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What Insurance Covers FTM Surgery?

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What Insurance Covers FTM Surgery?

For many trans people, the idea of undergoing gender-affirming surgery is daunting, not because of the fear of finally becoming who they really are but because of the price. Without insurance, the surgery can be quite expensive. However, insurance is available in Canada that covers the cost of the surgery.

OHIP covers transgender surgery

The Ontario Health Insurance Plan (OHIP) covers certain transgender surgical procedures. Fortunately, FTM surgery is one of the many procedures included. For example, all aspects of mastectomy procedures are covered, from the removal of excess skin and breast tissue, to the reconstruction of the chest and reduction/repositioning of the nipple and areola, to the minimization of any scars along the chest walls.

Qualifying for transgender surgery in Ontario

Although the province of Ontario funds FTM chest surgery through its OHIP program, you will still need to qualify. To be approved for this procedure you will need an assessment, from either a doctor, nurse practitioner, psychologist or registered social worker, that recommends the surgery. The assessment will contain information that states that you have received a diagnosis of persistent gender dysphoria and have completed a year of continuous hormone therapy. Once the Ministry of Health approves the surgery, you can get a recommendation for a qualified surgeon who specializes in FTM procedures.

Other provincial insurance

Most Canadian provinces and territories offer provincial insurance coverage for transgender surgery. Please visit the Ministry of Health website for your particular province for details. You can find a comprehensive list of each Health Ministry here. It’s important to remember that each province has different insurance options for trans people seeking FTM surgery and the qualifications may not be the same as in Ontario. If you are not an Ontario resident but wish to have your transgender surgery in the province, contact the Ontario Ministry of Health. You can view their site here.

Private insurance coverage

If you have private health insurance through your workplace or other means, it may cover your surgery. However, not all insurance providers in Canada offer this type of coverage. To find out what your provider covers in terms of FTM surgery, it’s best to contact them directly.For questions regarding FTM surgery insurance coverage and to find out if you qualify, please contact us. We are here to help.