Coverage tips

Healthcare for the LGBTQ community

Learn how LifeWise supports the LGBTQ community’s right to safe and affordable healthcare. Explore our plans and services or find a doctor.
August 21, 2023   |   4 minute read
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Among the 2.2 million members we serve in Washington state are people who may face discrimination simply for being who they are. Whether you’re lesbian, gay, bisexual, transgender, or queer, we support your right to safe and affordable healthcare. Your doctor’s office should be a judgment-free place where you feel safe to ask questions and discuss issues about your health. 

LifeWise has medical plans with benefits that help you get quality healthcare from the provider of your choice. Unless your doctor recommends otherwise, you should always seek preventive care for the sex you were born with. Your doctor may recommend tests or specific care based on signs or symptoms; in which case your visit could be billed as diagnostic rather than preventive. A copay or deductible might apply.

HIV PrEP therapy and drug coverage

HIV pre-exposure prophylaxis (PrEP) tests, screenings, counseling, and medications are covered at no cost when used as preventive healthcare for people receiving or undergoing evaluation for HIV infection. Please view our Preventive Services list for more information. 

Mental healthcare

Many healthcare plans, including LifeWise, cover mental health and substance-use disorders. Copays may apply. Counseling and psychotherapy for stress and anxiety, building self-confidence, and navigating life’s challenges are examples of covered care. Primary care physicians and counselors can also help you establish better community and family support which can help lessen the risk of depression and anxiety. Our Find Care tool is also a great resource for locating a mental healthcare provider in your network. 

Gender affirming benefits and services

Benefits and services are provided for gender dysphoria (formerly known as, gender identity disorder) and medically necessary surgery. Members will also find coverage for prescription drugs and mental health services received in preparation for gender-affirming surgery.

Coverage and requirements can vary by plan and specific age requirements apply as well. Sign in and check the benefits in your account to confirm coverage. Contact us if you still have questions about specific requirements.

Locate doctors and specialists in the LifeWise network who offer gender-affirming treatment services.

You can also search for providers on the World Professional Association for Transgender Health (WPATH) website. Before setting an appointment, use our provider directory to confirm that the provider is in network. 

Anytime you need additional support, contact a LifeWise customer service representative. The phone number is on the back of your ID card. 

The list provided was accurate as of 12/7/2021. Confirm a provider’s status before arranging care by checking our online provider directory or by contacting customer service.

Locate a surgeon

For gender-affirming surgery, your in-network doctor can request a pre-service review. To ensure understanding of your specific plan coverage and to avoid surprise bills, we recommend checking in with a LifeWise customer service representative. Upon approval of gender-affirming surgery, copay and deductible requirements apply.

Get started by researching gender-affirming clinics with an experienced surgeon. Again, use our Find Care tool and browse by category or specialty (Medical Care, Primary Care, etc.). Refine your search by using the More Filters drop-down and then All Expertise. Scroll and find providers that support gay, lesbian, bisexual, gender-affirming, or queer medical services.

Remember, your LifeWise customer service representative is a great resource, too. We can quickly confirm if a provider you are considering is in your network. 

If the provider you are using is out of network, submit a claim form to LifeWise. Include all procedure and diagnosis codes, costs for each procedure, and medical records. With that, we can process your claims directly. 

Not sure if your plan includes out-of-network coverage? Contact customer service to check.

Note: LifeWise does not cover or support conversion therapy programs designed to change a person’s sexual orientation or gender identity.

Read more about Gender Transition/Affirmation and LifeWise on our FAQ page.

Benefits under your health plan may differ, so sign in to your account and refer to your benefit booklet for information on what your specific health plan covers.
Your health plan covers preventive care services as required by state and federal law. For more information, please review the “A” and “B” rated services on the United States Preventive Services Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on

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