Reviewing the Gender-affirming benefits [PDF] is a good place to start learning about how the plan covers medically necessary services after you meet your annual deductible.

To begin accessing Aetna’s gender-affirming care benefits, your first step is to call your Aetna service advocate at 1-800-884-9565. The Advocate Team can give you a high-level overview of your benefits and the services covered. They can also help you find providers in your area or connect you with additional support:

• If you have clinical questions or need help with plan approvals, tell the advocate you’d like to work with an Aetna nurse care manager trained in transgender or gender-affirming care. The advocate will try and connect you during your call, so you can get started right away.
• If you have questions about claims or transgender and gender-affirming benefits, the advocate will have an advocate from the Transgender Support Center call you.

If you work with both a nurse care manager and a Transgender Support Center advocate, they will work closely together to support you throughout your journey.

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Transgender and gender-affirming benefits are the same as for any other medical condition and are based on the Standards of Care for the health of transgender and gender nonconforming people published by the World Professional Association for Transgender Health (WPATH). Your Adobe coverage includes medically necessary services including, but not limited to these. Some services may require additional documentation, such as a referral letter from a therapist. Review the list of Aetna clinical criteria for coverage. If you have questions about a procedure or provider, contact the Aetna service advocate at 1-800-884-9565.

• Medical (e.g. office visits, outpatient care, inpatient hospital care, mental health care)
• Lab services
• Hormone therapy
• Gender-affirming surgery, including mastectomy with chest reconstruction and gender-affirming chest surgery
• Preoperative and postoperative exams and treatment for medical complications
• Hair removal (electrolysis/laser)
• Non-genital, non-breast surgical interventions:
  • Liposuction and lipofilling
  • Pectoral implants
  • Facial feminization surgery
  • Voice surgery and thyroid cartilage reduction
  • Gluteal augmentation
  • Hair reconstruction
• Voice and communication therapy to develop verbal and non-verbal communication skills

For information about available in-network gender affirming surgeons, log in to the Aetna website (SSO) and go to the Member Resources section. If you don’t see an in-network surgeon near you, contact your Aetna nurse care manager who can help you find a provider that will accept your insurance. If you don’t currently have an Aetna nurse care manager, call the Aetna service advocate at 1-800-884-9565 and request a Nurse care manager.

Adobe’s health care plans offer consistent access to care and resources, independent of the state where you live. The Aetna medical plans cover gender-affirming services and will reimburse travel expenses (subject to IRS limits), for an employee or covered dependent, to a state that can provide these services if traveling 100 miles or more. For coverage details, see your plan’s booklet and schedule of benefits, and contact Aetna if you have any questions. 

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Adobe’s Aetna and Kaiser medical plans offer comprehensive coverage to support your physical wellbeing, from preventive care and medications to managing health concerns or chronic conditions. If you’re gender nonconforming, non-binary or on the transgender continuum, your needs may be different. Be sure to talk with your provider about the care and screenings that are appropriate based on your personal situation.

You also have access to emotional and mental wellbeing resources through your Aetna or Kaiser medical plan or through Adobe's employee assistance program (EAP). The EAP is a great place to start and then check out the many in person and digital care solutions available through your medical plan.

If you are on a journey of building a family, we have a variety of supports to help along the way. They are highlighted on the personal and family services page:

• Fertility benefits
• Adoption support
• Surrogacy assistance

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