Trans-related health costs that are deemed “medically necessary,” such as hormone therapy or gender confirmation surgery, are what the new rule will cover. Previously, Medicaid coverage only allowed trans folk 18 years and older seeking treatments like confirmation surgery and hormone therapy to be covered in order to treat gender dysphoria, whereas now Medicaid coverage will be open to everyone seeking certain treatment—as long as they meet requirements. (Gender dysphoria is when a person’s gender doesn’t match with their assigned sex.) For instance, to get hormone therapy to control puberty, a doctor must sign off on the person’s eligibility for the treatment. In addition, the person who will be receiving the treatment must have reached stage two of the five “Tanner Stages” of physical puberty.
The new rule will also call for a person to be 16 years or older and meet similar requirements in order to receive coverage for cross-sex hormone therapy (estrogen or testosterone). However, there are some cases in which a person younger than 16 years of age can still have cross-sex hormone treatment covered. If a person meets all of the necessary requirements except for meeting the age requirement, and the hormone treatment is “deemed medically necessary,” then the treatment can be covered.
Despite a rule prohibiting Medicaid coverage for cosmetic surgeries, surgeries done to match a person’s gender can still be covered if, again, they’re considered medically necessary to treat gender dysphoria.
You can learn more about the rule here.