Testosterone question about insurance billing.

[Hulud]

My girlfriend is 18 and has long been interested in testosterone treatment, but hadn't considered it seriously until I had "said it's alright." I've been doing research on the matter, and she's pretty much all for it, except for one thing: she does not want to have to go through her dad in order to get the process going. She is insured, but by the company her dad works for. Her dad has handled all of her medical stuff in the past, but there was a bit of a revelation that this isn't necessary anymore since she's now a legal adult, and she has the freedom to pursue whatever medical treatment she can pay for. But she wants this to be completely confidential. Basically, she doesn't want her parents to find out.

So, since she is insured under her dad rather than herself, will he receive some sort of notification about it? Will he get some sort of statement in the mail with the visit to the endocrinologist listed?

Also, does insurance even cover that sort of thing? I don't know much about the insurance provider, except that it is probably Aetna.

Does she even need to visit an endocrinologist, or can she get the prescription from her GP?

[TheAetherealMeadow]

Why does your girlfriend want testosterone treatment?  I'm sure you mean estrogen?

[Kohitsu]

Why does your girlfriend want testosterone treatment?  I'm sure you mean estrogen?

I was wondering the same thing...

I wish I could answer your question regarding insurance, but I don't know much about it myself. 

[Hayzer12]

Or maybe he's referring to an FTM, and using wrong pronouns.....

And if your significant other doesn't want the parents to find out, then I doubt they've went to therapy and even has the go-ahead for treatment.

[Hulud]

Since I'm  posting in the FTM forum, that means she is a female who wants to take testosterone in order to be male. If she was a biological boy wanting to be a girl, I would not post in the FTM forum. The reason why she is my girlfriend rather than boyfriend is because she does not look masculine enough to refer to herself as a male. I am a woman, and she is a woman who wants to be a man, but she is too womanly-looking to comfortably refer to herself as a man.

No, she obviously has not had any treatment of any sort, psychological or physiological, which is why I'm asking these questions. If she had already gone to any sort of doctor about this, then I would have no reason to ask this question, because we would have already found out the answer.

Please don't waste your time criticizing my semantics and perhaps just give me a reasonable response to my perfectly reasonable question.

[xAndrewx]

Hulud, we occasionally get people who do not understand the forum setup and various other things which is part of why you got those responses. If she herself (using the pronouns you chose) has chosen not to use male pronouns then that is understandable but usually people on here such as myself use male pronouns automatically when talking about transmen and honestly, a person doesn't have to look male to be referred to as male if they are male. (wow the word male too many times in the same sentence sorry)

Your partner would need to either find a doctor who will do informed consent usually the person does a mental exam (like a being asked questions on a questionare from how I understand it) or will have to sign a paper saying they understand the effects and want the treatment. Or she would need to find a therapist who will write her a letter after a certain amount of sessions (3 months according to the standards of care but the amount of time is not mandatory). Then find a doctor who will prescribe testosterone. I would suggest sending her here to get to know everyone because the site can be a useful resource and the forum may be helpful for any questions you both may need answers to.

Also... welcome to Susans  It's great to see a supportive partner seeking out resources.

Disclaimer thingy sorta: I do not speak for the whole of susans so I tried to keep my answers general. Sorry guys, feel free to correct anything I put

[GentlemanRDP]

The answer to your questions might vary from state to state, but I'm not entirely sure.

When I decided to start testosterone, I had to go and see a gender therapist for four months - although, if you go by the Standards of Care, the therapists will typically make you go for six months. My therapist knew that this was what I wanted, so she was okay with cutting the time down. After therapy, the therapist will write a referral letter to an endo saying that the patient is committed and is ready for HRT (Hormone replacement therapy,) you then take this letter to an endo, they do bloodwork and you're on your way.

Right now, I'm on my stepfather's insurance, so he gets the bill, and he lives in another state, so I don't know what letters he might get,
But I assume that he gets some kind of notification of what the insurance covered.
Sorry that I can't be more help.

[Kaylie]

Hello Hulud and welcome to the forums! Its great to hear that you are so supportive of your significant other 

(I'll just stick with the pronouns you were using for this post) As for the insurance questions: Usually the primary plan holder (in this case her father) will receive a bill in the mail for anyone who is on the plan when they use medical services. Also there is usually a way to access this information online, so her father also might be able to view transactions and other account information via that venue. I'm not 100% sure on how detailed these statements are, but he would probably find out sooner or later especially if the copay is significant (which it might be for seeing a specialist like an endocrinologist). Due to federal HIPPA privacy policies these providers would not be able to disclose any information about her treatment without consent since she is a legal adult. But the statements would probably at least include which office is being billed so he could probably find out what types of doctors from that.

So, unfortunately I don't think she would be able to hide that information from her parents while using their insurance 
She would probably have to either confront her parents on the issue or try and find clinics and providers willing to give discounts to uninsured patients.

Hope that helps even though its not very positive info.

[Caldwell]

It should be noted that with the new version of the SOC you no longer are required a certain amount of therapy, or even therapy at all.

[Hulud]

Thank you all, this is exactly the sort of information I was looking for.

Also, what is the SOC, and what is the general range of copay for an endocrinologist visit?

Perhaps I should note that she plans on paying for everything herself.