Trans people on Medicare can now apply for the costs of their gender confirmation surgery to be covered, following a ruling today.

The Health and Human Services Department’s Appeals Board ruled today that a ban on coverage for trans-related surgery must be removed.

The ruling – which follows a long-running dispute – did not specify that all confirmation surgery costs should be covered, but allows for consideration on a case-by-case basis.

Medicare is a national health insurance program which helps to provide insurance to the elderly and disabled.

Despite the limited scope of Medicare, the ruling also has wider implications for trans people fighting to get their surgery costs covered by private insurers, as Medicare guidelines are often used as a basis for private insurance contracts.

Medicare spokesperson Aaron Albright told Associated Press that following the ruling, Medicare “may cover this care case-by-case or under a local coverage determination based on clinical evidence to determine medical appropriateness.”

Jamison Green, president of the World Professional Association of Transgender Health, told TIME: “We’re very excited about it.

“Now there is considerable evidence that shows that this is a valid condition, that the treatment is effective … it can be disabling if it’s not treated.”

According to the Board, the policy banning the payments was based on obsolete information compiled in 1981, and had not since been revised.