Is this for real??? please read

Am I seeing things or does ambetter the insurance I'm currently on because I'm low income cover everything... Facial feminization surgery testicle removal (don't know the name for) GRS And Top surgery everything but hair removal

Am I being tricked or is this for real

Better view do you guys see anything or is this amazing

The graphics you posted make it difficult to understand your question.

I think the best way to find out what your coverage is, is to call them.

Thoughts for the call:

1. Know who you are talking to. Get a name, badge number, title
   
2. Write the questions AND the answers down
   
3. Ask specific questions - what is my copay for a procedure.  While the insurer may cover top surgery, a $1,000 copay may make it difficult to afford the procedure
   
4. Ask specific questions. Ask about a 'gonadectomy', a medical term used to describe the removal of the testes/ovaries
   
5. Ask for a copy of the insurance agreement - in total. This might be impossible as most insurers don't want you confused by what is in their contract
   
6. Try to find someone who has experience with this insures - likely difficult as most transfolk don't publish their details and it would be a violation of privacy to give out names
   

Good luck and let us know what you find out.

My deductible is 250 dollars and it says this too You'll pay 25%,
we'll pay 75%
Your plan will share the cost of many covered expenses until your max out-of-pocket is met.
$900.00 Max Out Of Pocket

Hi Rebecca and now Miki!!!!

We are on at the same time Miki, that is rare. I was going to mention that I would take up such a policy in the bat of an eyelid..... but, if it sounds too good to be true...... it most likely is.

Miki appears to have covered your next steps.

Celia xx

Well, that still appears a very good deal!

I directly contacted my insurance company and told them the surgeries I wanted and they sent this back confirmed it's all covered with the slight concern it has to be approved

So it seems they do Infact cover everything I want but it has to be deemed necessary...

In which case how do I fight that..

To rectify I said FFS GRS breasts augmentation and testicle removal surgery (can't think of the name at the moment)

RebeccaMarie wrote:So it seems they do In fact cover everything I want but it has to be deemed necessary...

In which case how do I fight that.

Generally speaking, there are varying levels of crap gatekeeping, but to sum up, it usually revolves around explaining that failure to give you access to the procedures is a matter of mental health concern and that you will become progressively suicidal if denied.

It means you need to talk to a 'professional' such that they will endorse your story.
It usually requires hormones for a time period, and living full time as the gender you require to be.

Now, remember, it doesn't mean you need to give a damn what you said before the surgery after the surgery. If you are NB, lie, say you are a girl. Say you are trapped in the wrong body. Tell them you are feeling like ending it all. Even if you are not.
Keep in mind, they've likely heard it before.

Maybe it isn't a lie.

It's not a lie I've considered suicide before in fact the only reason I haven't is because I'm more scared of dying as my father was atheist and loved trying to prove the Bible wrong making it hard for me to believe in a God especially considering my condition

I don't have suicidal thoughts though and I Know I was ment to be a girl since I was 6 or so or I wore my sister's clothing at a young age before I even knew what it meant wanted to be called Chrissy in elementary school (I prefer Rebecca now) I used to image games where I became a girl preferred playing a girl in games and even had dysphoria moments pretty early causing some injuries.. and even tried birthday wishes asking God even just anything at all to just magically turn me into a girl I even asked Santa Claus as a kid lol

I have Clear memories of having cry fits basically begging God and asking why I was put through this I also have memories of sitting outside for hours trying to convince God I should be a girl and come up with reasons why it would be better for everyone the reason I sat outside is because I used to do it inside and I felt he couldn't hear me lol I got pretty desperate for a while as a kid before I figured out what this transgendered stuff was and how I could actually be who I wanted but then that caused more complications with my family who was extreme trans and gay haters

In your case choosing the 'right' medical professional may/will be necessary.

If I had my druthers, and I have, my choices for professionals would be:

1. A knowledgeable primary care physician (PCP in the common lingo)
   
2. A knowledgeable endocrinologist - it may be necessary to do a complete blood assay (you should have this anyway as a benchmark
   
3. An experienced psychiatrist - obviously you are going to need a mental health professional to sign off on your Gender Dysphoria (a psychologist is not likely going to be recognized by your insurer to sign off on your GD)
   

I do realize your situation is different and funding may be your biggest problem. But hang in there.

I have been EXTREMELY fortunate during my life to always have excellent health insurance. Right now I have Medicare and the VA. Medicare, if I were to choose will do 'bottom' surgery but not top and no hair removal. The VA and my VA PCP were right there when I disclosed Miki to the world. The VA provides counseling and non-surgical help, but as of now, no surgeries or hair removal.

Good luck with where you are going. Remember, you have friends here to help you in your travels.

So a interesting update so Christmas day I was searching for a local doctor that took my insurance and performed testicle removal and the doctor not only responded but his assistant started getting everything started already contacting financial assistance my insurance was getting therapist involved for the letters

Part of the transition story for many is the gatekeeping and the fear it won't happen.

But in a lot of cases, it is just the process and the waiting.

I had to do some waiting, but, it DID eventually happen.

I'm hoping that it is for you, also just a matter of waiting dear.

You will get through this.