Jump to content
  • Welcome to the TransPulse Forums!

    We offer a safe, inclusive community for transgender and gender non-conforming folks, as well as their loved ones, to find support and information.  Join today!

Insurance with surgeries


Raven1981

Recommended Posts

Been in contact with my insurance and figuring out what they will cover and how much they will cover and my insurance with Cigna will cover the Gender Reassignment Surgery fully for me minus my deductible where if I go in-network it will be 2500 and if out of network then it is 13000.  So That is one reason why I want to make sure to have a doctor that takes my insurance and I have the packet that tells me the requirements that my insurance requires for bottom surgery.  But I am happy that I will be able to have my insurance cover my bottom surgery.

 

Male to female reconstructive genital surgery, which may
include any of the following:
Vaginoplasty**, (e.g, construction of vagina with/without
graft, colovaginoplasty)
Penectomy
Vulvoplasty, (e.g., labiaplasty, clitoroplasty, penile skin
inversion)
Repair of introitus
Coloproctostomy

 

My insurance does not cover breast Augmentation as to it is considered to be cosmetic along with part of FFS like the forhead and brow lift and hair line.  It will not cover VFS or nose, but it will cover the Chin and jawline.

 

So my insurance that I have through my work will only cover 1 item on my face which is fine cause I really want my chin and jawline to me more feminine but wish I had better insurance to cover more on FFS.  Then I am really glad that my insurance will cover the full bottom surgery.

 

Link to comment
  • Forum Moderator

Very good Amy.  Look carefully for a surgeon!  

 

Jani

Link to comment

You are lucky!  My insurance really doesn't cover anything.  

Link to comment

That’s really great! As far as what’s not covered, you should still try to get everything covered. Because anything that is “medically necessary” and that is covered for some other issue (eg breast reconstruction for a cancer patient) means they can not just deny a claim for the same thing because of a different diagnosis. 

 

Basically no matter if it says covered or not, you can still try to get it covered. You never know. And it’s worth the effort of trying just in case I think. 

Link to comment
2 hours ago, Kirsten said:

That’s really great! As far as what’s not covered, you should still try to get everything covered. Because anything that is “medically necessary” and that is covered for some other issue (eg breast reconstruction for a cancer patient) means they can not just deny a claim for the same thing because of a different diagnosis. 

 

Basically no matter if it says covered or not, you can still try to get it covered. You never know. And it’s worth the effort of trying just in case I think. 

Thank you Kirsten.  I know through my insurance, bottom is medically necessary.  Also since I am a Cancer survivor from Testicular cancer and have had one of them already taken which is why my T was already low and my cancer spread up to my chest area.  So no matter what, I know that I can get my bottom covered.  Wonder if since I have my medical records and how far my cancer has spread if I can get breast covered as well.

Link to comment

having had cancer in the past will not help you. I only mentioned the cancer thing because so many women do have to deal with it.  And because insurance covers reconstruction, by law they can’t deny that surgery completely to anyone.If you can show it to be “medically necessary” you’ll have a chance at having it covered. 

 But having a cancer diagnosis in the past won’t help you with it now. 

Link to comment
  • Admin

That is very good news, Amy.  If you can find an in-network surgeon(s) (don't forget the anesthesiologist, etc.) who has experience, that would be awesome.  If not, your insurance company may be willing to let you go out-of-network) for the smaller co-pay, because its not your fault that there's no one in-network who is qualified.  Best of luck to you!

 

HUGS

 

Carolyn Marie

Link to comment

Amy,

I have Cigna as well. Their coverage is pretty phenomenal.  I suggest you discuss with them about the things that are not 'covered' as I have known others that have managed to get a lot from the insurance. 

 

 

Link to comment
3 hours ago, Kylie said:

Amy,

I have Cigna as well. Their coverage is pretty phenomenal.  I suggest you discuss with them about the things that are not 'covered' as I have known others that have managed to get a lot from the insurance. 

 

 

Hello Kylie

 

I know in Cigna there are different plans.  The plan in Cigna I have through my work that they offer is only Cigna HSA High deductible plan.  That does not cover too much.

Link to comment
  • 3 weeks later...
  • Forum Moderator

Amy, one thing to make sure you look for is that your whole medical team takes your insurance. I have been seeing stories from the Denver area about people going for surgeries, thinking everything was covered by insurance. yet to get a huge bill from one team member who was out of network. Anesthesiologist mostly.

 

So make sure you research every member of your team.

 

  Kymmie

Link to comment
  • Forum Moderator

This is very important!  My wife had this situation recently for a routine test that needed to be evaluated by a non-affiliated doctor.  Ouch! 

Jani

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Who's Online   4 Members, 0 Anonymous, 85 Guests (See full list)

    • Petra Jane
    • Couples Outfit
    • Karen Carey
    • April Marie
  • Recently Browsing   0 members

    • No registered users viewing this page.
  • Forum Statistics

    • Total Topics
      80.5k
    • Total Posts
      767.2k
  • Member Statistics

    • Total Members
      11,939
    • Most Online
      8,356

    Chaidoesart
    Newest Member
    Chaidoesart
    Joined
  • Today's Birthdays

    1. **Angela Charlotte **
      **Angela Charlotte **
    2. Carlie
      Carlie
      (63 years old)
    3. Cbxshawn
      Cbxshawn
      (49 years old)
    4. HannahO
      HannahO
      (31 years old)
    5. JustKatie
      JustKatie
      (40 years old)
  • Posts

    • Willow
      Hi   boy you back to work and miss lots.  No time to catch up right now. But I will.   just wanted to let everyone know I’m still here.   willow
    • Davie
      "No one feels alone in a bookstore."
    • Davie
      Thanks, @VickySGVfor some truth. Hatred may speak loudly in a political agenda, but there is always love, there is always love.
    • VickySGV
      Doesn't this belong over in the Humor Topic??  Grim humor I admit, but it has the dark humor picture of the folks protesting the Sacramento Sanctuary Laws.  If the world is going to end next week why are these people so concerned about someone staying fertile and able to have children??   Crazy.
    • VickySGV
      Once again the opposition is telling scary, unfounded  baloney about what IS being done to any Trans Person.  The truth about the very little and very cautious treatments just will not sink into them because it will sink them.  They bully their own Cis children unmercifully to fit into their molds, and that is gruesome in itself. I am happy to say I know that Trans children and all Trans folks in the area have access to wonderful care based on what some of my former State colleagues who have Trans family members and fellow employees there in Sacramento keep telling me about. 
    • Carolyn Marie
      https://www.9news.com/article/news/local/local-politics/republicans-gop-ballot-initiatives-target-transgender-people/73-c47ad7ee-40ca-43e0-bb83-07e662eb1029   The reason CO has a Dem super majority is b/c it's a very blue state. A ballot initiative is going to go absolutely nowhere. They're wasting their time.   Carolyn Marie
    • Carolyn Marie
      https://www.nbcnews.com/nbc-out/out-news/sacramento-sanctuary-city-transgender-people-rcna145287     Carolyn Marie
    • missyjo
      good for you dear. my guess is soreness is good sign things are going on there. water them n hope. smiles   actually was speaking to someone other day n they said the growth leveled off after a few years  which coincided with a few years of very high stress..n then when the high stress resolved, she grew another cup size..
    • missyjo
      darling I completely agree. but it will need road testing I'd think.    and I recently asked a surgeon about an idea I had for easier recovery...do a zero depth 1st..recover then add a canal..he said NO. this surgery is hard enough on body to recover, do not do it any more than needed. also said penile inversion usually is sufficient n includes a few centimeters of perineum tissue anyway..so keep the perineum pull through as a reserve technique in case there is a problem with theb penile inversion.    hugs to any who want them
    • awkward-yet-sweet
      I can't tell from the article if being trans was part of the motivation for the crime, or whether it was simply incidental to it. Clearly at least one of the perpetrators was known to the victim, which seems to continue the pattern that the most dangerous people for us are often people we know.  😒
    • awkward-yet-sweet
      Beans, beans, the musical fruit...   But beans and rice make a complete protein, and a pretty cheap base for any sort of meal. Since two of my partners are Hispanic and one is Asian, we use a lot of rice. Plenty of beans too, although 90% of the time they are on the form of black-eyed peas. That crop grows really well in the South no matter how hot and dry it gets.  And the Native American trio of corn, beans, and squash is a classic.  Actually, those ingredients tend to show clearly whether kids were raised with a healthy diet or not. Kids raised eating those foods luke them. Kids raised without experiencing those foods tend to reject them immediately. Rather strange.
    • Ashley0616
      I feel a little better about going outside. I got my EpiPen just in case of an emergency. Today was rough started euphoric and then depression hit real hard and I don't even know what it was about. It just happened. I want to see a bright future but it turns dim because of something. I was disappointed on how much supplemental insurance was more than regular health insurance. I enjoy seeing other successful people making it as a couple through everything in fact I cheer them on but it just makes me think if I will find anyone. I barely dated anyone when I was physically fit male and then it seems the older I get it gets harder. Not to mention everyone down here leaves as soon as they find out I'm trans. It's only going to get more difficult because of borderline personality disorder. It's dang near seems impossible that people would even put up with that. After all that I'm still trying to be positive and hope for the best but I always expect the worst and that has always been the case. Pushing 40 and I haven't even experienced true love.
    • Ashley0616
      Couldn't be any more truthful!
    • Mmindy
      Good afternoon everyone,    I’ve been working in the shop and preparing a few training props for shipping. So my responses and activity here has been very slow. I’m doing well just real tired.    Hugs,    Mindy🌈🐛🏳️‍⚧️🦋    
    • Mmindy
      That’s good news, listen to your doctors and your body. You may be asked to start a daily exercise routine and walking around the neighborhood. The worst thing you can do is become sedentary and laying around.    Hugs,   Mindy🌈🐛🏳️‍⚧️🦋
  • Upcoming Events

Contact TransPulse

TransPulse can be contacted in the following ways:

Email: Click Here.

To report an error on this page.

Legal

Your use of this site is subject to the following rules and policies, whether you have read them or not.

Terms of Use
Privacy Policy
DMCA Policy
Community Rules

Hosting

Upstream hosting for TransPulse provided by QnEZ.

Sponsorship

Special consideration for TransPulse is kindly provided by The Breast Form Store.
×
×
  • Create New...