FTM - Costs of Endo & HRT without Insurance

[vanderpn]

I just learned recently that the specific health insurance plans that are available through my dad's company (I'm still a dependent) do not cover HRT. I'm still trying to figure out what the details are, but I thought that I would do some research on what potential costs might be.

So, I was wondering if any fellow transguys who have started HRT could tell me about your costs pre-insurance, including appointments with an endocrinologist, blood work, the testosterone itself, etc.

[becky.rw]

Any licenced doctor or even supervised nurse practitioner can prescribe these things if they feel comfortable doing so; you don't necessarily have to set the bar so high for yourself on cost.   Heck, I know in some US cities, there are walk in health clinics using informed consent that treat mostly poor and indigent patients without insurance, and they most certainly can get appropriate HRT.

If you do go the full therapist/psych/endo route, without insurance, you're definitely in the thousands of dollars territory, not to scare you off, but no sense pretending otherwise.    Then again, electrolysis/laser hair removal is still likely to be more expensive than that. 
edit: missed the FTM... you probably don't need the hair removal thing...

[vanderpn]

Thanks for the info, becky. I currently have a therapist, but because it's for other issues in addition to the trans stuff, thankfully that's covered by the insurance.

Do you have any suggestions for how to find a regular doctor/nurse that would prescribe it? I haven't seen a general practitioner in several years, so I'm not sure where to start in that regard. I live in a moderately sized city (about 250k population) that has two main hospital networks.

[becky.rw]

It is hard to find them, but if you start googling with the phrases "informed consent"  transgender / gender conforming; or WPATH, you should be able to zero in on some compatible health care providers.   radremedy.org is also an interesting "lookup" site that could provide you some leads.

For a smaller city though, you may have to accept the idea of travelling some distance. Its worth the trip.

[FTMax]

Insurance may not cover your testosterone, but it will likely cover your doctor visits and lab work as long as it is coded as something you would need.

I didn't have trans-friendly health insurance when I started transitioning. I found a doctor at an informed consent clinic. She wrote the reason for my visits as "non-specific endocrine disorder". That covers why I'm seeing her, and why I need to have everything tested that I get done.

Copays for visits are $30.
Lab work is roughly $15.
A vial of testosterone that lasts me around 5 months is $60.
I buy needles in bulk online in 100 packs, cost me less than $20 and I'm good for 2 years.

If insurance had refused to cover:

Full billing price of my visits is $220. I'm sure cash patients get service at a discount though, and they do work on sliding scale.

Lab work initially was $550, and I get all that tested once a year. Quarterly lab work was around $250.

Price of testosterone doesn't change, as I pay out of pocket for it. So still $60. And needles are also an out of pocket purchase, so another $20.

Insurance: $125
No Insurance, Full Price: $850 yearly visit / $550 quarterly visit (assuming the same things are tested for at each time and I refill T and needles each time)

[vanderpn]

That's good to know, FTMax. I knew that I had heard of ways to get things considered medically necessary, and that's helpful to have a specific example of the phrasing that your doctor uses.

That gives me hope for at least an initial visit; I see a psychiatrist, and back when my anxiety/depression was out of control, he even suggested getting my thyroid tested at one point.

Thanks becky for the link to that site; I found some possibilities that I hadn't found before.