State Health Insurance

[JohnAlex]

I'm so disappointed.  My health insurance is currently though Kaiser.  and I love Kaiser. took me a while to find if Kaiser would cover T (they do) and then to find a trans-friendly doctor and then a therapist to write a letter for my doctor.  but I had a plan and everything was going to work out.

But now my dad tells me that he can't afford Kaiser anymore and is looking to get his kids on state health insurance within the next few months.  I doubt I could get a prescription for T in that time.  So now I'm wondering if anyone knows how to find out what my state health insurance will cover.  I live in Washington State. 
Is there a chance that they'll cover T?  or therapists?

I feel lost all over again.  I got to restart and figure this out all over again.

[Darth_Taco]

State health insurance only ever covers the necessary stuff since it's funded by tax-payer money. So no, it won't cover any transgender stuff.

[Felix]

Oregon Health Plan covers transgender stuff. It's pretty low down on their list of priorities, but they make a point of considering it necessary and not cosmetic.

Anyway, on Oregon medicaid testosterone is free if you get the shot at the doctor's office instead of doing it yourself. The appointments with the physician are covered, and the labwork is covered. It's going to get billed as what it is (liver panel, cbc, hormone levels, etc), and doesn't have TRANS stamped all over it. It is decidedly a grey area to operate in though.

That's probably not helpful though, as I don't know much about Washington.

[JohnAlex]

Oregon Health Plan covers transgender stuff. It's pretty low down on their list of priorities, but they make a point of considering it necessary and not cosmetic.

Anyway, on Oregon medicaid testosterone is free if you get the shot at the doctor's office instead of doing it yourself. The appointments with the physician are covered, and the labwork is covered. It's going to get billed as what it is (liver panel, cbc, hormone levels, etc), and doesn't have TRANS stamped all over it. It is decidedly a grey area to operate in though.

That's probably not helpful though, as I don't know much about Washington.

Well that's hopeful to know.  Maybe Washington might be something like that.

[Robert Scott]

Each state determines what it will cover --- here in MN it will cover therapy, dr. apt and T --- they use to cover surgery but a couple years ago stopped

[JohnAlex]

Each state determines what it will cover --- here in MN it will cover therapy, dr. apt and T --- they use to cover surgery but a couple years ago stopped

How do I find out what they will cover?  I tried google searching it and going to their website, but couldn't find what I needed to know.

[Paul]

How do I find out what they will cover?  I tried google searching it and going to their website, but couldn't find what I needed to know.

It was different for me because I was told ahead of time that my insurance covered it, but for my own reassurance I actually called their office and asked what they covered regarding Trans stuff and the guy went over everything and then mailed me a packet so that I had it for my own records.

[Nygeel]

I think it depends on the insurer as well as the state. I know in New York HIP covers transgender care, but I'm not sure of other companies.

An option that will work 100% (at least to get on T) is to get your insurance to cover you as male. If you're a (cis) male with extremely low T, they have to give it to you where as with trans issues they might not.

This is from 2006, and from fox news so it's probably not accurate...

OLYMPIA, Wash. —  Washington Medicaid officials are taking steps to end publicly funded sex-change surgery.

However, the state is required to pay for at least two more operations and will continue to cover hormone treatment and psychotherapy for low-income people diagnosed with gender-identity disorders.

http://www.foxnews.com/story/0,2933,207447,00.html

So, you can have hormones covered.

[Paul]

I think it depends on the insurer as well as the state. I know in New York HIP covers transgender care, but I'm not sure of other companies.

Where is HIP out of?  I live in NY, but I've never heard of it.  I get CDPHP through work, but that's only for around/near Albany.  CDPHP covers therapy, psychiatry, any labs, specialists, hormones, surgery.

[Nygeel]

Where is HIP out of?  I live in NY, but I've never heard of it.  I get CDPHP through work, but that's only for around/near Albany.  CDPHP covers therapy, psychiatry, any labs, specialists, hormones, surgery.

HIP is NYC area. I just got insurance through my mom, but it doesn't cover hormones (as far as I know).

[JohnAlex]

I think it depends on the insurer as well as the state. I know in New York HIP covers transgender care, but I'm not sure of other companies.

An option that will work 100% (at least to get on T) is to get your insurance to cover you as male. If you're a (cis) male with extremely low T, they have to give it to you where as with trans issues they might not.

This is from 2006, and from fox news so it's probably not accurate...

OLYMPIA, Wash. —  Washington Medicaid officials are taking steps to end publicly funded sex-change surgery.

However, the state is required to pay for at least two more operations and will continue to cover hormone treatment and psychotherapy for low-income people diagnosed with gender-identity disorders.

http://www.foxnews.com/story/0,2933,207447,00.html

So, you can have hormones covered.

That sounds nice.  But how do you get the insurance to be willing to change your gender on their paperwork?  won't they just want to go off of your ID, especially if they aren't trans-friendly?

[Nygeel]

That sounds nice.  But how do you get the insurance to be willing to change your gender on their paperwork?  won't they just want to go off of your ID, especially if they aren't trans-friendly?

I don't know exactly. I know that my doctor wanted to do it for me, and that they have people at the clinic I go to who know how to deal with insurance companies. Beyond that, I'm clueless.

[Robert Scott]

Just a word of caution --- if you switch your gender marker with your insurance there are things that you won't be able to get covered by your insurance -- like a pap smear - which might not be that big of a deal unless you have problems in the future.  You also can't get a hysto.  Those things are not an option under male in health insurance.  Just FYI

[wheat thins are delicious]

Just a word of caution --- if you switch your gender marker with your insurance there are things that you won't be able to get covered by your insurance -- like a pap smear - which might not be that big of a deal unless you have problems in the future.  You also can't get a hysto.  Those things are not an option under male in health insurance.  Just FYI

There are ways to get it covered by insurance even if you have a M marker.  I'm not sure how exactly but I know people that do.

[Felix]

JohnAlex, I spent forever digging through documents on the Washington medicaid site and couldn't make heads or tails of it, but this might help - http://slog.thestranger.com/slog/archives/2011/04/08/trans-rights-in-washington