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Transgender Health

Academic Blue – BCBSTX

The UH Endorsed Student Health Insurance (Academic Blue – BCBSTX) plan covers Transgender Services as follows.

Transsexualism/Gender Identity Disorder Expense

Benefits are payable for Eligible Expenses incurred by a Covered Person for the treatment of transsexualism/gender identity disorder on the same basis as any other Sickness according to the limits and maximums shown in the Schedule of Benefits. The Eligible Expenses must be incurred while the Covered Person is insured for these benefits.

Eligible Expenses include:

  1. mental health counseling (subject to the limitations applicable to inpatient and outpatient treatment of Mental and Nervous Disorders);
  2. hormone replacement therapy;
  3. sexual reassignment surgery:
    1. for female to male: mastectomy, hysterectomy, salpingo-oophorectomy, vaginectomy, metoidioplasty, scrotoplasty, urethroplasty, placement of testicular prosthesis, phalloplasty; or
    2. for male to female: orchiectomy, penectomy, vaginoplasty, clitoroplasty, labiaplasty.

The Company will pay the Covered Percentage of the Eligible Expenses incurred in excess of the Deductible Amount.

No benefits will be paid for the Eligible Expense above under any other similar benefit provision contained in this Policy.

Outpatient Expenses (In-Network) 80% of Reasonable and Customary (R&C) unless otherwise stated.**

Prime Therapeutics - Prescription Drugs Information 
(Outside UH Health Center)
$20 generic, $50 brand name, $70 non-formulary brand

Toll Free: 888-275-3235

Emergency Room (In-Network) 80% of R&C subject to $150 Hospital copay per visit.

Surgery Expense (In-Network) or Out of Hospital) 80% of R&C unless otherwise stated**

*Copayment plus the cost difference between the brand-name drug or supplies per prescription for which there is a generic drug or supply available.

** Subject to deductibles, copays, limitations, and exclusions.

The above summary is not a guarantee of benefits. Contact BlueCross Blue Shield of Texas Customer Service at (855) 267-0214 for benefits information.