Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: vanderpn on October 16, 2016, 06:50:38 PM Return to Full Version
Title: Does Cigna Cover HRT and related expenses?
Post by: vanderpn on October 16, 2016, 06:50:38 PM
Post by: vanderpn on October 16, 2016, 06:50:38 PM
I just found out that my dad's insurance is changing from Aetna to Cigna next year. So, of course, I immediately started researching to see how trans friendly they are.
From what I can find, Cigna has a policy that considers GRS medically necessary, but I can't find anything that discusses whether HRT is or not.
So, does anyone know whether Cigna has a policy about hormones, endocrinologists, blood work for hormone levels, and/or any other related expenses?
Thanks so much for the help.
From what I can find, Cigna has a policy that considers GRS medically necessary, but I can't find anything that discusses whether HRT is or not.
So, does anyone know whether Cigna has a policy about hormones, endocrinologists, blood work for hormone levels, and/or any other related expenses?
Thanks so much for the help.
Title: Re: Does Cigna Cover HRT and related expenses?
Post by: Brooke on October 16, 2016, 06:54:54 PM
Post by: Brooke on October 16, 2016, 06:54:54 PM
https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0266_coveragepositioncriteria_gender_reassignment_surgery.pdf#__utma=149406063.1761118586.1402926656.1407417514.1407421027.129&__utmb=149406063.1.10.1407421027&__utmc=149406063&__utmx=-&__utmz=149406063.1407342625.125.16.utmcsr=americansformarriageequality.org|utmccn=%28referral%29|utmcmd=referral|utmcct=/&__utmv=-&__utmk=260421901
"Coverage for gender reassignment surgery and related services, including pre and post-surgical hormonal therapy is specifically addressed under many health benefit plans. In addition, procedures associated with gender reassignment surgery that are performed solely for the purpose of improving or altering appearance or self-esteem related to one's appearance, are considered cosmetic in nature and not medically necessary. Please refer to the applicable benefit plan document to determine benefit availability and the terms, conditions and limitations of coverage."
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"Coverage for gender reassignment surgery and related services, including pre and post-surgical hormonal therapy is specifically addressed under many health benefit plans. In addition, procedures associated with gender reassignment surgery that are performed solely for the purpose of improving or altering appearance or self-esteem related to one's appearance, are considered cosmetic in nature and not medically necessary. Please refer to the applicable benefit plan document to determine benefit availability and the terms, conditions and limitations of coverage."
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Title: Re: Does Cigna Cover HRT and related expenses?
Post by: vanderpn on October 16, 2016, 07:01:12 PM
Post by: vanderpn on October 16, 2016, 07:01:12 PM
Thanks Brooke. So, does that mean that they don't have a company-wide policy discussing HRT, and that I'll have to wait for the specific plan to see?
Grr... I'm so impatient. :P
Grr... I'm so impatient. :P
Title: Re: Does Cigna Cover HRT and related expenses?
Post by: Brooke on October 16, 2016, 07:36:06 PM
Post by: Brooke on October 16, 2016, 07:36:06 PM
Yeah, I think so. Typically if an insurance company has coverage for gender identity services it is plan specific
I think most carriers at this point will cover hormones across the board even if they don't cover gcs across the board.
If your dad has the plan info you should be able to inquire into specific plan details by contacting Cigna or your dad's company's insurance rep.
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I think most carriers at this point will cover hormones across the board even if they don't cover gcs across the board.
If your dad has the plan info you should be able to inquire into specific plan details by contacting Cigna or your dad's company's insurance rep.
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Title: Re: Does Cigna Cover HRT and related expenses?
Post by: JenSCDC on October 21, 2016, 05:07:45 AM
Post by: JenSCDC on October 21, 2016, 05:07:45 AM
My plan has the exclusion that Brooke pointed out, yet CIGNA has still been covering my endo visits and my meds.
Title: Re: Does Cigna Cover HRT and related expenses?
Post by: Barb99 on October 21, 2016, 12:45:13 PM
Post by: Barb99 on October 21, 2016, 12:45:13 PM
Cigna does cover GRS and meds. HOWEVER, our company has Cigna and we have an exclusion that reads "All transgender services are excluded". Yet they have been covering all my meds, doctor visits and blood work.
I'm going for GRS next month. I plan to submit a claim for reimbursement. We'll see what happens!
I'm going for GRS next month. I plan to submit a claim for reimbursement. We'll see what happens!