Breast Augmentation covered by insurance?

[AlyssaJ]

Have any of the post-op women out there had their insurance cover breast augmentation as part of your transition? After reviewing my health insurance's Gender Re-assigment coverage, I noticed that BA is listed both under covered and non-covered services. I reached out to them and found out that BA is covered if the 5 criteria for GRS are met, those being:


The individual is age 18 years or older
The individual has a confirmed diagnosis of gender dysphoria
the individual has undergone a minimum of 12 continuous months of hormonal therapy
Documentation that the individual has completed a minimum of 12 months of successful continuous full-time, real-life experience
The individual has received the three required referrals for surgery


Now I'm a long way from deciding if GRS is in my future, but I am doing my research and found this both interesting and promising. Just curious if anyone else has had success with insurance covering BA.

[jentay1367]

I'd say more than 90 percent of us can't get our Insurance to even cover something as cheap and simple as HRT. Who's your carrier? That might help anyone replying, because every one of the Insurance companies out there has and uses different criteria. You'll always find someone that got a BA or whatever through their carrier. But that information is apocryphal at best and doesn't do you a bit of good with your carrier. These people generally follow the WPATH or nothing at all. With the latter being what seems to be the case in most instances.

[grace7777]

Actually my health insurance does cover HRT. Now, I am in California, and I think California law may require them to do it. In fact they Will cover SRS, but there are a lot of hoops to jump through. I am not sure about BA, but more power to you if you can get it covered. One thing that surprised me about my insurance is that they will cover Electrolysis after a certain period of time on HRT.

[jentay1367]

and that's great Grace, but you live in the most progressive State in the Union. It's a blessing for you that it's so. Do keep us apprised as to your progress with the system.
It would be interesting for us all to watch. I wish you smooth sailing!

[AlyssaJ]

I have coverage through a Blue Cross/Blue Shield affiliate. They cover HRT, Orchy, Vaginoplasty, Penectomy, and Mammoplasty-BA and a few other less common things. I was surprised to confirm that it sounds like BA will be covered given that I meet their criteria.