BCBS is a collection of insurance companies that pass paperwork around. But they are independent companies. Hence if I tell you that BCBS will pay and I live in Michigan and you live in South Carolina, you could end up disappointment. BCBS of Michigan is one company and BCBS of South Carolina is a different company.
And to further complicate the matter each BCBS has various insurance plans that are sold. So you need to find out if the plan that was sold to your company pays for Transgendered care and if so what Transgender care. There are Diagnostic Codes and the Procedure Codes. And there are lots of them for various branches of transgendered and intersex conditions.
The bottom line is that you have to find out if your plan at your BCBS pays for the Transgendered care you need. What you need is the Summery Plan Description, the contractual agreement between BCBS and your company. It is a very large document. I asked for it and was not given it. I was given a two page flyer. Human Resources wimped out on me.
After Two and a half months BCBS has still not made a decision on my surgery pre-certification. And we have been told fourth times that BCBS had given us the wrong place to send the documentation. So I took action.
I have signed HIPAA forms so that all of my care givers can discuss the issues with my attorney. I have signed two BCBS HIPAA forms so BCBS can discuss both medical and physiological issues with my attorney. If they tell us the current office is again the wrong office to send the documentation, I will instruct my attorney to mediate the issue with BCBS.
And remember if you loose your cool when talking with BCBC, they have won. When you loose your cool they can write you off as non-cooperative and no further progress is likely.
