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insurance question

Started by julian6, July 04, 2011, 03:00:39 PM

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julian6

hey everybody - I'm still really new to a lot of "this stuff" and trying to figure it all out...so I was wondering if anyone had health insurance that DID cover any part of their transition - Dr.'s visits, hormones, supplies, top surgery, etc., or anything else I'm missing. 
Or if your Dr. "justified" (such an awful way to say it but I don't know another word to describe) why insurance should cover something. Ex: Taking T for another medical reason that is covered by insurance and then the side effects just happen to give you male secondary sex characteristics.  I hope this makes sense - and no, I'm not thinking of insurance fraud - I was just curious.
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LordKAT

My insurance doesn't cover trans related care but does cover scripts, including T. It is cheaper to pay for it out of pocket. Counselors sometimes won't take insurance, I have heard some docs do the same.  My doc is covered as my endo is my primary care doc and many of the blood tests are the same for high blood pressure or ruling out dependency issues.  It also matters if your insurance has you down a male or female on what they will cover. Beware of changing that before you have a hysto as HRT is cheaper than a hysto by a long shot.
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Bahzi

I have a Humana PPO, and it's covered all my blood work so far, I only paid my $20 co-pay for the office visit right before I got the lab work across the hall in the same building.  The testosterone was only $60 for a 5 month supply, so I didn't bother using insurance for that, especially since my prescription co-pays haven't been great in the past anyways.  My doctor is a general practitioner though, so maybe they're not scrutinizing claims as much as they would with a specialist such as an endocrinologist. 

I would assume that my doctor and her office's medical billing staff didn't bill it with some generic code or something, since my lab test orders that I took with me said the code number and then 'TRANSSEXUAL' next to each of the tests she wanted run.  Maybe my plan does cover those things,  I really have no idea since I work for a small company with no HR person and could never get a full copy of my benefits statement.
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MaxAloysius

The Australian healthcare system covers the same amount of money for my doctors visits and for my T pills as it does for everything else, and would have covered a portion of my counselling fees as well had I taken the standardised test everyone has to take to claim back on mental health services. But I suppose it may be different for something like the T shots or surgery, I won't know until I get there.

I assume the private healthcare service I'm afforded under my parents won't cover most trans related things, but I have yet to check. It did cover a portion of my psych and endo appointments though.
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Robert Scott

My health insurance covers everything once I meet the deductible -- and I do that within the 1st month.  So far it's covered all my doctor & therapy apt.
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Dominick_81

I have to pay for the T out of pocket. My doctor visits and blood work should be covered, as I have not got'n a bill yet.
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