I read that Dr. Crane accepts insurance from United Healthcare, Anthem Blue Cross, and Kaiser Permanente, but I'm not sure how this works. Can I sign up for insurance through any of these providers, even if I'm in a different state from where surgery is performed, and still have bottom surgery covered? Do I have to pay out of pocket first and then get reimbursed?

I hope this is still helpful but I'm quite sure you can see doctor crane through Kaiser if you are from out of state unless you're region has a different specific doctor.  You might even be able to specifically request an out of region doctor if you would rather go to doctor crane. I have Kaiser and live in nor-cal so its not really a huge problem for me but kaiser can be quite accommodating. I do believe that Dr. Crane is one of few surgeons that kaiser covers on the west coast so if you're over here somewhere there's a good chance you'll have him as your patron doctor. Hope this helps even a bit.

I am using out of state United healthcare. I did have to get an override on the trans surgical exclusion through my employer first.

Crane's office is also partnered with Blue Cross Blue Shield. I have a BCBS plan in NJ and they're covering everything (hallelujah!). The San Francisco hospital he and Chen work out of is within network for me, but I had to get an exception/override for the hospital in Austin, TX where I will be having my surgery. Luckily my case manager is great and took care of that even with Austin being out of network. I'd recommend requesting/connecting with a case manager for whichever insurance you choose/have. Yours can probably do the same if Crane or Chen aren't in network - make the case that they do the exact type of surgery you need and there's a lack of providers in your network otherwise. And if possible, make every effort to get insurance that does not have a blanket exclusion for transgender care. Also, keep on Crane's office for submitting prior-authorization on time - they're slow (possibly understaffed) and probably won't do it at the 3 month before surgery mark like they should on their own.