I'm trying to get reimbursement from my insurance (Medicare) just got my first denial letter (progress right?) on the grounds of cosmetic procedures are not covered.

I already submitted a letter from my psychologist stating medical necessity, referencing wpath and that I am following recommendations from wpath as well as steps taken (HRT RLE name change).

No where in the letter from my psychologist does it mention permanent hair removal is Not cosmetic or elective- only that it's medically necessary.

I am looking for citations and documentation that explicitly states medical necessity, not cosmetic, impacts on daily life, and reasons why it is not considered cosmetic or elective. Any references to SOC is also helpful.

Any other suggestions, thoughts and tips are also appreciated.

Thanks!
Brooke