Gender Affirming Surgery Exclusion Removed for Medical Mutual Small Groups

Medical Mutual is removing the benefit exclusion for gender affirming surgery currently in place for small groups. This change will allow services related to gender affirming surgery to be covered when deemed medically necessary. Grandmothered/grandfathered groups and COSE MEWAwill see the change take effect January 1, 2022, while ACA groups will see the change at their next renewal in 2022.

There will be no immediate impact to medical rates. Certificate books will be updated to reflect the change and we will send letters to affected group officials. Grandmothered/grandfathered groups will also receive an updated certificate amendment. As a reminder, Medical Mutual does not mail certificate books to members when there is a change. However, members can always access them on their My Health Plan accounts under Benefits & Coverage.

Contact your Cornerstone representative with any questions.