DPHHS Announces Changes to Gender Dysphoria Coverage for HMK Members in Accordance With New Federal Final Rules, Effective Oct. 13, 2026

Oct. 15, 2026

Beginning Oct. 13, 2026, the Montana Department of Public Health and Human Services will no longer cover or pay for certain pharmaceutical and surgical services when prescribed, furnished or performed for gender transition for Healthy Montana Kids and Children’s Health Insurance Program members under age 19. This policy change comes as new federal rules limit Medicaid and CHIP payment for certain services.

Claims processing information: Effective Oct. 13, 2026, claims for puberty-blocking medications or surgical procedures are not covered when the medication or procedure is prescribed, furnished or performed for gender transition for a Medicaid member under age 18 or an HMK/CHIP member under age 19.

For more information, read the DPHHS notice.

If you have questions, please email Provider Relations or call 406-437-6100.

The information in this article is provided by the Montana Department of Public Health and Human Services and is being provided by Blue Cross and Blue Shield of Montana as a courtesy to and on behalf of the Montana Department of Public Health and Human Services.