Genital Surgery. The Member must provide documentation in the form of a written psychological assessment from at least two qualified behavioral health providers experienced in treating Gender Dysphoria, who have independently assessed the Member. The assessment must document that the Member meets all of the following criteria: Has persistent, well-documented Gender Dysphoria; Has the capacity to make a fully informed decision and to consent for treatment; Must 18 years or older; If significant medical or mental health concerns are present, they must be reasonably well controlled; Complete at least 12 months of successful continuous full-time real-life experience in the desired gender; and Complete 12 months of continuous cross-sex hormone therapy appropriate for the desired gender (unless medically contraindicated). HPN makes no representation or warranty as to the medical competence or ability of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians. HPN shall have no liability or responsibility, either direct, indirect, vicarious or otherwise, or any actions or inactions, whether negligent or otherwise, on the part of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians.
Genital Surgery. The Insured must provide documentation in the form of a written psychological assessment from at least two qualified behavioral health providers experienced in treating Gender Dysphoria, who have independently assessed the Insured. The assessment must document that the Insured meets all of the following criteria:
Genital Surgery. The Insured must provide documentation in the form of a written psychological assessment from at least two qualified behavioral health providers experienced in treating Gender Dysphoria, who have independently assessed the Insured. The assessment must document that the Insured meets all of the following criteria: Has persistent, well-documented Gender Dysphoria; Has the Capacity to make a fully informed decision and to consent for treatment; Must 18 years or older; If significant medical or mental health concerns are present, they must be reasonably well controlled; Complete at least 12 months of successful continuous full-time real-life experience in the desired gender; and Complete 12 months of continuous cross-sex hormone therapy appropriate for the desired gender (unless medically contraindicated). SHL makes no representation or warranty as to the medical competence or ability of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians. SHL shall have no liability or responsibility, either direct, indirect, vicarious or otherwise, or any actions or inactions, whether negligent or otherwise, on the part of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians.
Genital Surgery. The Insured must provide documentation in the form of a written psychological assessment from at least two qualified behavioral health providers experienced in treating Gender Dysphoria, who have independently assessed the Insured. The assessment must document that the Insured meets all of the following criteria: Has persistent, well-documented Gender Dysphoria; Has the Capacity to make a fully informed decision and to consent for treatment; Must 18 years or older; If significant medical or mental health concerns are present, they must be reasonably well controlled; Complete at least 12 months of successful continuous full-time real-life experience in the desired gender; and Complete 12 months of continuous cross-sex hormone therapy appropriate for the desired gender (unless medically contraindicated). SHL makes no representation or warranty as to the medical competence or ability of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians. SHL shall have no liability or responsibility, either direct, indirect, vicarious or otherwise, or any actions or inactions, whether negligent or otherwise, on the part of any Gender Dysphoria Treatment Center/Facility or its respective staff or Physicians. Covered Services include Prior Authorized Medically Necessary Genetic Disease Testing when: Such testing is prescribed following the Insured’s history, physical examination and pedigree analysis, genetic counseling, and completion of conventional diagnostic studies, and a definitive diagnosis remains uncertain and a genetic disease diagnosis is suspected, and; The Insured displays clinical features, or is at direct risk of inheriting the mutation in question (presymptomatic); and The result of the test will directly impact the treatment being delivered to the Insured. Covered Services include the following accommodations, services and supplies received during an admission to a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, Residential Treatment Center or Hospice Care Facility. Semiprivate (or multibed unit) room, including bed, board and general nursing care. Private room including bed, board, and general nursing care, but only when treatment of the Insured's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when an Insured receives private room accommodations for any reason other than Medical Necessity. Inpatient accommodations provided in c...
