Finally

Finally the Office of Personnel Management (OPM) is considering requiring, or at least prohibiting explicit exclusion (the current practice with all policies under the Federal Employees Health Benefit Plan (FEHB), coverage for transition care including Sex Reassignment Surgery (SRS).

This, noted here, follows the Department of Health and Human Services (HHS) decision recently to include transition care in Medicare plans. Currently it's neither excluded or included, unlike the FEHB where it's excluded.

This means before (Medicare) or after (FEHB) January 1, 2015 patients undergoing transition with either Medicare or FEHB can have as much as 60-80% of their costs covered, especially the major costs of SRS, which can run $12-15,000 overseas or $20-25,000 in the US.

It's likely any coverage will be for US surgeons but there isn't a lack of them, only the waiting time varys from a few months to 6-9 months depending on the surgeon. But as with some health coverage, patients may still have to pay (always full payment up front with SRS) and get reimbursed.

Some surgeons are in some state or local government health plans because their clinic is in the state which makes coverage through the insurance company. Companies which cover it usually do so through riders with their employees health plans and pays direct for the employee minus other costs such as travel, lodging, etc.

This is good news for active or retired federal government employees and those on Medicare. Currently some coverage is defaulted in the health plans, such as drugs, therapy and etc because they're not sex/gender specific than specific to transitioning people.

But it took four years after President Obama endorsed a letter to OPM on LGBT issues which instructed OPM to act on the health insurance coverage. And a good number of patients under FEHB have either paid out of pocket or delayed finishing their transition because of the time for this decision.

At least OPM got there, and so in the 2015 policies people under the FEHB will not see the words, "Sex transformation services and surgery excluded" in the plan coverage brochure and an explanation of the coverage based on the status of the provider (preferred, general or other).