Scheduling Appointments at UHS
- Gender-affirming services and hormone therapy appointments with a primary care provider can be scheduled through the eTang portal. Visit the Transgender Care page for more details.
- If you need assistance, call Clinic 3 at (510) 643-7110 and ask to speak with a clinic nurse. The clinic nurse can arrange appointments and prepare you for your visit.
Referrals
If you receive a referral from a UHS provider, a member of the SHIP Trans Care Benefits Team will contact you by eTang secure message to schedule a phone consultation to discuss the SHIP gender-affirming benefits, pre-certification requirements, locating in-network providers and go over any questions you may have.
Pre-certification* is required for the following services:
- Hysterectomy
- Mastectomy (top surgery)
- Breast augmentation (augmentation mammoplasty)
- Gender-conforming facial surgery
- Gender-confirmation (reassignment/bottom) surgery
- Fertility preservation
- Travel expenses
*Pre-certification is required prior to receiving the services. Failure to obtain prior-approval will result in claims being denied. To request pre-certification, the provider of service will need to submit the request form with supporting medical documentation to the SHIP office.
Pre-certification is not required for the following services:
- Hormone therapy
- Electrolysis or laser hair removal of full body (as of 8/1/24)1
- Tracheal shave
- Vocal training (speech therapy)2
1When there is no in-network provider available, services are subject to the $450 deductible, then covered at 90% of the reasonable and customary charge (NOT the actual charge). To receive an estimate prior to obtaining services, log into your Wellfleet account to access the Cost Estimator Tool or contact Wellfleet Customer Service at (877) 657-5033 for assistance.
2After the 12th visit per plan year, services are subject to pre-certification and medical necessity review.
Estimated Costs* for Common Surgeries
- Mastectomy (top surgery): $18,000 - $23,000
- Hysterectomy: $25,000 - $37,000
- Orchiectomy: $11,000
- Augmentation mammoplasty (breast augmentation): $16,000 - $24,000
- Gender-confirmation (reassignment/bottom) surgery, including metoidioplasty, vaginoplasty, phalloplasty: $25,000 - $150,000
*Please use these estimates as suggestions only; costs vary widely. Estimated prices are based on case rates, which may include costs for services after the surgery, such as follow-up care if needed.
SHIP members are responsible for the $450 deductible and any applicable co-pay and co-insurance, up to the out-of-pocket maximum of $3200 per plan year for in-network services. More benefit and coverage details can be found on the gender-affirming benefits flyer. Pre-certification is required for most care.
If you don't have SHIP
- At UHS: All registered students can obtain services with the Transgender and Gender Diversity Care Team. For information about fees, visit the Billing and Cashier's Office webpage. The Transgender and Gender Diversity Care Team can send prescriptions and lab work to outside pharmacies and labs.
- Benefits & Coverage: Check with your health insurance provider to see what medical care is covered.
- Kaiser members: Kaiser does not permit patients to go outside their system. Learn about Kaiser's gender-affirming care.