​​​​​​​​​​​​​​​​​​​​​​​​​​​Notice: ​ Proposed Federal Rule Changes for Children Under 18​

The Maryland Department of Health​ is reviewing the December 18, 2025, federal announcement​ related to gender-affirming care. At this time, there is no change to gender affirming coverage under Maryland Medicaid. Check here for more information, including any changes, as it becomes available.

This transmittal updates providers on coverage for Gender-Affirming Care (GAC) services for minors. On August 13, 2026, the Centers for Medicare and Medicaid Services published final rule CMS-2451-F, which prohibits states from drawing down federal matching dollars for GAC for minors under 18, effective October 13, 2026. The rule does not prohibit states from using state-only funds to cover these services.

Gender Affirming Care

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Maryland Medicaid covers medically needed care that upholds the safety, dignity and respect of transgender and gender expansive people. Gender affirming care is for those who need medical care to make their body match their lived gender. ​

How do I get care? 

To get Medicaid gender affirming services, you must:

What gender-affirming services does Medicaid cover? 

Some services include:

  • Hormone therapy and lab testing
  • Voice surgery, therapy and lessons
  • Hair removal and transplants 
  • Fertility preservation services
  • ​Facial surgery 
  • Top surgery
  • Gender affirming surgery
  • Preventative care after transition
  • Revision or reversal of prior gender-affirming procedures
If you get your Medicaid benefits through one of Medicaid’s HealthChoice managed care organizations (MCOs), contact them for more information about covered services. You can also talk to your health care provider for help with medical information.​ 

FAQ

​Resources 

Contact

For questions about Medicaid's gender-affirming care benefits, email [email protected].

​Maryland ​Medicaid covers medically needed care based on the latest health guidelines. Medicaid will cover care without discrimination.