Susan's Place Transgender Resources

Community Conversation => Transitioning => Gender Correction Surgery => Topic started by: blue.lotus on August 11, 2016, 04:23:04 PM

Title: Financing SrS with Insurance
Post by: blue.lotus on August 11, 2016, 04:23:04 PM
I've read a couple of threads saying how they were able to finance SrS with insurance and I was just wondering how this was possible. What insurance covers this? Currently, I have Molina so I'm not quite sure If I'm covered

Thanks
Title: Re: Financing SrS with Insurance
Post by: Maybebaby56 on August 13, 2016, 08:47:56 PM
Quote from: blue.lotus on August 11, 2016, 04:23:04 PM
I've read a couple of threads saying how they were able to finance SrS with insurance and I was just wondering how this was possible. What insurance covers this? Currently, I have Molina so I'm not quite sure If I'm covered

Thanks

You have to look at the coverage and benefits description of your insurance carrier.  Many insurance companies follow WPATH guidelines and will cover SRS if you meet their pre-certification requirements. I have Aetna, and they cover it. If you're not sure, just call them.

~Terri
Title: Re: Financing SrS with Insurance
Post by: JLT1 on August 13, 2016, 09:06:47 PM
There is a thread entitled "How I got insurance to cover FFS".  Much of what is in there applies to SRS.  Except that coverage for SRS is generally easier to get.

Jen
Title: Re: Financing SrS with Insurance
Post by: FTMax on August 14, 2016, 09:39:13 AM
Calling and asking if they have exclusions for transgender care is a good start. What I did was use the online messaging option and list the specific procedures I wanted to have done, and asked what kind of coverage I could expect for those things.

They got back to me about a week later with a complete break down of what I could expect to pay in and out of network, what % of the expenses they covered and what I would be responsible for, who I could go to that was in network, etc. The only thing you may find with insurance is that you have more limited options of who you can go to. So I wouldn't get your heart set on a particular surgeon until you know who your options are.

To get them to cover it, I needed a letter from my doctor saying I was healthy enough for surgery and met the WPATH guidelines, as well as 2 letters from mental health practitioners saying that SRS was medically necessary and that I met the WPATH guidelines.