Expenses And Insurance

[Guest Mr. Fox]

My mom is worrying about the cost of transition, and whether insurance will cover it. Any info about getting insurance to cover stuff would be handy. I'll try to find out what plan and company we have.

Adrian

[Guest savagedm]

My mom is worrying about the cost of transition, and whether insurance will cover it. Any info about getting insurance to cover stuff would be handy. I'll try to find out what plan and company we have.

Adrian

Unless you have a VERY GOOD insurance plan, it is generally not covered. I have heard stories of people getting creative with the wording on their hormone prescrips and getting insurance to cover that however....

~Brooke

[Guest Leah1026]

Check your plans handbook. You have a 98% chance of finding an exclusion for transsexualism. It sucks, but that's the way it is. When I started out it really peed me off because I couldn't even get therapy paid for. But over time I chose to put a positive spin on it. The spin being: I owned my transition. Nobody could accuse me of their having to pay for my "lifestyle". Nobody could dictate who I would see or when I had anything done. I controlled everything. I'm very proud of what I accomplished. I did what I once considered impossible and nobody can EVER take it away from me.

[Guest]

Unless you have a VERY GOOD insurance plan, it is generally not covered. I have heard stories of people getting creative with the wording on their hormone prescrips and getting insurance to cover that however....

~Brooke

Creativity is the keyword. With therapists most will agree that insurance should cover therapy sessions for transgendered as it is medically approved by our SOC. Reality though shows insurance may not cover it. The therapist just lists the main diagnosis as depression which for most of their transgender patients is also true. The downside of doing this is that transgenders don't get counted in the statistics properly so it always looks like there are far less of us then there really are.

[Guest Michelle M]

It's disappointing that we have to pay for it ourselves. Yet, it's good in a way. It might show people how determined we are and that it's a real thing. We want it so bad that we're willing it pay for it out of our own pocket, y'know? We're hardworking individuals that help the economy, we aren't lazy people abusing the system, like some (not all) people do with welfare and disability.

[Guest Mr. Fox]

I've heard a suggestion of getting it covered as a "hormonal imbalance."

[Guest phebe09]

Ah, the American "healthcare" system. Pay through the nose for insurance, so that when you get hurt, it can be shoved up your bum. I'm not a big fan of Michael Moore, but even my brother liked Sicko.

Anyway, if you want to claim it's a hormonal imbalance, you could run into some trouble if the insurance company finds out. It might be worth a shot, though.

[Guest Brianna]

I've wondered this as well.

Thats unfortunate that insurance companies aren't as open as they should be. But then again, I'm not surprised, they refused to pay for a mole removal for my dad...i was like whatttt??? I doubt our insurance company will support transsexualism. I honestly don't even know what company we use, but apparently its good (my dad uses it for like all of his employees who get benefits).

I'm fortunate though, if my parents support me, I won't really need to worry about paying for the stuff, and my parents have enough money for it. I suppose thats one benefit of coming out while being a teen.

I admire those who completed their transitions out of their own pocket, its inspiring to see how dedicated they are to being who they truly are.

But anyways, good luck Adrian. Love as always.

Alyssa.

[Jayme]

Aetna considers sex reassignment surgery medically necessary when all of their guidelines are met

http://www.aetna.com/cpb/medical/data/600_699/0615.html

Hope this helps

Jayme Ann

[Guest Leah1026]

intercourse! My post was wiped out on my computer. I’ll try to reconstruct it.

This Aetna statement sounds good on the surface, but I’m suspicious:

1. They require 2 letters of recommendation. But it doesn’t mention if you have to see their psychs. If so are their psychs really tight when it comes to diagnosing who’s a “true transsexual” and who isn’t?

2. They mention a one year RLT, but they also mention you must be employed the whole time. Anybody who deals with us knows how tenuous the employment picture can be for us. Maybe they are using the employment requirement to drop people from coverage?

3. They also feel it necessary to tell MtF’s that only 15% of us will make it through that year. Since when? Why was it necessary to even include that statistic (even if it is true). The only similar statistic I’ve ever heard is: Only 10% of MtF’s get SRS. That’s a completely different kettle of fish. Many people make it throught the first year, but can’t afford surgery due to a multitude of reasons.

4. They don’t give much information on surgeons. Can you see anyone or do you have to see their surgeon (the butcher of Xxxxx City?). Do they say you can only use an American surgeon? Again, limiting your choice.

5. Do they pay for surgery up front or do you have to pay up front and they reemburse you later? Kinda defeats the purpose of using them doesn’t it? Or maybe they find some reason not to pay after the fact?

6. They cite a study by Anne Lawrence on autogynephilia?! Oh my goodness? This is worrisome.

7. The also require you to see a urologist (theirs?) before surgery to rule out abnormalities. Is this just another built in chance to dump you?

8. This isn’t in the link, but it bears mentioning: I think this Aetna policy has been in force for 2 years and I have yet to hear of a single person that’s used it successfully. I’ve been very active on internet forums for 5 years and I know a lot of people and haven’t heard of anyone using Aetna yet.

Call me cynical, but experience has taught me that if it sounds to good to be true, it probably is.

[Guest Ryles_D]

I've read that it's almost impossible to get insurance that covers transitioning in US. They say it's cosmetic surgery on mental patients or something. Someone apparently did the 'hormone imbalance' (or something like it) and got the company to pay for hormones for a year before they realized and managed to not have to pay it back. But, yeah, you can probably face legal issues if you do that.

As for not having to worry as a teenager- I still expect I'll have to. Depends on how well off your parents are. Even if mine can afford it, they fret about money so much that I'd rather not have to ask. (though, the fact I'm 17 and starting college in 5 months might effect their willingness to as I'm slipping out of "teenager" range a bit faster than expected)