Susan's Place Transgender Resources

Community Conversation => Transsexual talk => Male to female transsexual talk (MTF) => Topic started by: Tammy Hope on June 02, 2012, 02:59:17 AM

Title: Wal mart insurance, and BC/BS
Post by: Tammy Hope on June 02, 2012, 02:59:17 AM
I've been told that Wal Mart has Blue Cross blue Shield

I've further been told BC/BS covers transition procedures.

Anyone know if either/both are true?

i can't enroll for the first year but i really would love to be able to count my chickens...
Title: Re: Wal mart insurance, and BC/BS
Post by: wheat thins are delicious on June 02, 2012, 03:07:55 AM
I do not believe the insurance walmart has will cover it.  I could be wrong though.  I work there too but don't have their insurance atm though I did in the past, but I'm on my dad's work's insurance right now.
Title: Re: Wal mart insurance, and BC/BS
Post by: Jeneva on June 02, 2012, 01:21:16 PM
BCBS does in fact cover transition related procedures, IF your company has chosen to pay to remove the rider that normally is on the.

I have BCBS from my wife's job via the State of TN and their plan specifically disallows it.
Title: Re: Wal mart insurance, and BC/BS
Post by: Julian on June 02, 2012, 03:26:02 PM
BCBS varies by state. I know that BCBS of Illinois specifically excludes anything transition-related.
Title: Re: Wal mart insurance, and BC/BS
Post by: JoannaH on June 08, 2012, 05:43:54 AM
BCBS is a collection of insurance companies that pass paperwork around. But they are independent companies. Hence if I tell you that BCBS will pay and I live in Michigan and you live in South Carolina, you could end up disappointment. BCBS of Michigan is one company and BCBS of South Carolina is a different company.

And to further complicate the matter each BCBS has various insurance plans that are sold. So you need to find out if the plan that was sold to your company pays for Transgendered care and if so what Transgender care. There are Diagnostic Codes and the Procedure Codes. And there are lots of them for various branches of transgendered and intersex conditions.

The bottom line is that you have to find out if your plan at your BCBS pays for the Transgendered care you need. What you need is the Summery Plan Description, the contractual agreement between BCBS and your company. It is a very large document. I asked for it and was not given it. I was given a two page flyer. Human Resources wimped out on me.

After Two and a half months BCBS has still not made a decision on my surgery pre-certification. And we have been told fourth times that BCBS had given us the wrong place to send the documentation. So I took action.

I have signed HIPAA forms so that all of my care givers can discuss the issues with my attorney. I have signed two BCBS HIPAA forms so BCBS can discuss both medical and physiological issues with my attorney. If they tell us the current office is again the wrong office to send the documentation, I will instruct my attorney to mediate the issue with BCBS.

And remember if you loose your cool when talking with BCBC, they have won. When you loose your cool they can write you off as non-cooperative and no further progress is likely.
Title: Re: Wal mart insurance, and BC/BS
Post by: Jamie D on June 08, 2012, 05:49:28 AM
Quote from: Tammy Hope on June 02, 2012, 02:59:17 AM
I've been told that Wal Mart has Blue Cross blue Shield

I've further been told BC/BS covers transition procedures.

Anyone know if either/both are true?

i can't enroll for the first year but i really would love to be able to count my chickens...

I know that I can look at the specifics of my Anthem Blue Cross plan on its website.  I had to sign up, but all the info I need is there, as well as preferred providers, and participating hospitals.
Title: Re: Wal mart insurance, and BC/BS
Post by: Tammy Hope on June 12, 2012, 08:02:52 AM
I'm told that our area is specifically under BC/BS of Arkansas.