SO! My dad owns his own business, and I have health insurance via his business. He's looking to change our insurance plan and he asked me to look into insurance plans that cover trans medical care (surgery/hormones/etc). What insurance plans have those who have had them had luck with in terms of trans coverage?


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Depends where you live.  Just make sure he adds the rider for trans care.

Blue Cross Blue Shield has been horrible. Aside from trans related care, they keep denying my standard doctor and vision appointments even with in network doctors. As far as SRS, they only have a few surgeons in network, Marci Bowers in San Francisco and some guy that I'd never heard of in Maryland that's done 4 in the last year. They may have more but these were the 2 that they'd found for me. I have been told that Aetna and United Health Care will treat out of network doctors as if they were in network as long as there are no in network surgeons in your area. BCBS won't do this even though they are not in compliance with the Pennsylvania PPO laws so I have filed a complaint with the PA Insurance Dept. My preferred surgeon had told me that they had tried to contract with them and were denied. I was also told that there was a conference between surgeons and insurance companies to discuss coverage of trans related health care including SRS and BCBS was the only insurance company that didn't bother to show up.

Quote from: HeatherR on October 16, 2015, 09:56:49 PM
Depends where you live.  Just make sure he adds the rider for trans care.

I live in NYS :-). Right now I have Aetna and have a ridiculous plan for trans care. They pay for HRT, and pay for parts of SRS... Basically just the 'creation of a neo-vagina" and there's a note that specifically says the creation of a labia or clitoris is considered "cosmetic" and not covered. Soooo basically they'll pay for a hole... Not a vagina... #keepinitclassyaetna

Also they don't pay for FFS or BA (which I know most insurance companies that cover transition don't cover those things either).


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Quote from: AbbyDS74 on October 16, 2015, 10:29:04 PM
Blue Cross Blue Shield has been horrible. Aside from trans related care, they keep denying my standard doctor and vision appointments even with in network doctors. As far as SRS, they only have a few surgeons in network, Marci Bowers in San Francisco and some guy that I'd never heard of in Maryland that's done 4 in the last year. They may have more but these were the 2 that they'd found for me. I have been told that Aetna and United Health Care will treat out of network doctors as if they were in network as long as there are no in network surgeons in your area. BCBS won't do this even though they are not in compliance with the Pennsylvania PPO laws so I have filed a complaint with the PA Insurance Dept. My preferred surgeon had told me that they had tried to contract with them and were denied. I was also told that there was a conference between surgeons and insurance companies to discuss coverage of trans related health care including SRS and BCBS was the only insurance company that didn't bother to show up.

Oof. Yeah Aetna hasn't been great for me, BUT they also have a myriad of plans. So it may be that they have a better Aetna plan that I currently do not have.


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I had just talked to someone that had SRS completely covered (- whatever percentage) with Aetna a few months ago. I'll see if I can get in touch with them and try to get info on their plan for you.

Quote from: AbbyDS74 on October 16, 2015, 10:36:06 PM
I had just talked to someone that had SRS completely covered (- whatever percentage) with Aetna a few months ago. I'll see if I can get in touch with them and try to get info on their plan for you.

Thanks! I appreciate it :-).


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I thought you were going to Suporn though? I didn't think they'd cover it outside of the US.

I also thought that Cuomo directed all plans to cover SRS and hormones at the minimum. I'm with GHI now.

Hormones should be covered if you're listed as a female, regardless of Trans status.

Quote from: iKate on October 17, 2015, 03:23:23 AM
I thought you were going to Suporn though? I didn't think they'd cover it outside of the US.

I also thought that Cuomo directed all plans to cover SRS and hormones at the minimum. I'm with GHI now.

Hormones should be covered if you're listed as a female, regardless of Trans status.

Yes, as I said above, my HRT is covered. And I am, BUT, also BA is still up in the air (and some insurance plans I know will cover BA for trans people), and also a family friend who's a lawyer who deals with insurance companies all the time said if I have a plan that covers SRS, there's a chance, albeit a small one, that if I make the case for why going to Dr. Suporn over a US Doctor is necessary, I may be able to get reimbursement.


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