Your rights to coverage
In Washington state, health insurers usually can't deny or limit gender-affirming treatment that's medically necessary. Examples include:
- Hormone therapy
- Counseling
- Breast surgeries and chest reconstruction
- Hair removal
- Facial surgery
- Surgery to make the Adam's apple smaller
If your insurer denies services, they must explain why. A provider experienced in gender‑affirming care then reviews the decision. Insurers may deny services only when medical evidence supports the denial or the service is not medically necessary.
If you think the insurer unfairly denied your coverage, file an appeal. For help, see our sample appeal letter for gender-affirming care.
You can also file a complaint, and we'll look into it.