Under the new policy, breast augmentation for transgender women will be considered a covered service under most of Aetna’s commercial health plans.
The policy change came after transgender women raised access issues to Aetna after their breast augmentation procedures were denied as part of their gender-affirming treatment. The members were represented by Transgender Legal Defense & Education Fund and civil rights law firm Cohen Milstein Sellers & Toll, who worked with Aetna to update its clinical policy bulletin to consider breast augmentation for transgender women as a medically necessary procedure.
“Our decision to update our clinical policy bulletin is consistent with many changes we have made over the years to better serve the needs of the LGBTQ community,” Jordan Pritzker, MD, senior director of clinical solutions for Aetna, said in a news release. “We appreciate the collaborative nature of this process, which allowed us to make an evidence-based change to our coverage policies regarding important care for members of the LGBTQ community.”
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