Transgender Benefits

VMware is proud to offer coverage for a diagnosis of Gender Dysphoria under our UnitedHealthcare (UHC) self- insured UHC HSA PPO and Traditional PPO plans.

Eligibility

VMware covered employees and qualified dependents covered on the UHC Medical plans with a confirmed diagnosis of Gender Dysphoria

Coverage Information

Members covered under the UHC Medical plans please refer section Gender Dysphoria coverage section for details under  Summary Plan Description [1] listed under the Notices and Documents on the US Benefits webpage

Note: Using Out of Network coverage have certain limitations and coverage information.

Here are some covered procedures under the UnitedHealthcare (UHC) medical plans.  Please refer to the applicable coverage section under Summary Plan Description. [1]

Transgender Benefits

Benefits for the treatment of Gender Dysphoria provided by or under the direction of a Physician.

For the purpose of this Benefit, Gender Dysphoria is a disorder characterized by the specific diagnostic criteria classified in the current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association.

Prior Authorization for Surgical Treatment:

You must obtain prior authorization as soon as the possibility of surgery arises.

Prior Authorization Requirement for Non-Surgical Treatment

Depending upon where the Covered Health Care Service is provided, any applicable prior authorization requirements will be the same as those stated under each Covered Health Care Service category in the schedule of benefits listed under Gender Dysphoria.

Non-Surgical Treatments:

Surgical Treatments:

Genital Male to Female:

Non-Genital Male to Female:

Genital Female to Male:

Non-Genital Female to Male:

Genital Surgery and Bilateral Mastectomy or Breast Reduction Surgery Documentation Requirements:

The Covered Person must provide documentation of the following for breast surgery:

The Covered Person must provide documentation of the following for genital surgery:

Exclusions and Limitations for Gender Dysphoria (review pages under Summary Plan Description)

  1. Treatments received outside of the United States
  2. Drug therapies that are dispensed from a pharmacy
  3. Drugs* for hair loss or
  4. Drugs* for sexual performance for patients that have undergone genital
  5. Transportation, meals, lodging or similar
  6. The following listed procedures;

* The drug exclusions listed above apply to drugs administered by a provider in a medical setting (including, but not limited to: office, outpatient, or inpatient facility). For drugs obtained at a pharmacy, refer to the VMware, Inc. Pharmacy page [3] on the US Benefits webpage for specific prescription drug product coverage and exclusion terms

What if You Have a Question?

Call the UnitedHealthcare Personal Support Advisor for Gender Dysphoria telephone number at 1-800-326-9166 during regular business hours, Monday through Friday. All calls are confidential.