RLE requirement for insurance

[devention]

One of the requirements for my insurance to cover GRS is "The patient has completed a minimum of 12 months of successful continuous full time real-life experience in their new gender, with no returning to their original gender". I'm going to try to contact them in the next few days here, but I'm wondering if anyone around here knows how they verify this sort of thing? I've been out at work and asking people to call me my male name since April, using the family restroom almost exclusively since last July, and working part time consistently through it all. Is that good enough for real life experience?

[Jessica Merriman]

Where I am they use the word of the Therapist who logs your first day of RLE in the medical file. Here you have to have two letters from them to get GRS. It is a WPATH requirement as well. I personally have never heard of an insurance company requiring it though. 

[devention]

Ah. I'll shoot them an email asking about it in the morning. Good to know. Thanks!

[LordKAT]

Many insurance companies do require it. The SOC stuff is just guidelines, not rules. They can and sometimes do check with your employer or school, they do check for name change and do have access to your medical records. Those matter.

[devention]

Ah. So you have to do the name change before they count it as RLE? If so, bummer. I won't have the money for that for a while.

[LordKAT]

I think they just find it hard to believe that you are full time if you don't even change your name.

[devention]

It's what my nametag at work says and what I at least attempt to get everyone at work to call me. I just don't have the money. >.<

[mrs izzy]

Ah. So you have to do the name change before they count it as RLE? If so, bummer. I won't have the money for that for a while.

Ya full time mean just that, living 100% in the cross gender role for 1 year with out breaks.

This is detailed in your primary letter and backed up from your second.

Transition is truly a very money hungry process.

Isabell

[Missy~rmdlm]

Here's a hint: If your insurance isn't in a new name it's obvious it's not RLE, that is a simple record insurance has direct access to.

[devention]

Ok. Good to know. Thanks, everybody.