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Health choice coverage for doctor/endocrinologist visits

Started by Will94, December 24, 2014, 12:15:09 AM

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Will94

I'm so torn apart right now. I'm afraid I wont be able to afford Hormone replacement therapy.
The shots themselves are okay but the visits to the endocrinologist is what scares me.

I have health choice (Arizona) and I know for a fact they wont cover anything for Transsexual issues.

I am so scared, it's something that I need but I wont be able to get covered. I want to die.

Please help me out, what should I do?? I can pay for my Therapy, but I cannot pay hundreds of dollars for a visit to the endocrinologist which I believe can cost anywhere from $200-600.
Should I get in touch with my primary care doctor about HRT or is my only option my Therapist? Is it possible they can write a letter saying HRT is medically necessary because I have body/gender dysphoria???

This is something I'm extremely worried about, and I don't want it to stop me from transitioning. I have come this far, I don't want to be stopped now.
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LordKAT

Self injection is the normal route. Why would you need to see an endo each time?
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ImagineKate

Ask your primary, believe it or not they can prescribe hormones. You don't need to see a special "transgender specialist" or anything, only a willingness to prescribe hormones and monitor you. LGBT health center or clinic does this all the time.
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Damara

Quote from: ImagineKate on December 25, 2014, 05:13:03 PM
Ask your primary, believe it or not they can prescribe hormones. You don't need to see a special "transgender specialist" or anything, only a willingness to prescribe hormones and monitor you. LGBT health center or clinic does this all the time.

I didn't know this, Kate! Can a doc that doesn't work in endocrinology do this? I'm seeing a new doctor soon at the suggestion of a friend. She told me he is non judgmental of trans people.. maybe he could get me started on hormone replacement.

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ImagineKate

Quote from: Damara on December 26, 2014, 03:38:34 PM


I didn't know this, Kate! Can a doc that doesn't work in endocrinology do this? I'm seeing a new doctor soon at the suggestion of a friend. She told me he is non judgmental of trans people.. maybe he could get me started on hormone replacement.

They absolutely can. I get my scripts from a nurse practitioner who works with my primary care doctor but she basically sees me and does everything. They operate under informed consent where you sign paperwork that says you understand and accept the risks. For example, a clinic like Callen-Lorde in NYC says that all of their providers can deal with trans hormone care and they're not all endos. Their process is they do an intake, you see a counselor to explain and go over stuff and you sign paperwork, do bloodwork and get your scripts. As a matter of fact, there may be an informed consent clinic in your area that does the same.

But as I said, most primary care doctors may be unwilling because they are unfamiliar. However it never hurts to ask, and usually if you're in a LGBT space like a LGBT clinic they will help you out, prescribe and monitor you. Worse come to worse they may ask you for a therapist referral.
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Will94

Quote from: LordKAT on December 25, 2014, 03:36:52 PM
Self injection is the normal route. Why would you need to see an endo each time?

I'm afraid I wont be able to do the injections myself. But for the most part I'm talking about the 'first' visit to the endocrinologist, because I heard it's more expensive then the after visits.
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HeyTrace19

Yes, check with your primary care physician!  If they are not willing to provide a prescription for you, they will refer you  to an endocrinologist, or another family doctor who feels more comfortable with hormones, a visit which should be covered by insurance.  The part that MAY not be covered would be the actual prescription.  I would encourage you to call your insurance provider and ask if your particular hormone/s would be covered.  This is YOUR life, do not let your fear stop you.  Learn what you can about your insurance, informed consent, and physicians in your area who may be helpful to you.
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FTMax

Definitely talk to your regular doctor and see what your options with them are. Or if they don't feel comfortable/don't feel that they have the right expertise, see if they have a colleague at a different practice that would. As Kate said, see if you can find an LGBT clinic. That was the route I went, and it cost me a total of $62 dollars for 2 visits with my doctor, blood work, and 3 months of gel testosterone.

If self-injecting has you worried, there are plenty of other options there. You definitely don't have to go back to the doctor each time you need a shot.
T: 12/5/2014 | Top: 4/21/2015 | Hysto: 2/6/2016 | Meta: 3/21/2017

I don't come here anymore, so if you need to get in touch send an email: maxdoeswork AT protonmail.com
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Madeline182

Nurse practitioners are great!  I saw it mentioned, it doesn't need to be "trans" med care.  My NP didn't ask for a note or anything.  We talk, and he felt the best treatment option for my health was HRT ;) AGREED!!!
Insurance? Low deductible in my opinion is best if you are going to make multiple health care visits throughout the year. 
Happy holidays <3
-Dead or Alive <3
[Chorus]
"Isn't it a pity that I'm not the prettiest girl in the world, sometimes I feel when I kick up my heels in the sun,
I'm the loveliest one."



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ImagineKate

Quote from: Madeline182 on December 28, 2014, 07:04:58 PM
Nurse practitioners are great!  I saw it mentioned, it doesn't need to be "trans" med care.  My NP didn't ask for a note or anything.  We talk, and he felt the best treatment option for my health was HRT ;) AGREED!!!
Insurance? Low deductible in my opinion is best if you are going to make multiple health care visits throughout the year. 
Happy holidays <3

Just to be clear, I do go to LGBT centric care, but I chose an affirming space to make me more comfortable. Yes, I do see a nurse practitioner but from everything I've seen she treats me just as well as a doctor would. She is trans and therefore understands my needs and doesn't judge me.
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Jenna Marie

You can also shop around for an endo willing to use one of the set of codes that the insurance company will accept (which is not uncommon in trans care, so most trans-friendly endos should have at least thought about the issue). I know of one woman who had her visits coded as "primary ovarian failure," which is accurate in a sense. :)  Personally, my own endo listed it as "hormonal insufficiency," without specifying the hormone in question, and then until I changed my gender marker with them I simply paid out of pocket for my own HRT so the insurance wouldn't be notified. I was being a bit paranoid - transgender care was covered aside from GRS - but it worked fine and the pharmacy easily understood "don't bill the insurance for this."
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