I went to a consultation with Dr. Loren Schechter last Monday, March 2nd 2015, and they're trying to obtain pre-approval for surgery. I'm starting to get really anxious about this. For those that have gone through trying to get insurance to cover it, how long did it take for you to get approval? I have two insurance plans as well, could that cause it to take longer? And if it matters I have Tricare and United Healthcare. Thank you in advance!

It just so happens I'm in the middle of an appeal with United Healthcare!  My story is new and quick though so hence the fight and appeal.  I just started T on Nov 20, 2014.  UH started out saying I needed a letter from a therapist.  When I got that they then said I needed to be on T for a year and live as a man for a year.  We looked up the WPATH and is states on page 201 that HRT is not a requirement for chest surgery. (When we called them out on that they stated that they HAVE to follow WPATH).    Then secondly, I have a big chest and can not physically pass as a guy even with binding.  It seems like every person we talked to had something different to say.  But the last person was great and told is exactly what to do and what to say in the appeal.  So I am waiting through this 15day process for their answer. 

It seems like if you have done everything for a year, they don't give you any grief.  Then it shouldn't take very long for an answer.  Maybe a couple of weeks?

Good luck!!

Thank you so much for that info. I've looked into WPATH, and it looks like it costs money to view it. So if it comes to having to appeal, I'll have to check that out even more. And considering I've been out and living as male for five years and T for a year and a half with an approval letter and three letters stating it's in my best interest to get surgery then I'm pretty hopeful now. I truly appreciate your in depth response!

Actually WPATH doesn't really require anything. (So a surgeon doing it all in informed consent, no T, and no therapy is acting completely within WPATH, and so is one going totally by the letter.) WPATH all a matter of recommendations and has no legal standing whatever. If the insurance wants to require T, therapy, or anything else it can require it. You can try to influence them but legally you have no leg to stand on.

As insurance starts covering surgeries, I believe we might expect more hurdles. Sorry to say.

--Jay