trans Healthcare in NJ??? opinions needed

[JHeron]

Hey, guys I couldn't find anywhere else to post a question like this but i have a serious decision to make as far as my health insurance in NJ. I have medicaid with Horizon Blue Cross Blue Shield in NJ but I've been looking for their policies concerning hrt or srs and there is literally nothing on their website, anybody have this insurance? I have two weeks to change to Aetna and I have seen their complete coverage documents where they detail they cover hormones, surgery etc with letters of rec. My mother's always told me Horizon is the best but maybe i should switch if Aetna covers my transition anyone have good things to say about Aetna?  I cant decide what to do

[Sydney_NYC]

I had NJ Horizon BCBS in 2013 privately and 2014 from the exchange (AKA Obamacare) when I first transitioned and there was an exclusion of ANY transgender care services in the booklet in the mail, but like you've discovered, it's nowhere on their website. They would not cover anything at all trans related. They did finally cover some HRT (Spiro and Estridol), but only after I legally switched my gender to female. I had them years ago with another employer and then they were pretty good. Now they are horrible under the exchange and medicaid. My cis-wife on regular healthcare matters had to appeal simple tests like a followup sonogram after an abnormality found on a mammogram. You will be better off with Aetna. I'm on Health Republic now and they cover HRT, but not surgery. I'm switching to United Healthcare next year.

[JHeron]

Okay I think I will thank you for the advise I had no idea they had trans exclusions but that does make sense when my searches for gid transgender and hrt came back with 0 results... I don't know about Aetna NJ but the website has an entire gender reassignment procedures covered article with each procedures criteria and etc so that's better than 0 search results lol

[Bimmer Guy]

I would suggest you at least call them to make sure they don't have any trans benefits before you switch.  Trans health coverage is getting added to health care benefits all the time.  No downside to just making a phone call.