Voice therapy and voice modification surgery
• Gender-affirming surgeries and therapies:
  • Alterations to abdomen, chest, trunk, buttocks
  • Alterations to face and neck
  • Alterations to genitals and gonads
• Laser treatment for surgery scars
• Fertility preservation procedures and reversal of prior treatments

Treatment requirements

The following requirements apply to gender-affirming treatments:

• Age: There is no defined age limit for care. However, minors do need parental content. 
• Medical necessity diagnosis: A medical necessity diagnosis may be required for gender-affirming treatments 
• Prior authorization: Some gender-affirming treatments may require prior authorization in alignment with Maryland Medicaid Administration guidelines 

For more information about covered benefits and requirements, please view Maryland Medicaid Administration’s Gender Affirming Care Information for Providers webpageopen_in_new.

PCA-1-24-012420POE-NN_04292024