I saw my neurologist today. We talked about this and that other than my medical issues, and he told me that he had seen a documentary on HBO about doctors in California performing gender surgeries, and the state paying the bill. Is this true? If it is, is it only for residents of California, or will they work with anyone regardless of where they live? He said it was mostly about one specific female doctor, but couldn't remember her name.
Has anyone else even heard this? I think I had heard about something like this several years ago, but I'm not totally sure. If anyone can help shed some light on this, I'm all ears.
California has mandated that insurance cover GCS. California is also considering setting up single payer insurance in the state however the problem is the cost will be more than the entire state budget. As for the doctors name, it might be bowers.
Jennifer,
If you are looking into insurance funded coverage for your surgery, then find an insurance that will cover it and get pre-approval before getting to involved. Some employer sponsored insurance will cover transgender surgery. The trick is to go to work for one of these companies.
I live in Florida and my surgery was not covered. My insurance did pay for a few things but not all.
Kaiser Permanente has a liberal policy that if is deemed medically necessary to treat your dysphoria than GRS can be approved.
Their policy
Kaiser Permanente has designed the Transgender Services Program (TSP) to serve the needs of our members who wish to explore or pursue gender affirming services. The case managers are licensed, caring social workers whose primary focus is to provide clinical guidance and support for members moving through the complex process.
Note: Our program is only available to persons who are enrolled in a health plan from Kaiser Permanente.
Program Enrollment
Many of our health plans include benefits for gender affirming services. Kaiser Permanente members who are interested in accessing our program regardless of their coverage — may enroll in TSP without a referral.
All Kaiser Permanente members who have a covered benefit for gender affirming surgical procedures and who have definitively decided to pursue this surgery are required to enroll in the TSP.
To enroll, call Kaiser Permanente Care Management toll-free at 1-866-656-4183. Program participation is confidential and at no cost to the member.
If you have questions regarding your Kaiser Permanente coverage for gender affirming services or want to learn more about the process, contact a TSP case manager at the Care Management number above.
Surgical Services
Most surgical services are provided by experienced surgeons outside of Washington; some procedures, like breast reductions, may be provided by surgeons in the Seattle area.
I was assigned a Gender Therapist, a Social Worker, a physician who specializes in transgender issues to write prescriptions. A voice/lifestyle coach and they will approve orchiectomy. Other services will be provided if necessary.
Quote from: Jennifer RachaelAnn on June 05, 2017, 07:25:26 PM
I saw my neurologist today. We talked about this and that other than my medical issues, and he told me that he had seen a documentary on HBO about doctors in California performing gender surgeries, and the state paying the bill. Is this true? If it is, is it only for residents of California, or will they work with anyone regardless of where they live? He said it was mostly about one specific female doctor, but couldn't remember her name.
Has anyone else even heard this? I think I had heard about something like this several years ago, but I'm not totally sure. If anyone can help shed some light on this, I'm all ears.
As far as I know, the only state funded transgender surgeries are for prisoners. That's a steep price for admission!
Hugs, Devlyn
Quote from: Devlyn Marie on June 06, 2017, 10:54:49 AM
As far as I know, the only state funded transgender surgeries are for prisoners. That's a steep price for admission!
Hugs, Devlyn
Made me laugh out loud at work!! :icon_yikes:
Same can be set for Oregon, I hear. I think residents must remain a year at least before being able to get free surgeries. We were almost going to move to oregon to get in on that
You shouldve asked what the program was called if he knew. Ah well, too late now
There's one problem for me with finding a job that offers that kind of insurance. I'm physically and emotionally disabled. Physically I have Myotonic MD. And emotionally I don't have the patience or tolerance to be around people. That's why I like keeping most of my friends online. No need to havve to sit around and put up with their crap. So due to those 2 reasons, I can't work. And believe me, disability barely pays a damn thing. I barely scrape by every month. If it wasn't for my wife, I would probably be living out of an abandoned building. Again.
Individuals in California who are on MediCal do get their GCS paid for by the state. I know a number of girls who have had their surgery paid for by the state.
I stand corrected.
Hugs, Devlyn
Quote from: I Am Jess on June 12, 2017, 02:58:15 AM
Individuals in California who are on MediCal do get their GCS paid for by the state. I know a number of girls who have had their surgery paid for by the state.
That is almost enough for me to want to move to Cali and take a low paying job. No really. ;)
I have Blue Cross/ Blue Shield (federal employee program). I live in California. They cover bottom surgery after 1 year of seeing a therapist but not breast implants. For FTM they cover everything.
Quote from: Ejo on June 12, 2017, 08:26:16 AM
I have Blue Cross/ Blue Shield (federal employee program). I live in California. They cover bottom surgery after 1 year of seeing a therapist but not breast implants. For FTM they cover everything.
Blue Cross/Blue Shield (again federal employees) of Florida did NOT pay for my surgery last year. This is really a hit or miss situation. Get prior approval first.
It is written in the policy that it is covered. California has additional laws in place protecting LGBT and force the insurance companies to cover those procedures.
Quote from: Devlyn Marie on June 12, 2017, 05:52:55 AM
I stand corrected.
Hugs, Devlyn
If you don't stand for something, you will fall for anything.
Quote from: Jennifer RachaelAnn on June 11, 2017, 09:57:02 PMI barely scrape by every month. If it wasn't for my wife, I would probably be living out of an abandoned building. Again.
Yup me to. Have to sell all of our old stuff online to have any extra cash. Disability pays barely.
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Yes a lot of things are covered depending on the insurance company. It does not happen a lot and the circumstances are not everyday type of circumstances. But talking in my support group. There has been cases of voice surgery, BA and even electrolysis being paid for by insurance. Kaiser was the insurance that pays for currently electrolysis. I know mine pays for orchiectomy and GRS. I have Aetna as my primary and Medical as my secondary. And have no clue what other services if any are covered.
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Quote from: Jennifer RachaelAnn on June 11, 2017, 09:57:02 PM
There's one problem for me with finding a job that offers that kind of insurance. I'm physically and emotionally disabled. Physically I have Myotonic MD. And emotionally I don't have the patience or tolerance to be around people. That's why I like keeping most of my friends online. No need to havve to sit around and put up with their crap. So due to those 2 reasons, I can't work. And believe me, disability barely pays a damn thing. I barely scrape by every month. If it wasn't for my wife, I would probably be living out of an abandoned building. Again.
Are you on Medicare? Medicare has covered trans health procedures since 2014. I'm trying to get my FTM top surgery paid for that way.
Just a note Kaiser Trans services apparently do not extend to those 65 and older. At least there is not one word of it in the Senior plan booklet they send out.
Quote from: The Flying Lemur on October 12, 2017, 11:56:05 PM
Are you on Medicare? Medicare has covered trans health procedures since 2014. I'm trying to get my FTM top surgery paid for that way.
Does it matter what state you live in? I'm in Connecticut and on Medicare.
Ryuichi
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Quote from: Ryuichi13 on October 27, 2017, 11:44:03 PM
Does it matter what state you live in? I'm in Connecticut and on Medicare.
Ryuichi
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To a point. States are allowed some wiggle room in how they interpret what counts as medically necessary. You'd have to research your state's policies to be sure.
Also, there's the matter of whether you even have a decent surgeon that takes Medicare within your state. I've known a couple people from other states who had only one or two options, and the results were...not good.
Quote from: widdershins on October 27, 2017, 11:54:49 PM
To a point. States are allowed some wiggle room in how they interpret what counts as medically necessary. You'd have to research your state's policies to be sure.
Also, there's the matter of whether you even have a decent surgeon that takes Medicare within your state. I've known a couple people from other states who had only one or two options, and the results were...not good.
Okay, thanks.
I'm still in the research phase of top surgery, so there's no hurry, but I DO plan on finding out if they do take Medicare there, as well as what kidds of surgeries they do there.
Thanks for the info!
Ryuichi
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