Receiving Medicare coverage in your given state. (U.S.A.)

A heads up for HRT/FFS coverage for all to access and utilize in the U.S. Medicare system and V.A. health care system

Do you see your state in grey in the picture? I assure you, all is not lost.

Hello again girls; Tia here at the request of administrator Cloe to relay some information that could very well assist you in your dream of becoming what you feel you are supposed to be. As my claim is current, the information should be up-to-date.

I am much older, and I so wish that I could have done what I’m preparing to do 30 years ago. Like most of us searching for help, we’ve had few resources and no one to speak to. I feel that no one should live with the disappointing regret of being uninformed and alone, like us older girls had to endure. Read this and utilize it as a reference for all claims, procedures, and problems. A literal treasure-trove of information, and girls keep reading for (smiley) bons!

https://transequality.org/know-your-rights/medicare                                      

Please note; this is written for beginners/new girls accessing our site, so please bear with me.

Being a network administrator and partially disabled, I have utilized my time in accessing sites and documents, (one I know most state Medicare offices would love for you to overlook.) It almost assures you some coverage even if your state says no. My PHD didn’t even hear about in his 237 assists.

First, I will address our veterans.

This site informs you of “Tricare,” exclusively for armed forces transgender personal. It is both a movement, and a possible detour care service for you, so please read.

https://www.healthcare.gov/transgender-health-care/     

 

https://journalofethics.ama-assn.org/article/exclusion-medically-necessary-gender-affirming-surgery-americas-armed-services-veterans/2018-04 

I used the word assists due to being a Vet. Once you’re at a PhD’s office and receive your second letter, they actually contact/introduce their surgeon, scheduling, etc. It’s basically  downhill from there in assisting us even through post-op and dilation (or opening/expanding our new vagina). Access these sites below to see where you stand for your next move.

https://www.google.com/search?newwindow=1&lei=Y4wWXeXPH5W-tAaW-JHoCA&q=does%20medicaid%20cover%20top%20surgery&ved=2ahUKEwir0_H_lI3jAhUXac0KHWIyCeYQsKwBKAB6BAgAEAE&biw=1094&bih=510

Does Medicare Cover Gender-Affirming Surgery? | Point of Pride

I’m assuming that you are already enrolled in Medicare/VAHC system, seen your general practitioner, and been referred to a psychologist. Once you are diagnosed with Gender Dysphoria, you’ll see your endocrinologist and receive your HRT medication. After a year, you tell your psychologist that you wish to change and see your PHD. (It’s as painless as I could make it girls). But it’s a basis for all you have to do as prerequisite for Medicare consideration. 

Please use this only as a reference. I am from Ohio, and they show no benefits for bottom or top. But if you are close to an adjoining state, you may go there. However, all work and Doctor visits must also be done there. I must access my Veterans hospital from Ann Arbor Michigan; even though I live in Toledo, Ohio, 40 miles south. No-matter, I am covered under them for surgery only. The Vet hospital covers our HRT and Doctor visits; civilian girls are through Medicare/Medicaid. That is our only difference.

NOW:

You have your surgeons name and are about to see him for an appointment on physical surgery. Now all you girls in the grey area of the map listen up. This is where things get touchy and where you deal with Medicare’s seemingly empty head and heart. (Now open next 2 documents and smile as you read).

GENDER REASSIGNMENT SURGERY MODEL NCD

https://www.icd10data.com/ICD10CM/Codes/F01-F99/F60-F69/F64-/F64.9

     Reading page 1 and 2 it states:  “Basic coverage does nothing for gender dysphoria due to the very people who are giving it to us will not/cannot see if we are female or not due to clothing”. We require top to appear as we feel for relief. And it’s true. Since our state’s are TRYING to detour us, appearing to put restrictions on our coverage, you girls who (Appearing) to not qualify actually do by utilizing this document referred to as/and entered in your claim as an ICD code #10. It is a federal waiver, allowing your state Medicare office (because you know their little deterrent secret) and allowing you coverage. They do however make you work for it slightly; so listen up. By following a couple of short cuts, life with the procedural administrators becomes tolerable.—————Below is my example of what I was told to do—————-

        When speaking to your surgeon, inquire if he/she does upper as well. Then when you ask if their facility would do it for you (always a yes) inquire if they recommend doing lower and upper on separate or on the same claim. Girls, no one knows better than the man getting paid for it and since you just confirmed they would complete both, he then informs you of what you must do for them to get paid.

     “This next procedure you do is important and is state specific; (If you must utilize the waiver).                  

You and/or your shrink may have to draw a personal document stating specifics on why you feel out of place from your gender dysphoria. “Yes, it’s crap because they already know,” but in some states it’s procedural. I do in Ohio, (No coverage), but not in Michigan, (bottom only) but many do not; so chin-up girls. 

Veterans? your VA PHD will do it!

And you civilian girls have resources as well. If obligated, if you read this exemption document. (It is long and has all that’s needed to be exempt) from state roadblocks including (human) claim help and additional help is available at the end of this. I do suffer from Gender Dysphoria even with the moxy I exhibit.

——————————My letter states——————————

Your surgeon’s facility should inform you of the how’s, when’s, and why’s of your document/reason for psychological review before your claim is submitted (if applicable). But I must say if you read on, it works. So with a little patience and openness, your chances of at least bottom surgery are awesome. Medicare is paying for your shrink so utilize them, their services, and advice as well girls.

https://transequality.org/know-your-rights/medicare

I am only one of many. I know more of you could help as well. I did this in 1-1/2 months. If I find more bon bons I promise to publish them and pass them on, but please, this is your time! Our time (us older girls) is almost up, and I will say waiting 30 years like I did reeks with regret. If you know of a short-cut, post/publish it here and allow our sisters know so we all can enjoy life as we should.

You are so lucky to be in this day and age. As an older person who has been around for a while, I’ll say this, “If this or any benefit is available, grab it and run.” We never know when we could lose it.

Much Love girls and good luck

Tianna Tracy

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017-Transmittals-Items/R194NCD.html

https://engage.ahima.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=7208d14e-5403-4c13-836b-6a377aaec18f

https://www.asha.org/Practice/reimbursement/Reimbursement-of-Voice-Therapy-Services-for-Transgender-People/

 

 

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Tia

I found out late in life that I was born an intersex person. Because the world was a very different place when I was born my parents made me all male. I knew something was't right from the first time I was intimate but couldn't put a finger on it . Now I am developing / changing and even though I didn't conscientiously think about it because my body is changing whether or not I want to. I am what I am. I have never been in any closet. when I was given the information about my birth. I simply relayed it. Those who stayed in my life I am careful to keep and those who didn't I politely apologized for THEIR behavior and moved on. This is one of the coolest things I have ever experienced. 13 months in I have Tanner 3- 4 development happening with my breasts ("B/C") and something is changing down below deep inside me. It feels right in a way I cannot explain. I am a gifted person. I have 2 degrees and 8 certifications in various trades. I am a pilot in recreational aircraft, (Ultralights) and a musician of 40-some years. (All Guitars). I am a meek and quiet person, a good listener and though I try to be a good friend, the people around me are adamant about trying to get me to remove my heart from my sleeve. I remain optimistic there are good people out there. I am LQQKing for a niche to fit in. The LGBT organization in my area is nothing more than a meat market for horny humans with a street-corner hierarchy. I hope the individuals here are different Xs Tracee
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Genny Beau
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I learned enough to really peak my curiosity here. I’m a veteran with Tricare and VA Service Connected Disability and I also currently have BC/BS. I want FFS and I didn’t think anyone would cover it but maybe BC/BS?

Regina Love
Member

The one comment I would like to make as a veteran is this: Tricare is for retired veterans and their spouses. As a Veteran with 16+ years of active duty time and no retirement (cutbacks in 1993), who is now rated at 60%, the VA does do care but it is through TriWest. Not Tricare.

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