HRT risks, self-pay and insurance

[Embrace]

Hi everyone.

I'm MtF and I've been seeing a therapist (specializing in gender identity) now for a couple of months and am strongly considering starting HRT in the near future.

So my question is this.  If I self-pay for visits, lab work and/or prescriptions (presuming my health insurance will not cover them) and wind up ultimately having health issues stemming from the hormone use (DVT, PE, etc.) can and/or will my insurance company likely dispute claims for treatment related to these issues? 

I understand that policies can differ greatly between insurance providers and with respect to what options your employer or group has elected to include.  But I'm curious as to whether or not there's a general rule.

Has anyone here wound up in this situation and if so how did it turn out?

Or does anyone happen to work for a health insurance company that might be able to offer any insight?

Any information would be greatly appreciated.

[Hideyoshi]

I have one of the crappiest private insurance plans available, and they still pay for my GP visits and one of my HRT-related meds, finasteride. They don't pay for the estradiol obv but it's so cheap anyways.

They pay for the labwork and visits 100% minus 30 dollar copay, which is really surprising given the fact that in every other area they cover little to nothing.  (talking 250 dollar ER copays and only paying out like 30% for specialist visits)

I'm fortunate enough to not have to go to an endo to get my levels checked, my GP does it all there.

I just don't think the ins company knows that's all for HRT/transitioning.  I would hope any problems that stem from HRT (hopefully none) they would pay for, and when the affordable care act comes into full effect I hopefully won't have to worry about it anymore.

[Embrace]

Thanks for the feedback, Hideyoshi.

I'm, of course, hoping they'll pay for it but given some of the claims I've had to fight for, I figured it would be out of the question.

Not that I'm cynical or anything! 

From what I understand, the risks increase with age, smoking and other health factors- a couple of which aren't in my favor.  I'm probably just over-thinking this, but it's a HUGE step for me and I'm trying to understand things and prepare as best I can.

[Hideyoshi]

If you smoke i highly doubt it'll be easy to find a doctor to prescribe you estrogen without you quitting first, if that's what you meant by a few factors against you that is