Hey guys! I am in need of some information reguarding health insurance covering top surgery. I am mostly interested in talking to people who have successfully used the insurance company Blue Of California. I have been reading only horror stories of being denied coverage even though the insurance companies say that there is coverage. So if anyone has any help on getting my surgery seccessfully covered through my insurance. Any help would be awesome. Thanks!

I am a MTF but I have had some experience with getting blue of California to pay for trans related care.

I filed some claims for therapy and they were all denied. I went around and around with them and got nowhere, and each person I talked to gave me a different story about what was happening which was frustrating. I finally wrote to the department of insurance at the state and got a senior level investigator involved and THEN blue decided to pay my claims under an "exception" basis. Apparently the therapist I go to is a "non-participating provider" (which I already knew) and as such blue felt that they didn't have to pay anything on my claims.  They won't pay any more claims unless I go "in house" and use their Mental Health services. This seems strange because I believe that they will pay something for other services provided by a "non-participating provider" like you might get if you were traveling and needed medical services at a random hospital that was not part of blue's network.

As you probably know, California law states that insurance companies have to pay for trans related treatment that is similar to treatments they pay for for non trans people:

http://transgenderlawcenter.org/archives/4273

I believe that blue is still trying to discriminate against trans people and is actively refusing to pay trans related claims unless the individual chooses to fight them. Be prepared to escalate your claims to the department of insurance.

I wish you good luck in your fight with blue.

~Eva