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How Do I get from HRT letter in Hand to Pills in Hand?

Started by Olivia-Anne, June 06, 2012, 08:01:18 PM

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Olivia-Anne

So I finally have my HRT letter, and I thought that was the hard part. I just am at a loss of how to start the process. I thought I would get some assistance with this from my therapist but, I guess she doesn't really have any information on this side of things. So, I do have insurance, a terrible HMO plan that apparently no Endo and not GP want anything to do with a TG patient. So I am left to fend for myself out of pocket which is fine. So here is where my questions begin.

1. What exactly is the process? From what I gather, I need to see a General Physician get refered to an Endo who then tests my hormone levels and prescribes accordingly? (Provided of course they aren't prejeduce)

2. Can I circumvent this process at all? I.E. just go to a testing labratory, order my hormone level to be tested and provide HRT letter and Lab results to someone with a degree online somewhere?

3. I heard Planned Parenthood is an option as well, My day off is in two days and I am going to walk in there and see if I can make some kind of progress on this. But do they do everything in house as in, lab test, prescribe, and provide?

4. What kind of costs are assoiciated with getting lab work done out of pocket? (I checked and my insurance is garbage again looking for an out of pocket cost and not a " you would be suprised at what they cover" answer).

5. Can an Endo be a 1 stop shop? As in they just need my HRT letter and they can order lab work check levels prescribe and monitor?

6.  Has anyone used Dr. Bushong's website for just HRT and not this 135doller surchage just to make an appointment nonsense?

Sorry for the wall of text, I've just had my letter for 2 weeks now and am struggling to get somekind of solid answers. Thanks for your help ladies!

<3 Liv
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michelle666

I thought with the new WPATH Standards Of Care, you didn't need a letter for HRT?
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Ms. OBrien CVT

See if there is a low-cost clinic near you.  Or check with a local GLBT group and see if they have an one you can see.

  
It does not take courage or bravery to change your gender.  It takes fear of living one more day in the wrong one.~me
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Jamie D

Every lab I have used for testing has required a doctor's order.

Any licensed medical doctor can prescribe medications and order blood work or other lab tests.  Some people do not have access to an endocrinologist.  An endo would be good, especially if you have complications, but it is not a legal requirement.

I believe you said you have an HMO.  Some plans do not cover transition-related testing and procedures.  However, they might cover hormonal imbalances or other similar conditions.  It is all in how the doctor uses the ICD codes.

Talk to your doctor.  Be frank.
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Alainaluvsu

When I got my letter, first I took the advice of my therapist who recommended me to an endocrinologist who has been known to deal with transgender patients. When that doctor didn't call back, I googled endocrinologists in my area and went down the list until I found one that would take me. I have been seeing this doctor for about 7 months now and she is the only doctor I have ever had to see about this at all. She's ordered my tests, prescribed me drugs, wrote up my lab work that needed to be done, and that's all I've ever needed. I didn't need any recommendations from a GP or anything.
To dream of the person you would like to be is to waste the person you are.



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Olivia-Anne

Quote from: Alainaluvsu on June 06, 2012, 10:45:05 PM
When I got my letter, first I took the advice of my therapist who recommended me to an endocrinologist who has been known to deal with transgender patients. When that doctor didn't call back, I googled endocrinologists in my area and went down the list until I found one that would take me. I have been seeing this doctor for about 7 months now and she is the only doctor I have ever had to see about this at all. She's ordered my tests, prescribed me drugs, wrote up my lab work that needed to be done, and that's all I've ever needed. I didn't need any recommendations from a GP or anything.
Cool! Thats kind of what I thought but i wasn't sure. That was how I had planned to spend my friday off, but I thought I would give planned parenthood a shot, but I am certain that will take a long time just to be seen. Thank you all for your replies.

@Michelle-I believe you are correct, all you need is informed concent, the letter was more of a personal thing to me and to get an official second opinion other then my own. I think I am also going to use it as sort of a "visual aid" for coming out to family, which is a whole other can of worms.

@Ms. Obrien- The only "Clinic" i have been able to find is Planned Parenthood, which is where i will probably spend this friday at, although i will be there right when they open soo * fingers crossed* on that one.

@Jamie D- I have a friend of mine who used to be a, well i dont know what her job was exactly but she handled allt he paper work/insurance stuff for a medical clinic downtown, went through my insurance plan for me and bascially said I can probably only get the actual perscriptions covered. My PCP that I called to make an appointment with initially is apparently prejeduce or something because they said they don't accept transgender patients. But on the plus side I can change my plan to a PPO the 1st of November and then one of my friends who is a docter (Stanford Med grad DR.) can be my PCP, at the moment she can't be my PCP because of my HMO. So basically I just need to get the first 6 months started and she can take over.

I do have another question though, I know this is a highly subjective question, but is the quality of care of a clinic up to par of a private Endo? Like, say a complication were to arise, would Planned Parenthood be able to deal with it or would they just end up refering me to an Endo? Cost is an issue, however, I don't want to endanger myself at the cost of what would ultimately just be the price of a good pair of shoes or something.

Again, Thank you for your responses they are more valuable than you realise!

<3 Liv

On a side note, I just want to personally thank you Jamie D. On everyone of my threads I am sure to receive valuable advise from you and for that I can't thank you enough!

On another side note, Alaina congrats on the name change! I've been following your transition on these forums and your insight and transformation is inspiring! I'm sorry for the job situation, unfortunitially I have a feeling I will end up taking a similar route with my job as well. But like I said, I will probably take a page out of your book and take that opportunity to change all the legal stuff over and go full time  ^-^
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Alainaluvsu

Quote from: Olivia-Anne on June 06, 2012, 11:41:28 PM
On another side note, Alaina congrats on the name change! I've been following your transition on these forums and your insight and transformation is inspiring! I'm sorry for the job situation, unfortunitially I have a feeling I will end up taking a similar route with my job as well. But like I said, I will probably take a page out of your book and take that opportunity to change all the legal stuff over and go full time  ^-^

Aww thanks :) That means so much to me. I'm glad I'm helping somebody like I've been helped in life!!
To dream of the person you would like to be is to waste the person you are.



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Jamie D

Olivia, the PPO will probably cost you more than the HMO, but in the long run, it will make your life easier.
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carol_w

Try Internal Medicine docs on your list, as well.  Many IM's take care of HRT. 
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Rory

I'm glad you asked this. I'm supposed to have my letters in hand within a week, but I feel really overwhelmed about where to start and how to go about things.
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bullwinklle

You just leave the HRT letter under your pillow, and the HRT fairy comes in the night and leaves you hormones.  ;)

I kid, I kid.  I actually worked with my therapist and regular doctor (he practices family medicine).  He has been a family friend forever, so that helped, but basically my therapist advised him about dosages and such (he also did his own research). I have my blood work done at his office, he gets the results and checks them for any issues, and prescribes my HRT.
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Olivia-Anne

#11
So at group last night I got some more information about HRT. Basically what I learned was, I can go to any Endo to get the whole everything done. There are some Internal Medicine and General care physicians that take care of it all. There are Some GCP's will only monitor but not prescribe. So its pretty much just finding someone that will work with you towards it, its just one of those things not outlined in black and white.

As far as costs ( here in kern county) hormone out of pocket costs range from 10$ a month to 50$ a month depending on insurance/no insurance and delivery method. Lab work costs apparently can be negotiated if your paying out of pocket cash. (something to do with health insurance not needing a kick back so you can catch a break that way or something...) But, lab work out of pocket can be anywhere from 250$- 300$ each time. There are also the doctor visit costs which depends  on the doctor and whatnot. From what i gather those are about 50$-100$ depending.

Also its 6:45 A.M. just woke up, hvaven't had coffee yet, so im sorry if this is incoherant, I am going to go to Planned Parenthood still just to explore that option and i will update what happens with that when i get back. For those with the same questions as me!

<3 Liv

Edit: Just got back from PP, basically they can't do the kind of testing or procedures needed for HRT there, they refered me to a bunch of other clinics. *sigh*
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Olivia-Anne

I know I know, I'm a double poster meanie! >:(

Ok so after about 30 calls in kern county area, being flat out hung up on 6 times, being told "im going to pray for you, and that god feels your worthy of redemtion"... and then taking some time to regather myself after all the disheartning phonecalls, I FINALLY have an appointment with an Endo that deals with transgender patients. I am going to Laguna Beach to see her, but I go there every other weekend anyways so its not that big of a deal, granted still 4 hours away but the price you pay I guess...

So for the people that are like me and like to know logistics of things, here you go. The first initial visit, since im a new patient and paying out of pocket is 325 dollers after that. The first visit is just for all the new patient testing information gathering stuff. After that they will order lab testing and that is a seperate entity, but they have a lab in the same building soo hopefully I can get it done same day.  From what i hear the lab will probably be about another 300ish dollers out of pocket. After the docter gets the lab results I guess she will evaluate and prescribe from there hopefully... Oh and after the initial visit the follow up visits are only 125 dollers. 

The way I found out about them through a google searching for resources. The link pasted below is OC LA county area because apparently Kern County is the Bible belt of California...

http://www.transgendered-soul.com/Resources/LA_TG_Resources.pdf
<3 Live
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Nov413

"Courage and perseverance have a magical talisman, before which difficulties disappear and obstacles vanish into air." - John Adams
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Olivia-Anne

Quote from: ShiningStar on June 13, 2012, 09:25:06 PM
Oh, wow. This is actually really helpful. Thank you!
This is fairly up-to-date right?
I found that it was kind of up to date a couple of the doctors in the hormone section had their numbers disconected. I should have updated my last post a little bit and called around a little bit and found a package deal that does initial visit labwork and you leave with a hormone shot in your system as a package deal, I'm at work so I don't have the info with but pm me if you want it.

<3 Liv
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Nov413

Quote from: Olivia-Anne on June 14, 2012, 05:09:22 PM
I found that it was kind of up to date a couple of the doctors in the hormone section had their numbers disconected. I should have updated my last post a little bit and called around a little bit and found a package deal that does initial visit labwork and you leave with a hormone shot in your system as a package deal, I'm at work so I don't have the info with but pm me if you want it.

<3 Liv
Yeah, that'll be great.
Is it still in the LA area?
"Courage and perseverance have a magical talisman, before which difficulties disappear and obstacles vanish into air." - John Adams
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