Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: lawliver on February 13, 2013, 08:17:34 AM Return to Full Version
Title: things didnt work out
Post by: lawliver on February 13, 2013, 08:17:34 AM
Post by: lawliver on February 13, 2013, 08:17:34 AM
My insurance doesnt cover hrt or srs, which means my doctor cant send a referral to an endo. I'm not sure what to do now. Any ideas? I feel so lost all over again.
Title: Re: things didnt work out
Post by: KayCeeDee on February 13, 2013, 08:46:58 AM
Post by: KayCeeDee on February 13, 2013, 08:46:58 AM
Sorry to hear that, sounds like you will be self-pay. The good news is that it isn't that expensive to do HRT as you can get the generics from Wal-Mart fairly inexpensively. If your doc is willing to work with you then you can get spiro and perhaps estrogen for other conditions that as a male you probably have. At the very least lab work may be covered under something else. Perhaps check with your local LGBT center for a support group and get leads from there? Good luck!
Title: Re: things didnt work out
Post by: lawliver on February 13, 2013, 09:01:47 AM
Post by: lawliver on February 13, 2013, 09:01:47 AM
Do they have anything like that for T? I'm going to be looking into my local LGBT community and making some calls to see if I find anything out. I'm hopefull, but everything seems to be falling apart around me. It's hard to stay positive. :'(
Title: Re: things didnt work out
Post by: blueconstancy on February 13, 2013, 09:14:02 AM
Post by: blueconstancy on February 13, 2013, 09:14:02 AM
Yeah, you can go to an endo anyway, you'd just have to pay for it all yourself. (If you have the money... which I realize isn't something we can assume. But there's no reason why your doctor should refuse a referral b/c of insurance issues only.)
T is pretty cheap, once you get the prescription. It's actually a lot cheaper than E, usually. The endo visits and bloodwork are the expensive part - and you can try to find an endo who is willing to bill it to insurance as something like "hypogonadism" or another diagnostic code that doesn't involve transsexualism. We did that for 2 years; endo billed insurance for "hormonal insufficiency" or something like that, and we paid cash at the pharmacy so that nothing got reported to insurance. (Mostly b/c I was paranoid - my insurance actually did cover HRT, just nothing "preparing for" GRS or surgery itself.) The insurance won't see what prescription is written unless and until you ask *them* to pay to fill it, so if they then happen to assume you're being treated with E instead of T for hormonal problems, well... ;)
Good luck.
T is pretty cheap, once you get the prescription. It's actually a lot cheaper than E, usually. The endo visits and bloodwork are the expensive part - and you can try to find an endo who is willing to bill it to insurance as something like "hypogonadism" or another diagnostic code that doesn't involve transsexualism. We did that for 2 years; endo billed insurance for "hormonal insufficiency" or something like that, and we paid cash at the pharmacy so that nothing got reported to insurance. (Mostly b/c I was paranoid - my insurance actually did cover HRT, just nothing "preparing for" GRS or surgery itself.) The insurance won't see what prescription is written unless and until you ask *them* to pay to fill it, so if they then happen to assume you're being treated with E instead of T for hormonal problems, well... ;)
Good luck.
Title: Re: things didnt work out
Post by: lawliver on February 13, 2013, 09:47:44 AM
Post by: lawliver on February 13, 2013, 09:47:44 AM
I'm waiting on a reply from my doctor about the referral. Hopefully I can work something out with my endo if i ever get a scheduled appointment. I'll keep you guys posted and let you know if i have anymore questions. thanks a bunch!