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Frequently
Asked Questions
  
Our Programs

Transgender Health Services

 

Provider FAQ

 

How do I refer my patients to the transgender surgery program?

Mental health providers should refer their patients to their primary care provider. Primary care providers should submit all referrals for transition surgery via eReferral, regardless of patient insurance type. The policy page of the Transgender Health Services program contains detailed instructions on submitting the eReferral.


I’m not sure surgery is appropriate for my patient – how can I get an expert opinion?

Use eReferral to submit a request for a consultation. The Transgender Health Services Program Clinical Lead will assist you with your questions.


How do I know if surgery is covered for my patient?

The Transgender Health Services Program Coordinator can help you find out if surgery will be covered for your patient.

Coverage depends upon what type of insurance your patient has. The Department has no ability to provide a service that is not offered under a patient’s health insurance plan.  The chart below describes current access to these surgeries.

 

Yes

No

Depends


Insured

  Medi-Cal Fee-for-Service

Yes – patient locates and arranges surgeon

 

Patient access to surgeries depend upon whether the treatment authorization submitted to Medi-Cal is approved

  Medi-Cal Managed Care

Yes – health plan locates and arranges surgeon

 

 

  Medicare

 

No

 

  Commercial Insurance

 

 

Based on coverage



Uninsured

  Healthy San Francisco

Available through separate program

 

 

  Sliding Scale

Available through separate program

 

Patient must have established relationship with an in-network provider


How can I build my skills and knowledge to better serve my transgender patients?

DPH offers a range of training opportunities for providers interested in learning how to better serve their transgender patients. More information about training opportunities will be available soon.


How can I help my patient prepare for transition surgery?

Educational materials will be available soon.