Expanding BCN medical coverage for transgender employees of the University of Michigan
Blue Care Network will soon begin covering additional medical services for University of Michigan employees who are transgender. This applies to members covered by U-M Premier Care and GradCare plans.
You can identify the BCN members who are eligible for these services by their group number, which is 00124316. The number is on the front of member's University of Michigan-branded ID cards. As always, be sure to check web-DENIS for benefits and eligibility.
The following additional gender-affirming services for University of Michigan members transitioning from male to female will be covered starting July 1, 2019:
Services are eligible for coverage if they meet medical necessity criteria and if members use in-network providers. Michigan Medicine, formerly the University of Michigan Health System, is the only provider in our network that currently performs the facial feminization surgical services.
There's a $30,000 lifetime limit per member for these new gender-affirming services.
Submitting authorization requests
These new services require authorization. Starting June 12, 2019, use the e-referral system to submit authorization requests.
Starting June 23, one of the following questionnaires will open in the e-referral system when you submit these authorization requests:
Preview questionnaires will be available on this website soon. Look for them on BCN's Authorization Requirements & Criteria page. We encourage you to use these preview questionnaires to prepare in advance your answers to the questionnaires you'll see in the e-referral system.
For more details, see the University of Michigan fact sheet on health plan coverage for gender-affirming services.*
*Blue Cross Blue Shield of Michigan doesn't own or control this website.
Posted: June 2019
Line of business: Blue Care Network