Hi! my name is Adriana im 23 years old and I've been in HRT for 4 years in April.
I am under Aetna insurance. I really want to get my facial feminization done as well as my breast and srs.

My insurance does cover SRS but it considers facial fem and breast augmentation as cosmetic. Though the WPATH considers it medically necessary & quote " these surgical interventions are often of greater practical significance in the patients daily life other then genital Reconstruction." 

I really need help on how to write an appeal, who to go to , and what surgeons in the Tri-state area perform facial feminization that are good and will take insurance. PLEASE HELP MY FELLOW TRANS <3 xoxo adriana

PM me an exact copy of the text from your actual policy.  As a heads up, they typically need to deny the claim or the preauthorization before you can appeal.  I started a thread a year or so ago that details what to do at each stage. 

Jen

im not sure how to private message but that is a link to my policy

http://www.aetna.com/cpb/medical/data/600_699/0615.html

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Quote from: Adrianaxo26 on February 29, 2016, 06:25:57 PM
im not sure how to private message but that is a link to my policy

http://www.aetna.com/cpb/medical/data/600_699/0615.html

As you will read, Private Messaging will only receive  messages until you reach 15 quality posts.

Quote from: Adrianaxo26 on February 29, 2016, 02:37:49 PM
Hi! my name is Adriana im 23 years old and I've been in HRT for 4 years in April.
I am under Aetna insurance. I really want to get my facial feminization done as well as my breast and srs.

My insurance does cover SRS but it considers facial fem and breast augmentation as cosmetic. Though the WPATH considers it medically necessary & quote " these surgical interventions are often of greater practical significance in the patients daily life other then genital Reconstruction." 

I really need help on how to write an appeal, who to go to , and what surgeons in the Tri-state area perform facial feminization that are good and will take insurance. PLEASE HELP MY FELLOW TRANS <3 xoxo adriana

How much will the insurance re-imburse for the facial feminization surgery ?   It would be good if it would at least cover the hospital and related charges !

Quote from: Adrianaxo26 on February 29, 2016, 06:25:57 PM
im not sure how to private message but that is a link to my policy

http://www.aetna.com/cpb/medical/data/600_699/0615.html

Please leave the link active for a few days.  This one will take some time......  I beleive it's doable.  I have different CPT codes for the medically necessary  FFS.  But work is difficult until Thursday.

Hugs

Jen

Please keep this topic going. I'm going through the same things but with blue cross and blue shield of kansas for ffs with Dr. Z.   I want insurance to atleast cover the $5k in hospital stay fees. I think an insurance company can do that much atleast for medically necessary to transition operations.

Quote from: JLT1 on February 29, 2016, 11:19:02 PM
Please leave the link active for a few days.  This one will take some time......  I beleive it's doable.  I have different CPT codes for the medically necessary  FFS.  But work is difficult until Thursday.

Hugs

Jen

Ok , thank you honey <3

Hi i actually got my written policy from my HR department and it will be mailed to me within the week! someone inbox me and told me thats what i needed, i couldnt reply. anyone know what steps to take from here

Any updates?

Hello-- wondering if anyone has had success having insurance pay for FFS  or breast implants or revisions?

I know that my hubby's insurance is willing to have cover having my encapsulated implants removed but not sure yet how much if any they will pay for replacement of implants.

I'm curious to know about this too...is it usually a state-by-state thing?

Quote from: JLT1 on February 29, 2016, 11:19:02 PM
Please leave the link active for a few days.  This one will take some time......  I beleive it's doable.  I have different CPT codes for the medically necessary  FFS.  But work is difficult until Thursday.

Hugs

Jen

Jen can you please help me? im in the same boat as her.   https://www.susans.org/forums/index.php/topic,215429.0.html
please please iv asked my trans-specialist doctor and other doctors with no help or knowledge of the issue to assist me.