As far as I know, SRS for transwomen isnt covered by any insurance as of yet ~ however they removed the ban from medicaid and medicare for transgender care, and if i read correctly that means covering hormone transition AND surgery. But regular health insurance still doesn't cover it.
However; I have Humana currently, and they cover all my hormone prescriptions as well as my Endo appointments... and my endo is listed as an OBGYN, and seeing as my gender is still legally M, they still chose to cover me for 10 visits until June 2015, so I would say thats pretty decent coverage. I pay 36$ for my endo appointments (as opposed to 400$) and my hormones cost about 25$ for all three scripts of progesterone, estrogen and spiro for a month's worth of each. I might be switching to shots soon and according to what I read from this facebook page called trans-miami, Medroxyprogesterone shorts cost 63$ for a 3 month supply, and thats without insurance and at Walgreens... so I can only imagine that if my insurance covers shots, it will be even cheaper than that, but if it isnt ~ it seems pretty affordable to me
FFS is still considered cosmetic and also not covered by any insurance. In some cases, GD is a coverable diagnosis for endocrinology appointments by most insurance companies (in FL at least, a friend of mine who's been transitioning for 10+ years and works at an LGBT resource center). So if you're in FL, chances are your insurance will cover hormones and appointments to some degree, some better than others. But surgeries and sometimes injectables are either not covered or covered very little.
I've jumped from United Health, to Coventry, to Humana... so far Humana has given me the most coverage. I hear some people do well with Signa too, but i cant personally comment on that. United covered my endo appointments, but my hormones were like 50$ a month, the same hormones i'm on now for half that.
Also, you should ask how much the cash cost of generic hormones is, because often times its cheaper than what your insurance will "cover"... sometimes you might have to pay more. its f***ed up =/
If you wanna know what they cover specifically, just call them and ask, thats what I did. They will all usually tell you the same thing ~ they cover specialist appointments with referrals and authorizations (which are easy to get, just make sure you go to an LGBT friendly PCP, they will put GD as your diagnosis and your appointments with an Endo or OBGYN will be covered to some degree depending on your insurance company ~ with United i had to pay 60$ for my endo apps. with humana i pay 35$) You have to be specific though ~ call and ask if they cover Estradiol Valerate , Medroxyprogestrone acetate, Spironolactone, Depo provera (which is pretty much estradiol valerate) and pretty much any other medicine you might know the name of ~ you cant ask if they cover transgender care because they don't really have any written policy on that, all they will tell you is "we don't cover any surgeries", and be very unspecific. Just call and ask them if they cover (x) medication and how much.
