Therapy and HRT with insurance or none?

[CuriousAboutLife]

What is a good insurance to help pay for the therapy sessions and the HRT. Curious if anyone has one that covers fully or has a low copay! Thanks babes!

[Phyliciaraine]

Right now my therapist is just using personality disorder for the paperwork so I can still see her.I've heard that you can usually get 1 or 2 endo visits covered and then the insurance knows and won't cover anymore. So then it's out of pocket to continue. Right now I live in a state where every health insurance I've looked at has trans exclusions. So I'm saving up for the oop expenses.

[CuriousAboutLife]

Yeah my therapist charges a rate of $60 a visit. Which is good, that's without insurance. But I'm sure the costs for hrt vary from person to person.

[Phyliciaraine]

They can, I've heard that the pills are the cheapest. That's the route I'm going to go for.

[Robin Mack]

If you find yourself with the luxury of being able to pick and choose insurance providers due to the ACA or because you're paying for it yourself, you would be wise to investigate what each covers.  In my current marketplace, there is only one insurance company that covers some of the cost of transition (including SRS).  I don't want to violate ToS by naming names (not that this is an endorsement, just a statement of fact), but if anyone reads this and wants to know which one I'm choosing they can PM me.

Good luck! 

[Phyliciaraine]

Yeah, all of the ACA plans in my state have trans exclusions.

[Ltl89]

My current insurance covers therapy, my endo, hrt and bloodwork with no copay.  I've also had to pay out of pocket without insurance which is terrible and should be avoided.  I'm still paying off huge inflated bloodwork bills.  Thankfully, I was able to work out a payment plan for one and greatly reduce the other one.  $3,000 for bloodwork should be criminal in my opinion.  When I didn't have insurance, hormones at CVS were costly but I got a discount that made it slightly more tolerable.  Apparently, walmart has generic stuff on the cheap, so I would check them out if you have to.  My therapist worked with me on a sliding scale that was bearable and I made do.   I should note I was unemployed, so all my savings were emptied at that time and my current income is being used to pay catch up.  If you can get insurance, please do.  All of my insurance companies covered me to some degree (I've had 3 different policies since starting everything) except one which I will shield from divulging.  Let me say (with my arms crossed) that they denied me coverage for everything including bloodwork.  With those sort of policies, you have to make sure everything is coded properly.  Good luck!

[Jerri]

I am in the US and use highmark regency blue cross blue shield, with the support of my work they are paying for both, therapy and hrt. my therapy is covered at 80% and scripts cost me about a dollar each for spiro,progestrin,and estrodol. I did have to petition and enlist the help of our hr benifits person to get trnstioning covered however.
jerri

[Jerri]

sorry didnt know i should say the name

[Ltl89]

Yeah my therapist charges a rate of $60 a visit. Which is good, that's without insurance. But I'm sure the costs for hrt vary from person to person.

Just wanted to note that some are willing to take you on a sliding scale without insurance.  If you are low income, 60 dollars a session is still a bit pricey.  I was able to go see my therapist for $20 a session, but I was unemployed at the time.  Just wanted to throw that out there to see if you can find a more affordable alternative. 

[CuriousAboutLife]

Yeah I work 30 hours a week and get paid weekly at $11 an hour. And my therapist still only wants to charge $60 for each session. So I was surprised and glad, due to me not having insurance

[Ashey]

I've been pretty lucky with my costs I guess, just paying out of pocket. My therapist cut the cost in half for me because he understood my financial situation but wanted to help. My endo hasn't been too expensive, and even luckier I got a bill for about $300 and I already paid half, and they said I didn't have to pay the rest. Found a great place for blood-work. They said they're family-owned and try their best to keep costs low. And my pills come from Walmart (like, half the price of Walgreens which is where I started getting them) so they're not that bad. Spiro is the most expensive right now, and kinda stings in the wallet-area, but I think I found a coupon that might make it bearable.

[Ginny]

In the past insurance companies have blocked access by saying that gender dysphoria was a "pre-existing" condition.  Shouldn't all plans under the ACA then make it illegal to discriminate against us, as they are no longer allowed to deny services based on pre-existing conditions? Or are they saying gender dysphora / transexualism is classified as something else now?  I'm not really sure how insurance worked with this and just assumed that I would have basic coverage applied to me. Of course I could be wrong, I had my first therapy session last week and she told me she was going to label it something other than dysphoria for insurance purposes.

[Robin Mack]

In the past insurance companies have blocked access by saying that gender dysphoria was a "pre-existing" condition.  Shouldn't all plans under the ACA then make it illegal to discriminate against us, as they are no longer allowed to deny services based on pre-existing conditions? Or are they saying gender dysphora / transexualism is classified as something else now?  I'm not really sure how insurance worked with this and just assumed that I would have basic coverage applied to me. Of course I could be wrong, I had my first therapy session last week and she told me she was going to label it something other than dysphoria for insurance purposes.

I imagine there will need to be some legal action to clarify that.  SRS/HRT *are* medically necessary, however at this point (probably in an attempt to get the ACA  passed in the first place through a trans-phobic legislature) it is up to the individual insurance companies to determine whether or not this is something they offer.  Over time (assuming the ACA survives) I believe that insurance companies will be forced to cover it.  On the plus side, if your insurance carrier *does* cover it they can no longer use the "pre-existing condition" clause to keep you out, nor can they force you into a higher premium group.