Trans Resource Navigator

Gender-affirming care in Pennsylvania

Care for adults
Allowed
Care for people under 18
Allowed
Medical Assistance (HealthChoices) pays for hormones
Covered
Medical Assistance (HealthChoices) pays for surgery
Covered
Private plans must cover care
Yes, by law

Gender-affirming care is legal in Pennsylvania for adults and minors. Medical Assistance (Medicaid) has covered medically necessary transition care, including hormones and surgery, since 2016, and state insurance guidance bars blanket exclusions in state-regulated plans. There is no shield law, and some hospital systems have stopped treating patients under 19.

Draft from official sources, September 24, 2026. Not yet checked by a person. How we verify

On this page
  1. Health centers near you
  2. Hormones by telehealth
  3. Clinics, programs, and funds
  4. Paying for care
  5. Rules for adults
  6. Rules for under 18
  7. Laws and court cases
  8. Sources

Community health centers near you

These federally funded centers must see you whether or not you have insurance, and charge based on income. Many, but not all, prescribe hormone therapy. Call and ask for "gender-affirming care" or "hormone therapy."

Sorting by distance uses your location only on this device. It is never sent anywhere.

Hormones by telehealth

These services prescribe hormones through video visits for people in this state. Point of Pride pays for a year and a half of care with several of them each spring.

  • Plume

    PaidNo Medicaid18+

    Trans-led telehealth service providing informed-consent hormone therapy, lab orders, prescriptions, and letters for surgery and documents, by app and video visit. Self-pay only since January 2026. A Point of Pride HRT Access Fund partner.

    About $99 per month ($90 in NY and NJ), which includes visits, messaging, prescriptions, and document letters. Labs and medications are billed separately and are often cheap with GoodRx or at a community pharmacy. Free for 18 months if you win a Point of Pride HRT Access Fund grant.

  • FOLX Health

    InsuranceTakes insuranceNo Medicaid18+

    LGBTQ-focused telehealth offering hormone therapy, PrEP, primary care, and mental health visits. Accepts major commercial insurance (Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare) but not Medicaid or Medicare. A Point of Pride HRT Access Fund partner.

    In-network with many commercial plans; self-pay membership about $69 to $98 per month all-inclusive.

  • Planned Parenthood

    Sliding scaleTakes insurance

    Many Planned Parenthood affiliates provide informed-consent gender-affirming hormone therapy alongside sexual and reproductive health care, on a sliding scale and with Medicaid. Most affiliates see adults 18 and older; a few see 16- and 17-year-olds with parental consent and a readiness letter. Many start hormone care by telehealth. Self-pay initial consults typically run about $120 to $250 before sliding-scale discounts.

Clinics, programs, and funds

Paying for care

Medicaid (Medical Assistance (HealthChoices))[1][2][3]

Since July 18, 2016, the Department of Human Services has not applied the old regulatory exclusions for "sex reassignment." Services related to gender transition that are otherwise covered (doctor visits, hospital care, prescription drugs) are paid when medically necessary, and DHS and managed care plans use the WPATH Standards of Care to decide medical necessity (MA Bulletin 99-16-11). Expect prior authorization for surgery; ask your HealthChoices plan for its gender-affirming care policy.

Apply online at COMPASS (compass.dhs.pa.gov), by phone, or at your county assistance office.

Apply for coverage

Private insurance[4][5]

Insurance Department Notice 2016-05 tells state-regulated insurers that policies should not exclude services based on gender identity or contain a categorical exclusion of gender transition care, and should provide medically necessary covered services regardless of gender identity. This is agency guidance, not a statute, and it does not reach self-funded employer plans. If your plan denies care, appeal with the plan first, then file a complaint with the Pennsylvania Insurance Department.

File an insurance complaint

The rules in detail

Rules for adultsNo state restriction. Community clinics such as Central Outreach Wellness Center describe their hormone care as consent-based, meaning no therapist…

No state restriction. Community clinics such as Central Outreach Wellness Center describe their hormone care as consent-based, meaning no therapist letter is needed. Telehealth prescribing is available statewide.

If you have no insurance and little money, in rough order:

  1. Apply for Medical Assistance through COMPASS. It covers hormones, labs, and medically necessary surgery.
  2. Go to a community health center (federally qualified health center), which charges on a sliding scale. Find one at findahealthcenter.hrsa.gov.
  3. Try LGBTQ-focused clinics in Philadelphia and Pittsburgh (see the city pages).
  4. Point of Pride runs an HRT access fund and a free chest binder and gaff program.
[8][13][3][1]
Rules for under 18Legal. Pennsylvania has no law banning gender-affirming care for minors, and parental consent is required.

Legal. Pennsylvania has no law banning gender-affirming care for minors, and parental consent is required. There is no shield law, so Pennsylvania does not have statutory protections against out-of-state investigations.

Access has narrowed in practice: according to TransYOUniting, a Pittsburgh community organization, UPMC ended gender-affirming care for all patients under 19 as of June 30, 2025. Families should call providers directly to confirm what they currently offer.

[6][7]
Laws and court cases1 law
  • 55 Pa. Code § 1163.59(a)(1): Former Medical Assistance exclusion for transition surgery; no longer applied since MA Bulletin 99-16-11 (2016)

Sources

14 sources. Numbers in the text, like [1], point here.Show all
  1. Medical Assistance Bulletin 99-16-11, coverage of services related to gender transition (July 18, 2016)Pennsylvania Department of Human Services (copy hosted by A4TE), Official page. accessed
    “Effective July 18, 2016, the categorical MA regulatory prohibitions on payment for services related to sex reassignment ... are no longer in effect.”
  2. 55 Pa. Code § 1163.59, Noncompensable services, items and outlier daysPennsylvania Code and Bulletin, Regulation. accessed
  3. COMPASSPennsylvania Department of Human Services, Official page. accessed
  4. Notice Regarding Nondiscrimination; Notice 2016-05, 46 Pa.B. 2251 (April 30, 2016)Pennsylvania Insurance Department, Official page. accessed
    “it is anticipated that a policy will not exclude services based on gender identity and will not contain a categorical exclusion of coverage for all health services related to gender transition”
  5. Complaints, questions, and helpPennsylvania Insurance Department, Official page. accessed
  6. Pennsylvania state profileMovement Advancement Project, Organization. accessed
  7. TransYOUnitingCommunity. accessed
    “UPMC chose to end gender-affirming care for all trans people under 19 years old starting June 30, 2025.”
  8. Gender-Affirming CareCentral Outreach Wellness Center, Organization. accessed
    “we are dedicated to providing consent-based gender-affirming care that aligns with YOUR goals and choices.”
  9. LocationsCentral Outreach Wellness Center, Organization. accessed
  10. New Patient Appointment InformationMazzoni Center, Organization. accessed
  11. Planned Parenthood Southeastern PennsylvaniaPlanned Parenthood, Organization. accessed
  12. Planned Parenthood of Western PennsylvaniaPlanned Parenthood, Organization. accessed
  13. Find a Health CenterHealth Resources and Services Administration, Official page. accessed
  14. Point of PrideOrganization. accessed