Gender Affirming Care Services for Youth: What Medi-Cal and CHIP Members Need to Know
Background
On October 13, 2026, the federal government stopped paying for some gender affirming care for youth. This affects Medi-Cal members under age 18 and Children’s Health Insurance Program (CHIP) members under age 19 who get certain gender affirming care services for gender dysphoria (impacted youth). Medi-Cal and CHIP are overseen by the California Department of Health Care Services (DHCS). It does not impact individuals receiving services outside of the Medi-Cal or CHIP programs.
What Is Changing?
As of October 13, 2026, some services for Medi-Cal members under age 18 or CHIP members under age 19 can no longer be paid for with federal Medicaid or CHIP funds. These include the following gender affirming services:
- Surgeries
- Medications, including puberty blockers and hormone treatments
- Youth already taking gender affirming hormones as of October 13, 2026 can keep getting them through Medi-Cal until April 12, 2027.
- These medications can also be submitted to Pucci’s Pharmacy for payment through HCAI’s grant pathway.
What Is Not Changing?
Impacted youth can still get many kinds of care for gender dysphoria through Medi-Cal, such as:
- Doctor visits
- Lab tests
- Speech therapy
- Mental and behavioral health care
- Care for problems from past surgeries
Medi-Cal will continue to cover these services when medically necessary, including for gender dysphoria.
How Will Youth in Medi-Cal Get Care the Federal Government is No Longer Paying for?
California will still pay for these services through a new program at the Department of Health Care Access and Information (HCAI).
California is creating a state-funded program through HCAI so that impacted Medi-Cal youth can keep getting the care they need. Impacted Medi-Cal youth will not be responsible for payment under this new program.
What do Youth Need to Know?
California is committed to helping impacted youth keep getting the care they need. HCAI—in partnership with the DHCS—is working to provide important information to providers (for example, doctors and clinics) and impacted youth.
Some important things to know include:
- Doctors and clinics should be aware of these changes.
- Impacted youth should talk to their doctor or clinic about care options.
- Impacted youth who already have care scheduled should contact their doctor or clinic as soon as possible. Consider asking some important questions:
- Will there be any changes in how, where, or when my care is provided?
- Will you participate in HCAI’s new program?
- Is there anything that I need to do?
Who Can Impacted Youth Contact for Questions?
- For general questions regarding Medi-Cal or CHIP, including about eligibility or coverage, impacted youth may contact the Member Helpline via phone at (800) 541-5555.
- For specific questions regarding medical or pharmacy services, or if told that their doctor or clinic are no longer offering these services, impacted youth may contact the appropriate entity as follows:
| Surgeries, puberty blockers, and hormone therapies* | Other medical services (e.g., office visits, laboratory tests, speech therapy and psychotherapy) |
| Regardless of Medi-Cal managed care or fee-for-service enrollment, contact HCAI directly via email at genderaffirmingcare@hcai.ca.gov. Note: Please do not send any of your confidential medical information in any emails to HCAI. | If enrolled in Medi-Cal managed care, contact their Medi-Cal managed care plan (MCP) for assistance. If enrolled in Medi-Cal fee-for-service, contact DHCS’ Member Helpline via phone at (800) 541-5555. |
*HCAI is able to assist only with gender affirming care services impacted by the federal changes.