How to get your MTF or FTM surgery covered by insurance or government
Here at TransgenderThailand, we take care of every little detail that can make life easier for patients. In this section, we talk about how it is possible to recover the costs incurred for sex change surgery and all the procedures, by getting it recognized by insurance companies and governments, whose purpose is to decrease gender dysphoria.
The nations for which we grant our help are, at the moment, the USA, Israel, Canada and Italy.Your first step is to reach out to us and submit the documents related to your insurance. This will help our team take you through the insurance approval process.
One of our main goals is to get your gender confirmation surgery covered by your insurance company or your government. We provide our service at $100 to all of our patients to give you a chance at success.
To help us verify the benefits, we will need the following information from you:
· Full Name
· Date of Birth
· Procedure(s) you are looking to have covered
· A scanned copy of your insurance card (front and back)
· Your best contact number (whatsapp preferable)
Once we have your information, our insurance advocacy team will contact the insurance company or the legal team in your designated country.
When we contact you, we’ll present one of the following options:
1.Your insurance carrier does not cover the cost of your FTM or MTF procedure(s).
This would mean that you would likely have to:
· Pay out-of-pocket for the procedure
· Finance your surgery with a loan
2. Your health insurance covers FTM or MTF Top Surgery
a. Your insurance pays out the cost of the surgery directly to the Hospital where your Sex Reassignment Surgery will be performed.
There are several documents that we would need from you for authorization approval:
A letter from a healthcare provider stating that you meet WPATH guidelines for surgery see WPATH guidelines* .
Notes from your consultation with our doctors, which we will have ready 1-2 days after your consultationThere may be additional requirements based on individual circumstances.
b. You have health insurance that covers transgender surgery but it’s on claim.
In this case you will have to pay up front and then you will receive your reimbursement after your surgery is completed.
It is still beneficial to go through the authorization process as this may help significantly reduce your hospital expenses. In many cases, your insurance will pay in full or for a portion of the surgery.
hospital expenses, and usually your insurance will pay in full or fora portion of the surgery.
What are some insurance companies that cover FTM/N & MTF/N top surgeries?There are several factors that insurance companies use to determine whether a patient’s surgery can be approved.
Larger companies that has seen a decent approval rates are:
Anthem BlueCrossBlue ShieldAetnaCignaUnited Health InsuranceAnthem Blue Cross Blue Shield MedicalIf you have the above health insurance and are looking for gender confirmation surgeons try to contact your insurance provider directly to see if they have information to guide you in order to have your SRS in Thailand.
As for the reimbursement of surgery directly by the government, it takes place both in Canada and in Italy.
Regarding Canada, the physician chosen by the patient must belong to the World Professional Association for Transgender Health (WPATH) 's internationally-accepted standards of care for Gender Dysphoria.
The surgeries that can be performed abroad are all those that are not performed in the country of residence due to insufficiently advanced quality standards and surgical techniques.
Even in this circumstance, there are two possibilities:
1. The government pays the hospital directly
2. The patient advances the cost of the surgery (s).
Regarding Italy, the only surgery that the government covers is the sex change surgery both for MTF and FTM. The conditions in order to request reimbursement from the Italian government are related to the waiting time and the advanced surgical techniques used in other countries such as Thailand.
The Italian government covers the cost of the surgery only in percentage. We work in conjunction with an Italian lawyers’ team to assure a fast and successful application process. In this case, the expenses of the lawyers will be covered by the patient, or the government depending on the occupational status.