I know for surgeries my insurance wants 12 months of continuous RLE documentation from my provider.  I'm just not sure what documentation they are looking for.  Like what would be acceptable for the start of RLE?  I know they like to see name change and gender marker updated but that wasn't the start of what I consider my RLE.

I'd just like some examples/information from someone who's been through it.

Thanks

Here it meant that my doctor established I was under her care and presenting as my target gender, which in my case is non-binary identity with female presentation.

Hugs, Devlyn

Call them and ask them outright what they're looking for - "continuous RLE documentation" doesn't tell you what you need to know, they should have been more specific.

We could give you a ton of suggestions and ideas as to what WE think would be considered "proper documentation", but we could be totally wrong. Any examples/information from others may not help you if they don't have the same insurance (maybe different insurance companies require different things?) Only way to be 100% positive that you get what you need is to ask yours directly.

I would assume they are talking about official paper documentation though - notes from doctors, notes from a gender therapist, legal documents for name change, etc etc - and not so much "well my friends and family call me "male/female name" all the time". That's my guess, though i'm sure they want to hear that you've socially and personally transitioned as well. They want physical proof that you're transitioning and living as the gender you identify as. What constitutes that physical proof is up to them, i guess.

I've only just started looking into top surgery and my endo was the one to bring it up at my last visit. He said i should call my insurance company for a list of surgeons they cover, then talk to my hematologist about which one/s she recommends if i'm cleared by her, and then he would have to write a reference letter for both insurance and surgeon. He also mentioned my therapist would likely have to do that, as well.

I'm going to keep an eye on this because i'm curious, too - i don't see my therapist for another two weeks but when i do i'll bring it up and see what he thinks. I can post his response, if you want.

TK9NY,  thanks for the reply.  I will definitely be calling them but I am not able to until March 1st.  I just wanted to get some ideas of what they look for so I can tell my therapist.  My primary therapist isn't experienced with these kinds of request and she would appreciate any information I give her.

I'm really just interested in getting an idea of what is acceptable and not.

Thanks for that description Devlyn.

I saved all my coming out emails.  I don't know if they will accept that, but I'm going to give it a try.  Failing that, they will accept my legal name change, which dates from three months later.  In my case, it's not going to make any difference for my surgery, since that is still more than a year in the future. 

It might make a difference for the gender change on my birth certificate.  I have to go by British rules for that, and they want two years of RLE.  But honestly, two years of two years three months doesn't make a heck of a lot of difference at this point.  It's an annoyance, that's all.

If it's stated in a therapist letter then that is considered documented. My insurance (Horizon BCBS of NJ) had the same requirement and that was sufficient to get approval.

Thanks for the information Sydney.  I was hoping for something easy like a therapist letter and not something more legal like name change.  I have BCBS of IL so here's hoping they follow similar guidelines. 

Jillian,

What did you find out about this?

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