Hey everyone! When I turn 26 this year, I will have to find my own insurance plan. This could be a good thing. I want to choose a plan that will specifically cover my top surgery and hopefully other Trans related medical care as well. I'm trying to find one but I just feel like I'm wading through too much information. Does anyone know a specific plan I should look into that will allow me to get surgery within the next year? Thank you everyone!
It varies based on where you live. I know that Kaiser Permanente HMO on the West coast covers transgender services, including hormones and surgery. It is listed with all the specifics of the coverage (routine physical, eye exam, prenatal, bone density CT screening, infertility, transgender services, etc.). In theory, I should have a $20 co-pay for "Transgender Services," a $20 co-pay for "Day Surgery Transgender," and a $100 co-pay for "Hospital Inpatient Care Transgender." But Kaiser isn't available everywhere, and possibly their other regions have different coverage.
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Oh awesome thank you for that info! I'm in colorado, I hope they offer it here!
Maine and California (and maybe a few other states) have state laws preventing discrimination in insurance for trans people. I don't know re: Colorado. It's an odd state with both very liberal (marijuana) and very conservative (Focus on the Family is there) impulses. Kaiser in CA is a not for profit, which is a leader on a lot of different health care issues. They were ahead of most of California. But they are almost the exception that proves the rule.
Otherwise it's your company that sets the plan. The insurance company itself is less important. For instance a company like Apple has very good policies but Hobby Lobby would not even if they had the same carrier.
On the individual market, insurance tends not to be as good. You usually pay more for less coverage. I've never found that to not be the case.
--Jay
Colorado is one of the 5 states where it is illegal to not cover transgender services under insurance.
I just moved to Colorado and my job offers Kaiser. I'm not sure what plan I should pick if they offer different ones (I'm not sure if they do) is my best bet there to call the insurance company and pick one that will cover my stuff (I want to go to Medalie, other than that I don't have an opinion on doctors right now)
Though the thing is that if there is a plan like Kaiser, they may have their own idea who they will work with. I think this is true in CA. Not sure re: Colorado where there are fewer providers. This can work in your favor, as they would be more likely to cover someone you are interested in.
--Jay
Calling first to see if they have an agreement with a doctor you prefer would be wise. Most often you have to use local doctors unless there really isn't a local one.