So I just found out today that my insurance through Kaiser covers SRS, but not breast augmentation, trach shave, etc. I was wondering if anyone has gone through them for SRS? Who was your surgeon? I'm probably going to give them one more call tomorrow just to make sure I'm not getting my hopes up for nothing. They cover my hormones and therapy, but $15 co-pay for SRS?! I'm trying not to get too excited. I hope the guy I spoke to about it on the phone was looking at that right!

WOW congrats, i agree i wouldnt get too hopefull on the $15 t sounds just a little to good to be true. but any coverage is good. great find and the best of luck

Quote from: Sheala on March 03, 2014, 06:35:38 PM
WOW congrats, i agree i wouldnt get too hopefull on the $15 t sounds just a little to good to be true. but any coverage is good. great find and the best of luck

My insurance is through the State of California and most procedures and things are a $15 co-pay so it wouldn't be too far fetched. I just want to make sure I'm not getting bad information, ya'know.

WOW i guess i need to move to CA.... lol here in PA well with my nsurance 1: its not covered.... 2: my copay would still be in the hundreds at the least.

Quote from: Melia02 on March 03, 2014, 06:49:42 PM
My insurance is through the State of California and most procedures and things are a $15 co-pay so it wouldn't be too far fetched. I just want to make sure I'm not getting bad information, ya'know.

When I had KP my copay was a lot higher than $15. When I had my gallbladder removed my copay came out to around $200... Which, still isn't bad mind you considering I was hospitalized for a week. But... Weren't no $15.

But, if you can get GRS through Kaiser for under a grand I'd call that a success. I'd be curious who they'd get to do the surgery though... Kaiser typically doesn't pay for out of network, or, at least that was my experience with them...

I am there with you.  Kaiser member, waiting to get started on HRT.  It is also interesting to note that California's Affordable Healthcare plans also cover SRS and HRT.

So I've spoken with 3 different people for assurance today at Kaiser. SRS is covered under my plan and it's $0.00 according to my plan. My plan covers all in-patient surgery costs and $15.00 co-pay for all "day surgeries." I'm not saying this is how it will be for everyone, but it's included in my plan. From the sounds of it all qualified SRS patients get transferred to the SF Trans Clinic. So we'll see what happens. I'll keep posting in this thread as things develop. I don't qualify for breast augmentation (I already have them anyway), trachea shave, or FFS. All those procedures are excluded from my plan.

I did have everyone I spoke with read word for word what is covered. Transgender Sex Reassignment Surgery is among what is covered under "Transgender Services."

Yep. That has been my finding too.  Sadly FFS, and tracheal shave are still considered purely cosmetic and breast augmentation can swing either way, which probably means a higher leaning to being deemed cosmetic as well.

Quote from: Colleen♡Callie on March 04, 2014, 06:25:16 PM
Yep. That has been my finding too.  Sadly FFS, and tracheal shave are still considered purely cosmetic and breast augmentation can swing either way, which probably means a higher leaning to being deemed cosmetic as well.

Is your insurance through a state government employer too?

Not state.

County.  County public library system.  So close enough.  But California actually made transgender issues standard for health insurance.  So all insurance policies that meet California standards, which is most, will cover transgender issues and SRS.

Including California's Affordable Healthcare.

Wait what Kaiser plans are you talking about?? I have kaiser.

California banned insurances from excluding transgender health care.

So basically any and all health care plans that are regulated by department of managed health care (DMHC) or the department of insurance (DOI) in California will include transgender issues in the plan.

However if you're on a "self-insured" plan that is governed through ERISA, which is a federal law regulation, there's a good chance the insurance plan won't cover transgender issues.

http://transgenderlawcenter.org/archives/4273

I am on the Kaiser Senior Assistance plan and have medicare.

I don't know.  I think medicare is federal, and mediCal is state?  Don't quote me on that.

Best thing to do is log on to your Kp.org account and look up what is covered with your plan under their coverage tab. If srs and hrt are covered it'll list "transgender issues" as under your coverage.

Colleen I've been out of the state and haven't been able to get much information via phone. Have you found out anything new? I'm curious to know what doctor does it. I'd rather just pay for it out of pocket if it's some second rate doctor, ya'know. Not all free things are good things lol. I've tried getting in touch with my PCM and P-Endo, but they both want me to make appointments. I should have got the psych stuff out of the way when my primary asked last January, but she didn't know enough at the time to drag me in.

I haven't.  Sorry.

I'm still waiting to get an appointment with my psychiatrist to start the process of getting on HRT.  SRS is a long way off for me. 

Quote from: Colleen♡Callie on March 10, 2014, 10:37:23 PM
I haven't.  Sorry.

I'm still waiting to get an appointment with my psychiatrist to start the process of getting on HRT.  SRS is a long way off for me.

Oh wow! Good luck to you and well wishes on your journey love!

They're making you see a psychiatrist for HRT? I didn't know that was still apart the Standards of Care protocol. I went right through to Endo and got my script. I also started overseas first, so maybe that's why. As soon as I get back to Cali I'll update this post.

It is apparently with Kaiser.  They don't let their counselors and psychologists sign off on it.

Quote from: Colleen♡Callie on March 10, 2014, 10:37:23 PM
I haven't.  Sorry.

I'm still waiting to get an appointment with my psychiatrist to start the process of getting on HRT.  SRS is a long way off for me.

Kaiser covers trans care but their attitude seems to be "If we're paying for it you're gonna jump through some hoops first"

Not sure what part of California you are in, but the psychiatrist I was referred to in the Sacramento area made things super easy. My primary care doctor referred me because I had asked for HRT. Ten minutes into my appointment with the psychiatrist she asked "how is HRT going for you?" I told her that I was not on hormones yet. She looked at me and said "Why the hell not? I'll put the letter in right now". She got up, walked over to her computer and put the referral in before continuing with my appointment.

Hopefully it goes just as smoothly for you.

That sounds too good to be true however I sure hope it is. I'm sure my Blue Cross will not cover any SRS help.

Good luck GF.