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Aveed (testosterone undecanoate)CareFirst (Caremark)

Gender dysphoria (adult)

Initial criteria

  • Member has a diagnosis of gender dysphoria
  • Member is able to make an informed decision to engage in hormone therapy
  • Member’s comorbid conditions are reasonably controlled
  • Member has been educated on any contraindications and side effects to therapy
  • Member has been informed of fertility preservation options

Reauthorization criteria

  • Member has a diagnosis of gender dysphoria
  • Member is able to make an informed decision to engage in hormone therapy
  • Member’s comorbid conditions are reasonably controlled
  • Member has been educated on any contraindications and side effects to therapy
  • Before the start of therapy, the member has been informed of fertility preservation options

Approval duration

12 months