Susan's Place Transgender Resources

Community Conversation => Transgender talk => Topic started by: Jera on July 22, 2014, 12:28:24 AM

Title: Insurance Question
Post by: Jera on July 22, 2014, 12:28:24 AM
When researching what my options might even be, I came across this as a question to ask a potential therapist:

"Would you be willing to classify our sessions as depression in order to meet insurance requirements?"

I had no idea this was a thing. Does anyone have any experience with this? Is it even legal? If so, would it only cover sessions with the therapist, or might it potentially cover HRT as well?

One of my biggest problems right now is finding an insurance plan I can afford that covers GD. But if this is an actual possibility, that might open a few doors.
Title: Re: Insurance Question
Post by: Jessica Merriman on July 22, 2014, 12:47:31 AM
Not much more different than asking and Endo Doctor to classify HRT blood test's as a "hormone imbalance". The right doctor will do what they can to help ease cost's for you and let's them bill a little higher for greater reimbursement. Mine previous to Medicare's exclusion lift did this for me. Doesn't hurt to ask!  :)
Title: Re: Insurance Question
Post by: Jera on July 22, 2014, 02:39:26 AM
Alright. It seems like borderline fraud to me, but if it's actually an ok thing to do, it's good to know I can look into it.
Title: Re: Insurance Question
Post by: Jessica Merriman on July 22, 2014, 02:43:31 AM
Quote from: Jera on July 22, 2014, 02:39:26 AM
It seems like borderline fraud to me
As far as I am concerned the fraud is being done by insurance companies who deny us service for a valid medical condition. That is one of the reasons a lot of doctors code it this way for us is they are sympathetic to us by being discriminated against. You should feel no guilt at all.  :)
Title: Re: Insurance Question
Post by: Flan on July 22, 2014, 03:27:08 AM
The coding side depends a lot of if insurance is excluding trans* care in general or if they really just exclude surgical therapies. Mental health services will probably be just coded as a visit or eval or whatever. As far as the MD side there are better ways to get around exclusion than "endocrine disorder, NOS" (not otherwise specified).