Insurance?

[Running Renegade]

My name is Tobias. Like nearly every other transgendered person out there... I want to start taking hormones. I'm sure you guys all know how it feels... You want it so badly it hurts, but then realizing you can't get it hurts even more.

My issue is with my insurance company... without insurance coverage, there is no way I'll be able to afford the testosterone. My request to see a gender therapist and an endocrinologist has already been denied once. At the moment, I'm seeing a general psychologist who only has an inkling of GID and the steps I'll need to take.

Already had my name changed legally; took care of the SS card and birth certificate and switched schools as well.

But... I need to find a way to get my insurance to approve my request for HRT. I have Tricare Prime; the military insurance company (which tells you right then and there how... iffy it is already with a GID diagnosis, heh).

Is there a certain way you have to word things? How did any of you, if having gone through similar issues, deal with it? One thing that sets me back, however, is my age. I'm under eighteen. And while I'm deemed mature and intellectual enough to be allowed to take and excel in college courses, I still cannot receive the treatment that I -need-.

At present, I'm schooling to become an EMT. With luck, the insurance plan I may be under once I become certified will help out a bit, as I expect it to be something other than Tricare. But until then, I need to look into other options.

   

[MCMCyn]

I couldn't get insurance to pay for my estrogen though they did pay for my testosterone blocker. At first i was paying roughly $220 a month for estrogen (Premarin). But someone in a support group recommended canadameds.com. You do need a prescription to order from there, but I was able to get my hormones for about 1/3 of the cost as in the U.S.

Same pills, same strength, same manufacturer, but at 1/3 the cost. Now I know why all the new construction around here is a Walgreens, Rite-Aid or CVS.........

[glendagladwitch]

In my experience, as far as office visits and labs go, your endocrinologist just has to put the right diagnosis code down.  GID is a no no.  An experienced endo will use the code for hypogonadism.  Even if the endo already submitted the paperwork and it was rejected, he or she can just resubmit it it with the new code.  If your endo refuses to do it, I suggest that you get a new endo, and give the old endo the finger on the way out.

As for meds, I don't know whether there is a way to get that covered, especially if there is a stop loss provision that they wil not pay for amounts in excess of the the standard max dose for your diagnosis.  But estradiol is so &*^%$# cheap.  It's less expensive than the $15 copay with most plans.  So I don't know that it is worth worrying about.

[Running Renegade]

Went to the doc last week (still no endo yet. Damn insurance company). She said she couldn't help me unless I found a way to make it so she wouldn't have to lie on the coding. -_- So... I'm still looking for options.