Author Topic: Insurance question  (Read 328 times)

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Offline Ashley_wolf

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Insurance question
« on: August 16, 2018, 06:27:22 pm »
So my insurance said I have to be on hormones for 12 months and living full time for 12 months in order for me to have SRS. So my councillor said she is willing to write my letter for the surgery. However my councillor said I should be okay and insurance should let me have the surgery even though I don't plan to go full time till I have my surgery. So my question is has anyone delt with this?

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Online KathyLauren

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Re: Insurance question
« Reply #1 on: August 16, 2018, 06:33:04 pm »
The one year HRT, one year RLE requirement is in the WPATH guidelines, which most insurers follow.  There may be insurers that will waive the WPATH requirements, but most will follow them.

For those of us with insanely long waiting lists, it is impossible to get into the surgery queue in less than a year anyway, so we have no trouble meeting the requirement.  I can understand that it would be frustrating if you didn't have long waiting lists to deal with.

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Offline Devlyn

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Re: Insurance question
« Reply #2 on: August 16, 2018, 08:07:28 pm »
The last step for me was sitting down with the surgeon to go over my eligibility. He checked my records, my meds, and my letters, then scheduled a surgery date. Bottom line, it's the surgeon who decides if you've met the requirements.

Having said that, my surgery came after a couple years full time, and only seven months on HRT. Again, it's the surgeon's decision if you're ready.

Hugs, Devlyn

Offline Colleen_definitely

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Re: Insurance question
« Reply #3 on: August 16, 2018, 08:11:27 pm »
And on that note I'm not sure if you're going to find a surgeon that takes insurance willing to do this for someone who hasn't walked the walk so to speak.
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Offline Harley Quinn

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Re: Insurance question
« Reply #4 on: August 17, 2018, 08:01:02 am »
My insurance does that as well. I they really have no way to check "full time" and to me full time is you living with the knowledge that you're a woman. The doctor letter is all they want there. If your doctor says it's been a year, then it's been a year. As for hormones, I imagine you'll hit a year just on the SRS waitlists. Mine was super fast at 5 months. You can kill a year just in electrolysis... so I wouldn't sweat it. With electrolysis, surgical wait times, and insurance vetting you'll be at a year easy.
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