Transition Friendly Insurance

[Jaelithe]

I saw an old thread on this subject, but the primary concern would(if I have my facts straight) be wiped out by the ACA's new laws on pre-existing conditions.  So, with that in mind, does anyone have any advice for someone shopping around for insurance to help cover all the expenses of transition?  I've been looking at Carefirst and Kaiser, but I'd really rather NOT call them up and say "Hi, I'm a transgender woman and I want a policy that's going to help me pay for all that..." 

You know, given the fact that insurance companies tend to ratchet up prices if they see long-term, expensive treatments on the menu.....

[Jasriella]

The only place I can think of that would have policies to help pay for transitioning procedures is someone in California. I haven't a clue otherwise but I dont think im speaking for myself when i say i would certainly like to know.

[Jaelithe]

The only place I can think of that would have policies to help pay for transitioning procedures is someone in California. I haven't a clue otherwise but I dont think im speaking for myself when i say i would certainly like to know.

This is all hearsay at this point, but the main method I've heard of tends to be 'tricking' the insurance company.  Listing therapy sessions as 'depression' and HRT as 'horomone impbalance'.  Though some insurance companies, or policies have specific 'no gender transition' exclusions to their services.  So anyone who has more specific information about policies that specifically include, or at least do not exclude, transitional services would be very helpful. ^^

[Carrie Liz]

I'm on Cigna. They cover it, saying that they'd pay 85%/15% of the total surgery cost up to a $5000 out-of-pocket maximum. And I only pay about $50/month through my company for it, with an $1100 deductible that I've already met after my most recent doctors' visit, so that's pretty damned good.

[Pinkfluff]

I'm on Cigna. They cover it, saying that they'd pay 85%/15% of the total surgery cost up to a $5000 out-of-pocket maximum. And I only pay about $50/month through my company for it, with an $1100 deductible that I've already met after my most recent doctors' visit, so that's pretty damned good.

This means that your company covers it, not Cigna itself (who just runs the plan). I got Cigna too but my company doesn't cover it.

[Dee]

Like pinkfluff says, it's a matter of what your group policy offers. I have blue cross blue shield, MA, but it doesn't cover surgery. However, and I'm not sure if it's been discussed (I've been MIA from the forums), but in the US, the IRS recently declared costs of transition to be tax deductible. Not sure if this gives health insurance companies an incentive to start including this in affordable single payer plans, but it's well with noting.

I would post a link, but I think it's against the regs.

[kathyk]

KAISER PERMANENTE!   In California Kaiser just decided to cover Transgender operations.  According to the emails I got from my doctor and my therapist they  "... now cover MTF bottom surgery, and FTM top and bottome surgery".  You would have a co-pay, but if you also carry other insurance you could potentially get a free operation.  They also included transportation and lodging in the town where the approved surgeon works.  That little bit came from a FTM in my group who just had some work done.  I'll be in the San Francisco area and I understand Marci Bowers may be broght in as one of the approved surgeons.  I hope so because she works only a short ways from my home.

If you have Kaiser where you live call Member Services and ask about Transgender coverages in your area.  They don't know who you are, and they won't try to get your information if you don't want to provide it. 

K