I think there was a case where one big insurance company was sued by a transwoman, and lost to pay for her SRS.
Have anyone got their SRS covered by Insurance despite any "legal precedent"?
Is CO still SRS capital of the world besides Thailand?
In different states, different insurances do cover it. Colorado isn't really the center anymore. A good number of people got to other places like California and Arizona. Mine is covered by my insurance just like any other procedure. Hugs
Mariah
I had my surgery covered by Cigna in California. I had to get a network adequacy exclusion and a letter of agreement since there were no in network doctors and to avoid having to pay upfront and be reimbursed. In some states it is required insurance companies cover these types of things. Just remember to stay determined when actually dealing with insurance companies, it is ridiculously frustrating at times. Best of luck :)
I think Oregon also has at least some insurance companies that do. Not sure if they're required or not. The state's insurance plans for low income/disabled people cover it though.
My insurance will cover every procedure wpath States is necessary to transition, electrolysis, voice, FFS, top and bottom surgery, and more.
I'm pre-approved by my insurance company for SRS with Dr Bowers. That would be near San Francisco.
Come live out my way. The west coast is the best coast :-)
I did, but it was back in 1998.
- Karen
Mine GRS with Bowers is covered 100%. They only thing that I have to pay besides travel expenses is a $200 co-pay for the hospital stay. I have a very high end policy with Aetna. I did a ton a research and chose it because of what it's going to cover for surgery.
I am in PA and have Aetna. My GCS is covered.
Quote from: pj on April 28, 2016, 07:06:01 PM
My insurance will cover every procedure wpath States is necessary to transition, electrolysis, voice, FFS, top and bottom surgery, and more.
That is amazing. What insurance carrier do you have? I have never heard of an insurance company covering anything more than GRS. I thought I was lucky because my insurance company, Aetna, covered GRS.
~Terri
I have Premera and it covers the same thing. Whatever is recommended by WPATH as a treatment is covered but it is a higher end policy offered from a big tech company. For example I have body and facial feminization covered. You can get more like hair transplant, removal, therapy, hormones, etc. It's a good reason for girls like us to go into tech if we can.
can someone name the companies that have the insurance that covers everything
I would like to find a job and get things rolling
I've been stuck because of finances , I would risk everything if I could get somewhere and work a job that would help with transition .
Quote from: Roxy Revolver on October 23, 2017, 10:34:52 PM
can someone name the companies that have the insurance that covers everything
I would like to find a job and get things rolling
I've been stuck because of finances , I would risk everything if I could get somewhere and work a job that would help with transition .
I am on my father's Kaiser Permanente insurance plan through his job at Intel in the Portland, OR area. They cover basically all trans-related expenses, including HRT, electrolysis, SRS, therapy etc. They even covered my travel and hotel stay expenses, plus a per diem, when I traveled out of state for phalloplasty. And my deductible for all my surgeries was $100 for out-patient and $250 for anything that required an overnight stay in the hospital, regardless of how many days it was. And everyone at the Gender Pathways Clinic have been super nice and helpful, which is a plus.
I am Canadian so the tax payers will pay for my Gender Confirmation Surgery. My company health insurance covers short term disability for recovery when having trans health related surgeries.
I general, the medicinal part of transitioning is covered. The cosmetic side (lifts, tucks, removals\additions, FFS and other "prunings") are not fully covered....unless the therapist\psychologist states there is for mental health stability\self-injury. The best way to find out is call your provider and ask questions or at the very least visit their web site.
Quote from: Denise on April 28, 2016, 07:06:01 PM
My insurance will cover every procedure wpath States is necessary to transition, electrolysis, voice, FFS, top and bottom surgery, and more.
Yes, please, Denise, which carrier do you have and are these procedures still covered? State funded for low income under current guidelines only covers therapy and HRT in Ohio.
As painful as dealing with them can be, you may look into the VA. Supposedly they cover quite a bit.
My insurance covers everything. FFS, BA, SRS, etc. BCBS Massachusetts.
Quote from: Colleen_definitely on October 24, 2017, 08:00:06 AM
As painful as dealing with them can be, you may look into the VA. Supposedly they cover quite a bit.
My insurance covers everything. FFS, BA, SRS, etc. BCBS Massachusetts.
They did until Trump was elected and new guidelines came out. Now all that's covered transition wise is HRT and therapy.
Oh crap, that I was not aware of.
Horizon BCBS of NJ is covering my GCS/SRS next week and getting it approved wasn't as bad as I thought thanks to the knowledgable surgeon's office. I was at a transgender health conference a few weeks ago and this was the #1 topic. Across the board BCBS seems to be covering for most states. However, I know several people who are having issues with United Healthcare. They were covering everything, but since the Trump Administration has hinted that it's not enforcing transgender healthcare for the affordable healthcare act, United Healthcare is saying all trans related care is covered but is not paying and betting on the odds with the Just Department not enforcing the ACA and Trump trying to dismantle the ACA. Aetna and Cigna is a mixed bag at the moment. Fortunately many stated (just recently NJ) have state protections where insurance companies must cover trans related care.
Ok, so basically I'm seeing a recurring trend where the more progressive the state, the more trans friendly their medicaid and medicaid based or affiliated insurance policies are. Kinda stuck living in Ohio, unless I can get my mail sent to one of you in a more liberal state to change residency, lol. J/K Guess I'll just have to wait until either I can afford it or policies change again. Who knows how long either of those will take, sigh.
HUGS!
I have been researching this topic and seems the more I look the more confused I become. I live in Tennessee and am disabled and have BlueCare of Tennessee. According to this https://www.bcbst.com/mpmanual/Gender_Reassignment.htm GRS is covered. But I can't find a doctor that does the surgery who takes my insurance. I have come too far in becoming the real me to have the rug pulled out from under me. If I can't get the surgery done I'll probably fall back into a very dark place again. I have prayed and cried hoping I can get it done. I am so worried.
Bobbie Ann, as far as I know, Brownstein & Crane in the bay area can work with all BCBS insurance. I only know for certain in my case, coming from Massachusetts.
Colleen, ma BCBS as far as I know absolutely covers GCS. My specific plan is self insured (large university) but the coverage and management all handled by BCBS. My coverage was uncertain as regards anything beyond GCS, however that's all I wanted so I'm happy.
BCBS of man has a policy that reads like it's based on an older version of WPATH however the people in their transgender team are fully up to speed and in my experience are good to work with.