Wow, that's really stupid that insurance companies are allowed to explicitly exclude sex-change related things from their policies. That should be against the law, since trans people should be able to receive adequate health coverage through their insurance.
Here, in Croatia, you can get everything covered through public health, the problem until recently was that there are hardly any specialists here willing to work with trans folks. Now, there are a couple of endos who will work with us, so T can be covered - however, from what I've heard, they won't GIVE you your T so you can take it yourself, but you have to come to the clinic/hospital each time to get your shot (supposedly it's due to a fear of you re-selling the T you receive). However, if you can't/don't want to come in for each shot, you can get your prescription in a neighbouring country (Serbia), and it costs about $100 for 3 years worth of T. EDIT: Maybe it might even be easier for you guys to travel to Serbia (or elsewhere where T is cheap) and get enough for a few years - it would probably be cheaper even with travel costs than getting it for over $60/month in the US. Just not sure how much you are allowed to carry across borders. Here, if you have a prescription, they supposedly don't cause you any problems when crossing the Croatia-Serbia border, even for a three-year supply.
Supposedly, there's also one surgeon in Croatia who does top surgery (which is also covered), however, I'm not sure how good he is. Unfortunately though, there's no one who does bottom-surgery here, so the closest option (and a good one, from what I hear) is again in Serbia. There are even some folks who are working on getting surgeries that can't be done in Croatia covered by Croatian public health. And they even managed to get hormone-blockers and a prosthetic covered for this kid who is now maybe 15 or so - so, he is using a prosthetic until he is old enough to get surgery (and they're covering the prosthetic on the basis of him having as normal and healthy of a growing up experience as possible). And he'll probably be allowed to get his ID as male when he turns 16, even though he still won't be on hormones or have had any surgery or anything. I was surprised to learn about all this, but it was all thanks to the kid's mom and this legal team of an LGBT organisation here being persistent and working things out with the government officials (they've been working on things since the kid was about 7 or 8 years old).
So yeah, I think the US could learn a thing or two from more "conservative" countries like Croatia. Or you guys should move here

It's not perfect, there aren't many people who will work with us, there is discrimination (but again, that's the case more-or-less everywhere), but things are definitely getting better and at least the government is willing to work with us.