Getting Electrolysis Covered

[initialz]

So my insurance explicitly covers facial hair removal for MtF transgender peoples.  However, I called them about it and they said that when I submit the claim the diagnosis code and procedure code would have to be on the bill.  Absolutely no electrolysis place I have been to does this.  I went and asked my doctor if he would write a letter "perscribing"  electrolysis and indicating the diagnosis code of gender identity disorder and the procedure code of electrolysis so I could submit it with my claim.  He told me while it would help me in my gender transition it is a cosmetic procedure and he would not be comfortable doing that.  He told me he might consider it if I showed him what the letter should say, but the answer would probably still be no.

I don't know what to do.  How am I supposed to get this covered if my doctor won't play ball.  Also would anyone have advice on what the diagnosis code is?

Halp!

[Blush]

Step...
1. Print the section of your health insurance that states coverage for electrolysis, stating that it's a medical nessecity and not cosmetic
2. Bring the copy to your GP
3. Pick the electrolysis clinic or individual you'd like to work with, get their mailing address and all that
4. Go back to your GP, and ask for a refferal to the clinic or individual who will do the electrolysis
5. Submit a copy of your referral from your GP (and another copy of the section of them explaining their coverage wouldn't hurt) to your insurance provider and make sure it's sufficient for them
6. Upon clearance, setup an appointment for electrolysis and begin!

P.S., the electrolysis clinic or individual might not accept insurance directly*, because usually patients are doing it for cosmetic reasons - if this is the case, you'll have to pay the full amount out of pocket, but you can submit those bills to your insurance provider and they'll reimburse you for the costs

Good luck!

[initialz]

How important is step 5?  Who would I send it to?  It wouldn't be a claim so I'm not sure how to clear it with them.

[Blush]

How important is step 5?  Who would I send it to?  It wouldn't be a claim so I'm not sure how to clear it with them.

Funny enough, it's like you should get insurance for your health insurance. If you have a note in your record, a name and what they told you, and just some kind of letter saying that YES, it IS indeed ok for you to undergo electrolysis, and yes they WILL cover it as it is documented in their coverage list - this will help you if there are any troubles in the future with coverage. It's like having someone who will fight with you in your corner.