FFS - Insurance question

[reignat]

Hey girls,

So I've been on hormones for 11.5 months now and I'm currently shopping for surgeons for my FFS. I work as a software engineer in NYC and we have UHC benefits at work.

Currently, UHC doesn't cover FFS for transsexuals, but I am in the process of initiating a request for coverage. I'd like to know what the process is because I don't know where to start. I am considering Dr. Zukowski for my FFS and I have my consultation scheduled very soon. So, do I get a consult, a quote and send a pre-auth or pre-approval request to UHC with the necessary letters from my therapist, endocrinologist (and anybody else??) first? How does this work?

Thanks for all your help. 🙂

[Dena]

If you have already contacted Dr Z's office, simply call the front desk and ask if a letter is required for surgery. I suspect they would like a therapist letter however it may not be a requirement.

[reignat]

If you have already contacted Dr Z's office, simply call the front desk and ask if a letter is required for surgery. I suspect they would like a therapist letter however it may not be a requirement.

Thanks much Dena! I have yet to visit Dr. Z for my consult so I guess I will wait until the day of my consult.

[Colleen_definitely]

My insurance does cover FFS and they just require a therapist letter.  As for starting a request for something they don't already claim to cover, they might want more.  You might try calling the insurance person at Dr. Z's office and see if they have any insight, as they may have helped do this before.

[ainsley]

My insurance does cover FFS and they just require a therapist letter.  As for starting a request for something they don't already claim to cover, they might want more.  You might try calling the insurance person at Dr. Z's office and see if they have any insight, as they may have helped do this before.

Sorry for dredging up a semi-stale thread, but I am curious what your letter had to state from your therapist?  I am about to undertake this with my insurance and am hoping my letters from my LCSW and Psychologist that I got for SRS will suffice.  Or, does the ins. require something specific to FFS needs?  If you can share, I would appreciate it, Colleen.  🙂

[Colleen_definitely]

Well I don't know for sure via personal experience since I didn't go through with FFS as I originally had planned, but I can't imagine that FFS letters would need to be terribly different.

Buuuuut as an update from before, I had been misled.  They wanted a therapist letter and a letter from a PhD holding shrink to do it.  Which you have.

More or less they're looking for "Ainsley might be pursuing a procedure that is unusual in the grand scheme of things but not because she's crazy.  She also has gender dysphoria, is transsexual, and this procedure would be of great benefit to my patient." 

Best bet is to call up the insurance company and ask.  BCBS MA which I have (for now) is actually super helpful in this area.