Susan's Place Transgender Resources

Does anyone know if I can get therapy and HRT covered by insurance in Australia.

Hi Emily,

I can only comment on where I have got to and I accept it may not have been the most cost effective route.  Also, I may be out of date wth some of this stuff - governments (state and federal) have a tendency to change the rules all the time!!

Therapy can be covered under health insurance - depends on the cover and the annual limits.  Mine is but only up to a low level $$ wise.  Medicare will cover this if you get a GP referral for a treatment plan.  The referral lasts 12 months and gets reviewed after 8 (I think).  If you go down this path, your insurance may not cover psychology (the part Medicare hasn't covered) if there has been any Medicare claim.  I have also read of concerns that this then gives Medicare a record of a psych plan in place which some people are frightened of.  Thought about that and didn't care.

If you are accessing all this in a place like Melbourne where informed consent isn't quite the model ( i have found that it sort of is but others complain of a huge gatekeeper approach - all with the same Psychiatrists!), then with a referral from your GP to the likes of Dr Harte or Dr Erasmus, Medicare will fund some of the cost.

Meds seem really variable and I suspect I do not have the cheapest approach yet.  My E prescription varies by up to 20% in price for the same thing at the same place!  However, both E and Spiro aren't too expensive (for Australia - remember we are not talking Walmart here!!) but Finasteride seems a bit pricey.  The reason I mention this is that there is some sort of pharmaceutical component in our health insurance that we have yet to work out. 

I didn't approach insurance with this in mind and we are happy enough with the cover we have for a wide range of things and feel we are ahead.  Remember a large portion of the premium is hospital cover so the extras part is good value.  I suggest that you look around amongst the insurers to see who has the best deal from a gender treatment perspective.

I am interested the see where you get to.

Hugs

Em

PS  By far the most expensive thing I have done is electrolysis - all out of pocket!  However, I look at it as outpatient FFS :)

Yes, Medicare should cover some (shrink, endo) or all (blood tests). Don't know about private though, would depend on your insurer. I really should find out about mine, it's not like I can afford the money but I am notoriously lazy when it comes to that stuff.

Hi Emma,

As with all things medical in Australia, your mileage is going to vary depending on who you see and your insurance.

Medicare has a set schedule of rebate (bulk billing) for GP, psych, and endo services, and the medical provider has the right to charge a gap fee above that.  Generally speaking if you claim under Medicare, you will not be able to claim under insurance.

The blood work you need for monitoring HRT is covered under Medicare.

Most medications fall under the pharmaceutical benefits scheme (PBS) which means they're already heavily subsidized by the government.

Thank you for your responded girls the reason I ask this question is I am on a government pension and wasn't sure if any transgender services were covered by Medicare as information on the internet is scetchy at best.  I have my first psych appt with Dr Lyons in Adelaide in April I should be able to get a mental health plan depending how long it has been since my last one by April it should have been 12 months.

I can't wait for April to come I am so excited to be finally taking the right steps toward happiness.

Emily.T xx

I doubt Medicare consider seeing a shrink or endo as being a transgender service. It's something everyone may need to do regardless of gender identity. Sure, that's how we may be utilising them, but Medicare probably only consider the individual practitioner not the overall intent of seeing those practitioners.

Quote from: Emily.T on December 30, 2013, 02:25:52 PM
Thank you for your responded girls the reason I ask this question is I am on a government pension and wasn't sure if any transgender services were covered by Medicare as information on the internet is scetchy at best.  I have my first psych appt with Dr Lyons in Adelaide in April I should be able to get a mental health plan depending how long it has been since my last one by April it should have been 12 months.

I can't wait for April to come I am so excited to be finally taking the right steps toward happiness.

Emily.T xx

Well I can tell you about Adelaide. Most of the Psych charge is covered by medicare but there is a gap about $20-$30 if I remember correctly, at Dr Lyons Unit. Endocrinologist is also medicare covered with a gap, Hormones both AA and E are covered by medicare on the PBS system.  I have implants from the endo and my private health insurer (HCF) will not pay for the fee as 'the surgery was not performed in a recognised hospital'. The surgery is a nick and a stitch takes 5 mins!

I'm on a DSP too,I see a psychologist on a plan which is 8 visits per year + another 2 if required.It's $160 for an appointment and medicare gives $85 back.I had 2 appointments with a psychiatrist which are over $300 dollars an hour,but you get nearly all of that back.Which is good because she's useless.If your in Brissie don't see Diana Hamilton,her ideas are 30 years out of date and if I didn't have a sense of humour,some of the things she said,I would have slapped her. :)My psychologist is really good though,so I'm gonna keep seeing her.She told me she has clients who are pensioners too and medicare subsidises all their meds,I think it's under $6 per script.

Thank you once again girls for all your great responded that is a load off of my mind .

Emily.T xx

Hi there,

I've been visiting/stalking susans for a while now, trying to absorb the crazy amount of info posted here, and thought I should finally get around to saying hi !!


I'm with teachers health fund and they cover the cost of prescriptions not covered by the PBS (eg finisterine) , as well as part-covering the costs of pilates classes too. The medicare safety net is also a godsend, you can claim the difference between any gap payments from GPs and therapy back on tax.

So far i'm only 7 months or so into transitioning, and 5 months on HRT. I'm finding cost-wise i'm spending more on petrol getting to and from sydney (from central nsw) than anything else ... even laser hair removal !!

Hi Kate thanks for the info and welcome to Susan's I to have to travel for me its a 2.5 hour trip to Adelaide for appointments so expensive but that's only because there is no services in the country for transitioning which sux but what can you do I wish you all the best with your journey and I look forward to starting mine.

EmilyT xx

This worries me as I am a single father living in a country town 3-4 hours away from a city in SA.   I have known all my life that I am not a male, but rather a female on the inside. Sadly I hide it from everyone and have yet to come out, which scares me to death. I made huge mistakes with the law as a teenager as I tried to act like a male so I could fit in, but sadly the depression of hiding it put me on a bad path from 16-25 years of age. At 26 I decided I needed children, as I will never get the chance in the future ( I love my kids more than anything) and a few years later I was gifted with kids. I then though I better bury it deeper, but the last 12 months it has not stopped getting worse and I often cry about it and wish I could just be born again. I hate it!

I want to do this but I do not know who to contact as the doctors in my town are odd balls and I am in contact with them a lot as I am graduating with a degree in a year as a Social worker! (yes I should know what to do..lol). So there is this fear of the stigma that follows and how it will affect my job prospects in the future if it gets out before I am ready to go public.

So you know about my story  "sort off" and now I just need to know who to speak to, and general step by step instructions as I am scared and confused :-\ I am aged 36 and weight 100kg (very over weight) 5 foot-10 although I am aiming to lose 10-20kg over the next few months while I try to figure out how to get on hrt etc.

Hi Sarah leah

and welcome to Susans! We have people come to visit us from all over the world, expressing different points of view, and you are likely to find someone to help you along your way :) Here are some important links and things to ponder as you begin your journey here.

• Site Terms of Service and rules to live by  (https://www.susans.org/forums/index.php/topic,2.0.html)
  
• Standard Terms and Definitions (https://www.susans.org/forums/index.php/topic,54369.0.html)
  
• Post Ranks ( including when you can upload an avatar/post links and photos) (https://www.susans.org/forums/index.php/topic,114.0.html.)
  
• Age and the Forum (https://www.susans.org/forums/index.php/topic,62197.msg405545.html#msg405545)
  
• Reputation rules (https://www.susans.org/forums/index.php/topic,18960.0.html)
  

I do know that some psychiatrists will do the therapy sessions by skype.

You may find some therapists to help on this website. www.anzpath.org.au if you click on the provider area it comes up with providers who wish to be listed.

Your weight will be an issue though, there is a big reluctance to put overweight people on HRT because of the medical risks associated with blood clotting disorders.

Thank you for the reply Cindy, I will look at those and the link. In terms of my weight I was worried it might be a factor and my age too.  :'(

I just want to do this asap and in terms of my weight I can try to drop it fast. I am going to stop eating junk and only eat fruit and veg mostly to see if it will help, as going for walks or to the gym is out as I am a fulltime single parent, studying and lack time and cash until my home sells. I am praying it will sell soon as the money I put into buying the home was my sneaky way of hiding 20,000Aus. I have been preparing for this like I said since I was 25 years old. I even set out a plan:

• Have children
  
• Raise 20,000 and invest it
  
• Get a degree in a job I care about, and one I will not be judged in for my gender

I have all these things done, now it is a matter of beginning my journey in "private" until I am ready to emerge as the person I was meant to be.

Again thank you for the welcome :)

Age doesn't matter, I was 61 yesterday! I went FT when I was 59.

One thing to also put in the pot when you read experiences on this site is that being transgender in Australia is just about a none issue compared to many places. People are generally very accepting and there are very strong Federal and state laws to protect us.

From personal experience, Medicare covers a percentage of endo costs. I never paid for a blood test as they were requested by endo. I paid full price for Estrodot patches, which didn't really cost that much. Never got to the point of using andro blockers, so can't help you there.

Can you get implants Jenna? They have been great!! Last 6 months at a time and your E level stays stable. I love them!

Wow, this thread is a full on Aussie chicks party zone!

Let me put my party hat on Grace.

(https://www.susans.org/proxy.php?request=http%3A%2F%2Fts3.mm.bing.net%2Fth%3Fid%3DH.4503858591761278%26amp%3Bpid%3D15.1&hash=a729476c64f7b1faf707d7e173a1056ba0cc9042)

I keep meaning to find out how many Aussie girls are here.

Oh wow, there are so many Aussie gals here....

It's really great to know all this info about Medicare et al, thanks for all the info :-)

If we are having a gathering of the Aussie girls, I suppose I shoul wander past and stick my nose in. . :D

Quote from: Cindy on January 02, 2014, 02:21:25 AM
I keep meaning to find out how many Aussie girls are here.

Plenty around I think, although we've been pretty well behaved recently.

Back on topic, just had my script for spiro and progynova refilled, cost me $53.00 total.  I'm still on half dose so the spiro gets filled every second trip so to speak.

Quote from: Laurenza on January 02, 2014, 04:44:24 AM
It's really great to know all this info about Medicare et al, thanks for all the info :-)

Medicare can be a bureaucratic labarinyth but helpful at times.  I do sometimes think there is merit in putting a small copayment in the system to increase people's stake in their own health, but that's a huge can of worms.

I am so happy that I started this thread and having it help Aussie chicks on their journey the only thing we are missing here is the party food so get dressed up everyone and let's dance.

Emily.T xx