Aetna Agrees to Expand Coverage for Gender-Affirming Surgeries One of the nation’s largest health insurers is agreeing to pay for breast augmentation for some trans women. Two years ago, Cora Brna, a health care worker in Pittsburgh, was devastated to learn that her insurance would not cover the breast augmentation she had planned to have along with a genital reassignment surgery.Credit...Sarah Huny Young for The New York Times Jan. 26, 2021 Allison Escolastico, a 30-year-old transgender woman, has wanted breast augmentation surgery for a decade. By 2019, she finally thought her insurance company, Aetna, would pay for it, only to find that it considered the procedure cosmetic, not medically necessary, and refused to cover it.