MEDICALLY NECESSARY LETTERS FOR TRANS, NON BINARY, INTERSEX, LGBTQPIA+ COMMUNITY 

Our free mental health program can assist you with letters of medical necessity to

anyone in the State of California. If you need assistance please email:

[email protected]

Your insurance will have very specific requirements to meet their criteria. It is important to know this because each insurance is independent. There are hundreds, if not thousands, of different combinations of insurances that sometimes have the same umbrella name but are uniquely different.

A medical provider can write a letter that surgery is medically necessary. A mental health provider, however, can engage in an assessment and then write a letter for hormones(s), surgery(ies), and/or medical procedure(s) that are medically necessary and help support you in your journey. Our assessments are done in a single session and we write you the letter immediately.

A review of your insurance member handbook will be an important and critical tool for affirming care.  It will determine your deductible, what is and is not covered, and what your insurance considers cosmetic.

Provider and Mental Health letters typically Include:

• A statement that, in the doctor’s or mental health professional opinion, the treatment is medically necessary and the appropriate step. Some plans also require clinical codes to be used.

• A brief description of the patient’s medical history.

• An explanation of why this procedure is medically necessary for this patient.

• The health care providers’ training in trans-related care.

• If coverage is denied, an appeal will be necessary with the reason for the denial and why it is medically necessary. There are often sensitive time restraints that must be followed. The appeal should be addressed in an urgent manner to protect your time restraints.