I am trying to find out if I could get insurance coverage for top surgery, I have blue cross blue shield federal and I can't find any information online. Can anyone help me out?
Quote from: nyrangers30 on May 15, 2015, 11:26:12 PM
I am trying to find out if I could get insurance coverage for top surgery, I have blue cross blue shield federal and I can't find any information online. Can anyone help me out?
I had BCBS Federal and they have not lifted any of their exclusions for transgender care. I was able to get my meds covered because my code was submitted as hormonal imbalance.
I changed to AETNA last open enrollment because they did lift their exclusion for GRS with this year's new plan.
Quote from: nyrangers30 on May 15, 2015, 11:26:12 PM
I am trying to find out if I could get insurance coverage for top surgery, I have blue cross blue shield federal and I can't find any information online. Can anyone help me out?
Every plan is different, even sometimes with the federal government. Call them directly and ask them to send you the information IN WRITING.
I would start by calling the customer service rep and asking them information. Write down everything they said. Then ask for their name. Write down the person's name, the date, and the time of call (and what they said, of course). Ask the person to send you in writing what the policy says for trans benefits. Tell her you want the nitty gritty details of inclusions/exclusions. You want the "fine print". Insurance companies can make it rough to get it...they want to boast to the world that they are giving us benefits, but really is it bull ->-bleeped-<- smoke screens that we have to dance through in order to get our care covered.
Quote from: Bimmer Guy on May 16, 2015, 12:02:49 AM
Every plan is different, even sometimes with the federal government. Call them directly and ask them to send you the information IN WRITING.
I would start by calling the customer service rep and asking them information. Write down everything they said. Then ask for their name. Write down the person's name, the date, and the time of call (and what they said, of course). Ask the person to send you in writing what the policy says for trans benefits. Tell her you want the nitty gritty details of inclusions/exclusions. You want the "fine print". Insurance companies can make it rough to get it...they want to boast to the world that they are giving us benefits, but really is it bull ->-bleeped-<- smoke screens that we have to dance through in order to get our care covered.
Before I had to buy my own insurance on my last birthday, I had the BCBS Federal Employee Plan. The only thing they would cover previously was my doctor visits and lab work. No surgeries, no hormones.
It looks like BCBS is a no. Aetna and Kaiser are (limited?) yesses.
Just did a Google search and found these links from Nov 2014:
http://www.washingtonpost.com/blogs/federal-eye/wp/2014/11/07/federal-worker-health-plan-to-cover-sex-changes-and-transgender-care-next-year/
"Blue Cross Blue Shield, the most popular carrier within the federal network, with more than 2.6 million government enrollees last year, will not cover transgender care next year."
http://archive.federaltimes.com/article/20141106/MGMT01/311060012/Transgender-care-available-some-federal-health-plans
"Blue Cross Blue Shield, which maintains coverage for a majority of federal employees in the FEHBP, has maintained its exclusion of transgender care for 2015."
http://go.nationalpartnership.org/site/News2?abbr=daily2_&page=NewsArticle&id=46061
"Coverage Changes
Aetna's federal employee plan will cover gender affirmation surgery next year and be available to enrollees in all 50 states. About 121,000 federal employees were covered through Aetna last year, according to the Congressional Research Service.
Kaiser Permanente, which covered 240,000 federal employees last year, and the American Foreign Service Benefit Plan, which provides coverage for members of the American Foreign Service Protective Association, also will cover transgender care, "Federal Eye" reports.
However, Blue Cross Blue Shield, which provided coverage for more than 2.6 million federal employees last year, has not announced plans to cover such care (Hicks, "Federal Eye," Washington Post, 11/7). "
This is why I changed to AETNA. It was very nice of the VA to offer them as a choice the very year they dropped the exclusion.
Quote from: FriendsCallMeChris on May 16, 2015, 11:31:53 AM
It looks like BCBS is a no. Aetna and Kaiser are (limited?) yesses.
Just did a Google search and found these links from Nov 2014:
http://www.washingtonpost.com/blogs/federal-eye/wp/2014/11/07/federal-worker-health-plan-to-cover-sex-changes-and-transgender-care-next-year/
"Blue Cross Blue Shield, the most popular carrier within the federal network, with more than 2.6 million government enrollees last year, will not cover transgender care next year."
http://archive.federaltimes.com/article/20141106/MGMT01/311060012/Transgender-care-available-some-federal-health-plans
"Blue Cross Blue Shield, which maintains coverage for a majority of federal employees in the FEHBP, has maintained its exclusion of transgender care for 2015."
http://go.nationalpartnership.org/site/News2?abbr=daily2_&page=NewsArticle&id=46061
"Coverage Changes
Aetna's federal employee plan will cover gender affirmation surgery next year and be available to enrollees in all 50 states. About 121,000 federal employees were covered through Aetna last year, according to the Congressional Research Service.
Kaiser Permanente, which covered 240,000 federal employees last year, and the American Foreign Service Benefit Plan, which provides coverage for members of the American Foreign Service Protective Association, also will cover transgender care, "Federal Eye" reports.
However, Blue Cross Blue Shield, which provided coverage for more than 2.6 million federal employees last year, has not announced plans to cover such care (Hicks, "Federal Eye," Washington Post, 11/7). "
thats unfortunate. I hope they change that sometime soon. thank you for your help everyone!
Open Season starts November 9, 2015. I would like to switch from BCBS to AETNA but the therapist I see doesn't accept AETNA.
Update to this:
On my last birthday I switched to a plan on CareFirst, which is owned by BCBS. I wrote them a very specifically worded email to see if they would cover all of the separate procedures related to my bottom surgery or if they excluded coverage for transgender healthcare. They (very enthusiastically) said that it was covered, gave me specific coverage details and pages to look at in the plan as reference, AND gave me the extension of an individual who could help me with claims if I had issues down the road.
So don't write off a provider entirely just because the internet collective says that they don't cover things. Email them. Ask specific questions about what you want. Give details that help contextualize the situation. Worst case scenario is you get a "no, we don't cover that currently", and you move on to the next provider.
If you're currently shopping, I'd strongly advise reaching out as far in advance of open enrollment as you can - they will probably be inundated with questions from people in the same boat.
BCBS excluding transgender care will be in violation of federal mandates so they had better get with the times and do what the damn law says.
It is a crazy maze to navigate. I live in Massachusetts and Blue Cross does offer SRS as part of their BC/BS Massachusetts benefits (may have to do with state laws against discrimination. So I was thrilled to see that and figured with the lift of the federal ban in 2014 that my federal BC/BS would cover the same. It does not appear so. The only change I have seen is that they will cover HRT in 2016, but it does not look like they cover any surgeries. I know this is an older thread, but it actually popped up in my google searches as I was looking for the same info. I'm going to give them a call, but so far very discouraging.