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About how much will HRT cost

Started by Clarity, December 30, 2012, 05:45:10 PM

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Clarity

Well, looks like I'll be starting HRT as soon as I can afford it. I would like to know about how much the cost will be. I've already checked with my insurance and found that they don't really cover anything as far as transitioning goes. I already know that my initial costs will include a couple Dr appointments and some blood tests. I think that the appointment can be covered by insurance if it is coded correctly. I've heard of some doctors using "Hormonal imbalance" as the reason for prescribing hormones in order to trick insurance into covering them. Does anybody know if this is something that is easily done? If not, how much can I expect to pay if I have to pay full price for HRT?

Rena-san

With my insurance, UHC, I pay a $20 copay for a month's supply regardless of the dosage. I know that the current dosage I'm on should cost around $60-70, and that this is according to some sources, the highest recommended dosage. This includes spironolactone and estradiol, both just oral form. (The estradiol is cheaper than the spiro in my opinion).

I told my insurance company nothing, and now that they are paying for it, as long as I don't lose coverage, it will continue to be covered with just a $20 copay. It took me three endo visits and four psychiatrist visits before my endo started me on HRT. Specialists under my insurance are $40 copays. The labs were mostly covered, but I had little $7-20 dollar payments for the parts the insurance didn't cover. Total, I guess it cost me about $300 just to start hormones then $20 a month after that with an extra $40-50 every time I need to see my endo/have a lab done.
(I didn't realize how much I've invested in this till right now. Ugh, it is totally worth it though. And at least I had insurance for it. Without insurance, this would have cost close to $5000--I was silly and had a genetic test done to make sure my chromosomes were fine--which they were. My hormones were naturally off--missing, and I was diagnosed as intersex. So I'm glad I had the tests done.)

If you already have insurance, and you got it without a preexisting "gender" condition--you had sought no treatment and had no history of treatment for it--then your insurance should cover hormones without question. I guess it depends on your insurance though, but for me, this is what my insurance told me. They will under no circumstance cover surgeries. Right now I'm on hormones and they are covered because:
1. They pry haven't realized what I'm doing or
2. If they have, my preexisting intersex condition requires the manual taking of some sex hormone--I just choose the one opposite my assigned gender! If I weren't to take hormones, my bones would likely fall apart.


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DanicaCarin

For me it comes out to $129 a month for Spiro, Finasteride, & Estradiol(Patch) & orals :o. My Therapist/Endo(Both online) had me getting my meds online, so that's what it would it would cost online w/no insurance. I'm planning to ask my primary if she knows an Endo that will prescribe for me with out a letter based on me having 18 months of HRT under my belt.
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Clarity

I'm having a hard time figuring out how I'm ever going to afford this. I've tried searching for a job, but have had no luck. I've had one suggestion lately to see if there is anywhere I could get financial aid for transitioning. I've tried every combination of search terms I could think of, but haven't had any luck. Does anyone know if there is anywhere I could get aid for paying for my transition?

Penny Gurl

Well my scrips cost about $34 to $44 a/mo (depends if I have them shipped to me.  That's from the clinic I go to in Chicago, they do my my hormone tests and checkups.  All with out insurance.  They have a sliding scale set up so depending what you make it sets up the office visit co-pay.  I currently make next to nothing so office visits are $20-$25, and they have a deal set up with the pharmacy in the building so the prescription cost are also greatly reduced.  If you're near Chicago it's work checking out.
"My dad and I used to be pretty tight. The sad truth is, my breasts have come between us."

~Angela~
My So-Called Life
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Alainaluvsu

#5
$16 for estrogen, which lasts 50 days under current prescription. If it was a 30 day plan would be about 20. - From Walmart.
$9 Finasteride - Walmart
$10 Spiro - Rite Aid

I have no insurance.
To dream of the person you would like to be is to waste the person you are.



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kae m

I currently don't have insurance and I'm unemployed, so I've had to get a bit creative in obtaining affordable medications. Right now it costs me roughly $1000 for a year of prescriptions:

  • spironolactone: $13 per 30 days
  • estradiol valerate: $167 per 15 weeks (fortunately I was able to stock up on this at $15 before my insurance ran out)
  • syringes & needles: ~$20 per year
  • progesterone: ~$20 per 30 days
My doctor costs $165 per visit, and I'm way overdue on having my blood work done, but from what I understand it will cost somewhere around $300-350 - I'm hoping that's an extreme overestimation, but it's why I'm so overdue on getting my levels checked.

Don't discount your insurance just because they say they won't cover it. My former insurance plan had an explicit exclusion for any care relating to transgender treatment. It was supposed to extend through therapy, surgery, and prescriptions, but the entire time I was under that policy all of my therapy, endo appointments, and medications were covered. And even if your insurance does cover something it is still worthwhile to shop around. As just a couple examples: Walmart has cheap estradiol tablets, Rite Aid has cheap spiro.

Good luck.
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Clarity

I think I could maybe find a way to afford hormones. I've looked at ways I could reduce some of my debts and found a way to get about $75/month less that I would be paying in bills. I actually scheduled my Dr. appointment yesterday to go in and get bloodwork done.


Zumbagirl

I have no idea what you doctor is going to put you on. I don't use insurance to pay for my hormones. I have been paying for them on my own since the start of my transition. Even today my hormones are not a medication covered on my health insurance.

I take depo-estradiol and a single vial costs me about $50 and that lasts me 3 months. A 3 month package of syringes costs me about $12. So every 3 months I have to come up with $62 to pay for my hormones. I remember when I was a pre-op I took spironolactone and honestly I forgot much I paid for it, but it wasn't much.

In the beginning I needed to have more blood work done, but my insurance covered it. I think my endo had it listed as hormone deficiency or something (hypogonadism I believe) and back in those days TSism was most definitely not covered under insurance. The insurance even covered my gender therapy as well, although I found myself paying for plenty of sessions out of pocket to avoid fighting claim denials with the company (united health care).

I was very careful in those days because I didn't want to have my medical records says the words transsexual or sex change on them, so I learned to pay for everything. When there is no insurance company and it was just between the doctor, myself and some cash, it's like nothing ever happened for insurance companies and other doctors. Back in those days, employers could peep into employee medical files, they still can but not to the extent that could have back then. I even went to a medical records clearinghouse and bought a copy of my own medical records after my transition just because I didn't want the therapy or my sex change to appear on my medical records for the rest of my life The only thing that showed up was a case of the flu I had.
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