So the plant im working at has health, vision and dental thru Cigna. Im wondering if anyone has had any experience with them and knows how trans friendly there health insurance plans are.
Thanks everyone.
Hi,
If your policy covers trans care, like here in California, please let me know if they follow WPATH standards and require RLE "gatekeeper" requirements before benefits kick in. I have an important reason for asking...Thanks. (Anyone else?)
I had Cigna insurance through Caesar's Entertainment, and I must say, I am an extremely satisfied customer. No BS with getting the hormone prescriptions covered, they took care of therapy, doctor's visits, and blood hormone tests, and the plan that I was on even covered SRS or Orchiectomy at an out-of-pocket rate of 15%/85%. Pretty awesome. I'm not sure if this was just because I was working for Caesar's, which got a perfect 100 on the HRC equality index, or if it's a Cigna-wide thing, but I had a great experience with them.
Cigna covers that which is considered to be medically indicated by WPATH, and this included SRS.
HOWEVER...
That is for individual policies. The so-called "self-insured" policies, the kinds offered by employer such as mine, are free to exclude whatever they want from the benefit. So my particular Cigna plan doesn't cover anything transition related.
And, this is in compliance with the law that was passed in CA back in May 2013. Employers are free to shaft their employess.
You really need to get a copy of the actual policy to know what if anything is covered. Most policies have exclusions for any sort of transgender care, even therapy. In all my years working in the electronics manufacturing world from 20 head count companies to thousands, they all excluded TG care, which in the mix was Cigna
Quote from: Constance on January 22, 2014, 02:30:08 PM
Cigna covers that which is considered to be medically indicated by WPATH, and this included SRS.
HOWEVER...
That is for individual policies. The so-called "self-insured" policies, the kinds offered by employer such as mine, are free to exclude whatever they want from the benefit. So my particular Cigna plan doesn't cover anything transition related.
And, this is in compliance with the law that was passed in CA back in May 2013. Employers are free to shaft their employess.
Same here, ihave cigna as well, and my employer excludes, and it is listed in my policy as elective and listed as cosmetic :eusa_think: total bs but ye the company can request certain exclusions which bring "their" total cost of the package
I own my own company.. getting ready to purchase new insurance wonder if I can get Cigna.. and that would mean I am covered..
Would be nice to have SRS covered if I go that route down the road
Carrie
I have not been having much luck with Cigna. Our plan has a transgender exclusion but I am still getting some coverage for psychologists and hormones. It's a pain in the but to get through their walls at times. I'm kinda stealth so I've complained about them a bit to hr but she wants me to get specific with my problems which I'm not too comfy with yet as still being new. Anthem in california was much easier to deal with in my opinion. I wish they would just come up with a consistent plan. To me its like ironic they don't cover it but are more than happy to have my seeing shrinks weekly and a plethora of antidepressants. Over the past year and a half I could of paid for srs almost looking at all of those bills. So its like a savings but they just don't see it our way all the time.
Actually, I should add that my hormone prescriptions are covered.
California department of insurance and the manage healthcare board both mandate that insurance companies doing business in California exclude all transgender exclusions. That any type of medical care for a genetic mail or genetic female also be covered for transgender patient. There must be parity quality in all policies based on a 2012
Stupid spell check... Should read parity and equality across the board in all policies based on a 2012 law.
I contacted those bodies and the way the CA is is written is that "self-insured" policies are not governed. Thus, employers in CA are indeed legally free to exclude transgender services from the "self-insured" policies they offer their employees.
What is a not self insured policy vs one that is?
In a way that only legalese can explain, "self-insured" basically means the policies purchased in bulk by an employer. If I bought an individual policy from Cigna, it would not be "self-insured."
Basically, it's bass-ackwards.
I have Blue Cross/Blue Shield PPO.
I think I just read that I need to be properly diagnosed in order to be covered. (Even then, I don't exactly know what they cover yet, have to call...)
I haven't seen a therapist, I just told my physician my condition and she took my bloodwork and I made an appointment next month with an endo she recommended. Does that mean, in order to get coverage, I'll still need to see a therapist? (Shh I'm self medicating because I can't wait until my appointment next month) or can my physician or endo diagnose me?