What Are My Benefits? Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 21 − Laboratory testing to monitor the safety of continuous hormone therapy as appropriate to the patient’s gender goals. − Permanent hair removal for purposes of genital reconstruction. − Voice lessons and voice therapy. − Members must be 18 years of age or older for the surgical treatment of Gender Dysphoria. • Surgery treatment for Gender Dysphoria, includes the surgeries listed below: − Genital surgeries: o Clitoroplasty (creation of clitoris) o Hysterectomy (removal of uterus) o Labiaplasty (creation of labia) o Metoidioplasty (creation of penis, using clitoris) o Orchiectomy (removal of testicles) o Penectomy (removal of penis) o Penile prosthesis o Phalloplasty (creation of penis) o Salpingo-oophorectomy (removal of fallopian tubes and ovaries) o Scrotoplasty (creation of scrotum) o Testicular prosthesis o Urethroplasty (reconstruction of female urethra) o Urethroplasty (reconstruction of male urethra) o Vaginectomy (removal of vagina) o Vaginoplasty (creation of vagina) o Vulvectomy (removal of vulva) − Chest surgeries: o Bilateral mastectomy or breast reduction o Breast enlargement, including augmentation mammoplasty and breast implants − Face and neck surgeries: o Thyroid cartilage remodeling / thyroid chondroplasty / tracheal shave (remodeling of the Adam’s apple) o Voice modification surgery • Routine diagnostic services, including diagnostic lab, x-ray, and ultrasound are included in the Gender Dysphoria Services copayment. When the routine diagnostic service is prescribed by a doctor and received on a different date of service and location, the service is $0 copayment. • Select services for the treatment of Gender Dysphoria may require Prior Authorization and Medical Necessity review. Home Health Services In-Network Out-of-Network Home Health Care Visit $35 copayment / visit $105 copayment / visit Private Duty Nursing $35 copayment / visit $105 copayment / visit Notes: • Refer to the Surest mobile app for additional coverage information. • Home Health Care Visits are limited to 90 visits per Participant per Plan Year for in-network and out-of-network Providers combined. • Private Duty Nursing is limited to 84 visits per Participant per Plan Year for in-network and out-of-network Providers combined. • Services received from a Home Health Agency (an organization authorized by law to provide health care services in the home) or independent Provider that are the following: − Ordered by a Physician. − Provided in your home by a registered nurse or provided by either a home health aide or licensed practical nurse and supervised by a registered nurse. − Provided on a part-time, intermittent care schedule. − Provided when skilled care is required. • For Enteral Nutrition administered at home, multiple copayments will apply (such as for formula and nursing visit). • Occupational therapy, physical therapy, and/or speech therapy visits performed in the home, billed by the Home Health Agency, will apply to the Home Health Services visit limits.