HRT and health insurances

[tgirlinva]

Can anyone comment on how insurances deal with HRT? Will they pay for my therapy sessions? as well as the hormones themselves? Can they kick me out of their policy b/c I'm a TS? Can they relegate the information to my employer (who's partially paying for it?) Thanks.

[Niya W]

Read thier exclusion policy. They cant tell your employer

[Priss]

Exactly... The exclusion policy.

I personally wanted to keep this all as private as possible. When I first started out I didn't have insurance and had aquired doctors, therapists and HRT on my own. That gave me a distinct advantage once I did aquire insurance. Yeah, I paid out of pocket for hormones and therapy and surgery... But once I did aquire insurance, I was able to simply tell them I was female and have them treat me that way. They never had to know a thing about my past. Once at that stage, they will pay for female related things like HRT, because it is a quite common female related thing. I never would have tried to get them to pay for SRS, simply the mentioning of it would tell them more about me than I would ever want them to know.

I don't know how this would have all worked out had I previously had insurance, Iam sure there would be some sort of nightmare paper trail in their records that would probably never go away, and I'd have probably ended up paying for everything myself anyway due to the exclusion clauses.

And of course this all stems from actions by groups in the past that one would think we'd be simpatico with... After all they lump us under GLBT. When push comes to shove however that "T" comes out of the alphabet soup so easily...

There was a time when transgender was not in their exclusion clauses. Unfortunately for us today it is, and we have to deal with that.

[Dawn D.]

I guess I am one of the lucky few. My Ins. is paying for my therapy and my HRT (not the E itself just the labs and Dr. visits since I don't have prescription coverage).

First, this is due to the issue of me attempting suicide back around last Christmas. And, that led into my GID. I guess it is all in how the Therapist's code for billing. Second, as to HRT, I happened to contract Osteoporosis in the spine and hips due to surprisingly low testosterone levels. Normally not a big deal, except, it turns out that they cannot give me T in order to counteract the osteo., since I also have an enlarged prostate and introducing more T can increase the risk of Prostate cancer. the second option would be one of the bisphosphenate drugs such as Boniva. I ended up with a near death experience from taking that drug! So, they cannot give it to me or any of the others in it's family. That left only one real option.........Estrogen!!!!! The stars and the moon must have been aligned just right for me, because I was ready to start asking for it anyway.

So, it can be done, but it is an odd set of circumstances that got me there.



Dawn

[Niya W]

Well soon insurgence will pay for every thing but SRS . Try Kaiser if they have it that far north Dawn

[Dawn D.]

Nope, only Blue Cross up here. But, I wish they'd cover the SRS too. There ought to be some way to prove it to be medically necessary?



Dawn

[GypsyKaren]

My Blue Cross did exclude my SRS, but they did pay for my hormones and therapy. The only problem I had was when my endo-doc coded my blood tests as transgender related (idiot), they refused to pay those.

Karen Starlene :star:

[Jenna1561]

My ins. company pays for my HRT, but will not pay for SRS. I do not believe they would pay for my therapy - I pay that out of pocket and prefer to keep it that way.

Jenna