Gender Affirming Care

From the beginning, our mission at Sana has been to make quality healthcare accessible, affordable, and understandable — and that includes access to gender-affirming care.

All Sana plans are self-insured, which means they are not subject to state insurance mandates. Because of this, our flexible network continues to offer access to the highest quality of care, including travel benefits, regardless of plan type or geographic location. 

Transgender Sana members may seek all, none, or some of the following interventions to help affirm their own gender identity. Please note that a diagnosis of gender dysphoria and prior authorization are required. 

Medical Care

Gender-affirming hormone therapy is the most common gender-affirming intervention. For PPO Plus Plans, generic hormone therapy is $10 per refill. Please see the SmithRx Formulary for specific pricing information by brand. Members of PPO Plus HSA (H) plans will owe the full cost prior to meeting their deductible and can reach out to SmithRx for an estimate of their pre-deductible drug costs.

Surgical Care

Specific surgical care coverage is defined by your plan. In general, Sana plans cover 50-100% of the following gender-affirming surgeries post-deductible:

• Augmentation mammoplasty
• Feminizing vaginoplasty
• Hysterectomy/oophorectomy
• Masculinizing chest surgery ("top" surgery)
• Masculinizing phalloplasty / scrotoplasty
• Metoidioplasty (clitoral release/enlargement, may include urethral lengthening)
• Orchiectomy
• Reduction thyrochondroplasty (tracheal cartilage shave)
• Vaginectomy
• Voice surgery

Important: Benefits and coverage are defined by your Summary Plan Description (SPD).