Texas and Medicare coverage?

[Phoenix]

Does anyone here have any info on what the best Medicare plan to have in Texas for transgender surgeries is? Are there any?

 

What about Medicaid?

[Carolyn Marie]

Phoenix, i checked the Medicare site, and the list of conditions covered under traditional Medicare Part B is silent about HRT or treatment for GD.  But there is a general statement about "medically necessary" treatment.  If you're going to use Part B, you may just have to check with your doctor.  There are prob a dozen or more Medigap or Supplemental insurance policies being sold there, and each is different.  You'll have to research it.

 

As for Medicaid, you are SOL.  It specifically excludes any care for transgender treatment.  Sorry.

 

Carolyn Marie

[Phoenix]

11 hours ago, Carolyn Marie said:

Phoenix, i checked the Medicare site, and the list of conditions covered under traditional Medicare Part B is silent about HRT or treatment for GD.  But there is a general statement about "medically necessary" treatment.  If you're going to use Part B, you may just have to check with your doctor.  There are prob a dozen or more Medigap or Supplemental insurance policies being sold there, and each is different.  You'll have to research it.

 

As for Medicaid, you are SOL.  It specifically excludes any care for transgender treatment.  Sorry.

 

Carolyn Marie

Well what’s confusing me is that I found this online, but to quote Beetle Juice “It reads like stereo instructions.”

 

https://swhp.org/Portals/0/Medical Coverage Policies/064-Gender-Assignment-and-Reassignment-Surgery.pdf

[Carolyn Marie]

Yeah, that reads like your typical incomprehensible gobbledygook insurance-ese statement.  The part that sticks out for me is this:

 

"For Medicaid plans, please confirm coverage as outlined in the Texas Medicaid TMPPM.
Gender reassignment surgery may be considered medically necessary for one or more of the following"

 

That appears to me to contradict what I saw on another site, where it said unequivocally that Texas Medicaid doesn't cover treatment for GD, period.  What I suggest is calling that insurance company and talking to them about it, and ask for an explanation of that document in plain English and preferably in writing.

 

Carolyn Marie

[Confused1]

@Phoenix

 

I had GCS in Arkansas a few months ago. Medicare plus Medi-Pak paid everything. I can't imagine it being much harder in Texas. Message me if you want more info.

 

Hugs,

Mike