anthem blue cross hormone replacement therapy anthem blue cross hormone replacement therapy

The first version of the guidelines, called the Standards of Care, was released by a small group of doctors at a San Diego meeting in 1979. On average, menopause occurs in women at 51 years of age. For a list of covered medications, see the plans formulary. Contact our physician here to get a free consultation about insurance for testosterone replacement treatment. 31573, 46505, 52287, 64647, 67345, 46505, 64611, 64612, 64615, 64616, Elfapegrastim agents (Rolvedon). You can take hormone medications as a pill, injection, or applied to the skin using a patch or gel. Notice shifts in sleeping and eating habits in your teen, as well as any issues he or she might be having, If you notice something unusual, start a conversation. She also has no intention of leaving law enforcement. Dr. Ehrensaft is one of the key early proponents of the gender-affirming model and helped write a new chapter on prepubescent children in the draft guidelines. These seemingly abrupt changes as well as other mental health issues or a history of trauma should be flags for providers to slow down, she said. Sinai. A child who expresses suicidal thoughtsmay benefit from a mental health evaluation and treatment. Dr. Ehrensaft and others are now working on large, long-term studies of patients in the United States. Beginning with the 2012 reports CMS began utilizing the Pharmacy Quality Alliance HRM list which was based on the 2012 American Geriatrics Society Updated BEERs Criteria. If you are considering using these new health insurance benefits to transition, contact your health plan first and see exactly how they are going to handle the benefits. A doctor may prescribe hormone therapy to relieve these symptoms. Many Anthem Blue Cross behavioral health services plans require the client to pay a copayment that may be between $15-30 each session. Lock up any potentially lethal objects. While reviewing one of the 2015 Blue Cross EOCs about another issue I tripped across the transgender language for their Gold PPO Multi-State plan. In short, the answer is, it depends. Subcutaneous testosterone pellets as a treatment for menopausal symptoms and/or reduced libido are considered experimental/investigational and, therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature. One of our experienced insurance agents will be able to help you find the plan best suited for your needs. When women approach their mid- to late-40s, their cycles may become irregular as they enter the perimenopausal stage. A popular strategy to accomplish these goals is to link positive patient care outcomes with increased reimbursement. This guide outlines Blue Cross Blue Shields coverage of therapy services. Men go through andropause as they age, just like women go through menopause when they age. An Independent Licensee of the Blue Cross and Blue Shield Association Hormone Pellet Implantation for Treatment of Menopause Related Symptoms dosage of the drug, and increased risk of non-compliance with safety measures such as the addition of progestin." Estrogen compounded with testosterone for subcutaneous HT is not FDA approved. So far, two have passed into law, in Tennessee and Arkansas, though the latter has temporarily been blocked because of legal appeals. *CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. The public is invited to comment on the guidelines until Sunday, with a final version expected by spring. a free consultation or with a simple call to your insurance carrier. %PDF-1.7 If your healthcare provider is not in your insurance network, then you will pay per the plan rules. That doesnt mean theyre all eager to flee. Your health insurance plan was created before 2014, when the ACAs requirement that health insurance plans cover mental health services was enacted.There are other situations in which your Blue Cross Blue Shield plan may not cover the. Individualized treatment consideringmedical and family history help guide therapy. Traditional hormone replacement therapies use synthetic, lab-made hormones. Generally, individuals in the U.S. secure health insurance coverage through one of the following channels: Many large private sector employers have taken steps to actively remove exclusions on transgender healthcare from their employer provided plans. The kids presenting these days are very different than what I was seeing in the early days, said Dr. Edwards-Leeper, who in 2007 helped set up one of the first youth gender clinics in the United States, in Boston. Read Also: What Causes Breakthrough Bleeding When On Bioidentical Hormones. Lupron Depot (leuprolide acetate), Though we cannot guarantee that your insurance will cover the cost of your testosterone replacement therapy, we can at least help you get the process started with a free consultation or with a simple call to your insurance carrier. Many doctors and activists praised the 350-page document, which was updated for the first time in nearly a decade, for including transgender people in its drafting and for removing language requiring adults to have psychological assessments before getting access to hormone therapy. About 1.8 percent of high school students surveyed in 19 state or urban school districts in 2017 described themselves as transgender, according to the C.D.C. Depending on the insurance company, these conditions can include the following: Other conditions, like having had a prostatectomy, may also preclude you from needing tests to prove low testosterone. Like most insurances, it is not typical for Blue Cross Blue Shield to cover services unrelated to a diagnosable mental health condition, such as: Blue Cross Blue Shield is also unlikely to cover therapy sessions occurring outside the therapy office, because of the greater potential for risk involved. Watch for angry outbursts, mood swings and a loss of interest in activities they used to love. Prices will vary with the carrier and specific Part D plan. 30years ago, physicians were trained to recommend hormone replacement therapy formost menopausal women. That said, even if your insurance doesnt directly cover it, you still have options for getting affordable couples counseling. Gammagard, Gammagard S/D, Gammaked, Gammaplex, Gamunex-C, Hizentra, Hyqvia, Octagam, Panzyga, Privigen, Xembify, 11981, 11983, G0516, G0517, G0518, J0570, Menopur (menotropins), Precertification is required for certain Transgender Services . Seek out professional support. Self-insured and custom fully insured groups offer a variety of these programs to help effectively manage their prescription drug benefit. Whats more, some of the mental health problems commonly seen in trans adolescents, such as depression and anxiety, may resolve after gender-affirming medical care, Dr. Keuroghlian said. endobj Of course, the amount that your insurance covers varies from provider to provider, and it also varies based on your specific health plan and other variables, like your deductible. Additionally, risksrelated to uterine cancer, breast cancer and blood clots have beendefined. Loss of ovary function and estrogen production are responsible for these changes. At the time, there was little public acknowledgment of transgender people, and they had scant options for medical care. Its common for traditional pharmaceuticalhormone replacement therapies to create synthetic estrogen using the urine of a pregnant horse. endobj And in some cases, thought to be quite rare, transgender people later detransition to the gender they were assigned at birth. But those first guidelines characterized gender nonconformity as a psychological disorder. And if taken in the early phase of puberty, blockers and hormones lead to fertility loss. You can opt for a private insurance company. An upsurge in teenagers requesting hormones or surgeries to better align their bodies with their gender identities has ignited a debate among doctors over when to provide these treatments. But the most contentious parts of the new standards among clinicians are the mental health requirements. Blue Cross and Blue Shield of Illinois prior authorization/step therapy program is designed to encourage safe, cost-effective medication use. Your health insurance company may have already approved you for testosterone replacement therapy if you have certain medical conditions or diagnoses from a physician. Its important to recognize the effects that stress can have on your life, to learn how to cope with stress, and to know when to get help. Kanjinti (trastuzumab-anns), Ogivri (trastuzumab-dkst), Otherwise, call your insurance company directly to ask about the specific types of treatment youre considering. Doctors prescribe Hormone Replacement Therapy to treat hormone imbalances, such as menopause and thyroid. Stress is a fact of life. von Willebrand factor (Recombinant) [Vonvendi]. The quality rating system outlines quality rating metrics and corresponding bonus payments. Your policy may cover traditional hormone therapy but not bioidentical hormones. Choose your plan below for a complete list of medical specialty drugs requiring clinical review by CarelonRx. To find out your actual out-of-pocket expense for therapy, search your Summary and Benefits document for your plan . Instead, some gender clinics with long wait lists are blindly affirming adolescent patients, she said, offering them hormones without taking these potential issues seriously. Some plans may want to approve a treatment plan in advance. Estrogen therapies are numerous, and include those indigenous to the human ovary, for example, estradiol and estriol. Please Select Your State The resources on this page are specific to your state. I love him too much and Im not going anywhere.. Call a suicide prevention lifeline. , J7181, J7177, J7178, J7189, J7212, Testopel (testosterone), estrogen containing implants, Depo-Testosterone (testosterone cypionate), Xyosted (testosterone enanthate), Aveed (testosterone undecanoate), Herceptin (trastuzumab), Herzuma (trastuzumab-pkrb), But the guidelines recommend restricting the use of medications and surgeries, partly because of their medical risks. 2157 Main St Fl 1, Buffalo, NY 14214 2.76 miles. , Rylaze (asparaginase erwinia chrysanthemi (recombinant)-rywn), Avonex (interferon beta-1a), Plegridy (peginterferon beta-1a), Rebif (interferon beta-1a), Betaseron (interferon beta-1b), Extavia (interferon beta-1b), Copaxone (glatiramer acetate), Glatopa (glatiramer acetate), C9399, J1595, J1826, J1830, J3490, Q3027, Q3028, S9559, Avastin, Alymsys, Mvasi, Vegzelma, Zirabev, Botox (OnabotulinumtoxinA), Xeomin (IncobotulinumtoxinA), Dysport (AbobotulinumtoxinA), Myobloc (RimabotulinumtoxinB). Also Check: Does Blue Cross Blue Shield Cover Low Testosterone. And sometimes, even when you have health insurance, you may be stuck paying out of pocket for one reason or another. She works in Leadville, CO and 3 other locations and specializes in Family Medicine. And although its unclear how often it happens, some people who transitioned as teenagers have reported detransitioning later on. It not only puts fear in us as providers, but way more fear I think for families who might be trying to balance this.. Lange enjoys her job working in criminal investigations and was recently promoted to sergeant. Plus, she was recently promoted to sergeant in criminal investigations, and she finds it deeply satisfying to help people and solve crimes. Notice shifts in sleeping and eating habits in your teen, as well as any issues he or she might be having at school, such as slipping grades. Hormone therapy also treats some of the long-term effects of menopause like bone loss. American women have seen anincrease in expected lifespan, from less than 50 years of age in 1900, to 80years in 2000. <>/Metadata 759 0 R/ViewerPreferences 760 0 R>> For more information, see the topic Stress Management. Blue Cross and Blue Shield of Illinois prior authorization/step therapy program is designed to encourage safe, cost-effective medication use. Does Blue Cross Blue Shield Cover Testosterone Therapy, Does Kaiser Cover Hormone Replacement Therapy, challenging for many Americans outside urban areas, Can Having Your Tubes Tied Cause Hormonal Imbalance, Does Melatonin Cancel Out Birth Control Implant, Does Insurance Cover Testosterone Injections, Blue Shield of California had released amendments, Does Blue Cross Blue Shield Cover Low Testosterone, Bioidentical Hormone Replacement Therapy After Hysterectomy, Safe Hormone Replacement Therapy After Hysterectomy. Herceptin Hylecta (trastuzumab; hyaluronidase-oysk), J9356, J9355, Q5113, Q5117 a free consultation or with a simple call to your insurance carrier. To make that a requirement for everybody is inherently unnecessary gatekeeping and also stigmatizing and pathologizing and a waste of resources, he said. Additionally, some state and federal public employees are covered for transition-related care through their group benefit plans. It seemed reasonable that estrogen replacement couldhelp symptoms of menopause, possibly even prevent dementia, cardiovasculardisease, osteoporosis, stroke and other age-related ailments. Around the late 2000s, clinicians in the United States introduced the gender affirming approach, which has since been endorsed by several major medical groups. The P&T Committee is an independent and external committee including practicing physicians, pharmacists, and clinicians from leading academic medical centers and clinical practices with expertise in evidence-based medicine. Because testosterone replacement therapy is sometimes considered a new therapy, many patients ask us this question, Does health insurance cover testosterone therapy for me? <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Certolizumab pegol (Cimzia), Etanercept agents (Enbrel, Erelzi, Eticovo), Golimumab (Simponi, Simponi Aria), The monthly premiums on Medicare Part D will depend on your specific needs. Many doctors and activists praised the 350-page document, which was updated for the first time in nearly a decade, for including transgender people in its drafting and for removing language . Dr. Edwards-Leeper said that now she was more likely to see adolescents who had recently begun to question their gender, whereas a decade ago her patients were more likely to have longstanding distress about their bodies. Transgender Surgery Travel Expense. Not all individuals who undergo gender transition will opt to complete the full transition with surgery. Announcer: Youre listening to The Doctor Is In Podcast, brought to you by Martinclinic.com. The communication you and your doctor can have with the insurance company, the fewer hassles you will encounter. Dr. Alex Keuroghlian, a clinical psychiatrist at Fenway Health in Boston, said, Im really not a believer in requiring therapy before transitioning. Also Check: Does Blue Cross Blue Shield Cover Testosterone Therapy. It does not apply to self-funded plans where Anthem Blue Cross is the Administrative Services Organization. Original Medicare has limited prescription drug coverage. See your state Medicaid program for details. 53. Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue . A total testosterone level near the lower limit of the normal range and a low free testosterone level which is less than normal based upon the laboratory reference range. The Blue Cross name and symbol are registered marks of the Blue Cross Association , Agents for Hemophilia A and von Willebrand Disease, Akynzeo (fosnetupitant and palonosetron) for Iinjection, Aristada Initio (aripiprazole lauroxil), Beta Interferons and Glatiramer Acetate for Treatment of Multiple Sclerosis, Bevacizumab for Non-ophthalmologic Indications, Cabenuva (cabotegravir extended-release; rilpivirine extended-release) injection, Darzalex (daratumumab), Darzalex Faspro (daratumumab and hyaluronidase-fihj), Drug dosage, frequency, and route of administration, Duopa (carbidopa and levodopa enteral suspension), Enhertu (fam-trastuzumab deruxtecan-nxki), Enzyme Replacement Therapy for Gaucher Disease, Gonadotropin Releasing Hormone Analogs for oncologic indications, Gonadotropin Releasing Hormone Analogs for the treatment of non-oncologic indications, Hyaluronan Injections - Step Therapy and Quantity Limit - MEDICARE ONLY, Implantable and ER Buprenorphine Containing Agents, Injectable Hydroxyprogesterone for prevention of preterm birth, Lemtrada (alemtuzumab) for Treatment of Multiple Sclerosis, Monoclonal Antibodies to Interleukin-5, Off Label Drug and Approved Orphan Drug Use, Pepaxto (melphalan flufenamide; melflufen), Phesgo (pertuzumab/trastuzumab/hyaluronidase-zzxf), Proprotein Convertase Subtilisin Kexin 9 (PCSK9) Inhibitors, Prostacyclin Infusion and Inhalation Therapy, Radioimmunotherapy and Somatostatin Receptor Targeted Radiotherapy, Rituximab agents for Non-Oncologic Indications, Rituximab agents for Oncologic Indications, Selected Injectable 5HT3 Antiemetic Agents, Selected Injectable NK-1 Antiemetic Agents, Vascular Endothelial Growth Factor (VEGF) Inhibitors, Select Clotting Agents for Bleeding Disorders, Xiaflex (clostridial collagenase histolyticum) injection, Zilretta (triamcinolone acetonide extended-release), Xipere (triamcinolone acetonide injectable suspension). Pellets are implanted in the physician's office and release their contents over a period of months. Greg Abbott of Texas has described gender surgeries as genital mutilation and child abuse.. Easy access to exceptional care for a wide range of conditions in a secure, discreet, and convenient online process. This often raises the question of whether hormone replacement therapy is covered by insurance. Im going to give you some information this morning, this is interesting. All travel expenses are limited to the maximum set forth in the Internal Revenue Code, not to exceed the maximum specified above, at the time services are rendered and must be approved by Anthem in advance. Mental health conditions Blue Cross Blue Shield covers may include: Note that therapists are required to assign you a diagnosis for the above conditions, as well as share the diagnosis with your health insurer, if you are using insurance benefits to pay for therapy. For example, if the doctor requires you to go to a pharmacy to obtain a certain drug, Part B wont cover that and that could leave you in $100s of dollars in drug cost. Contact us: contact@healthyhormonesclub.com, Florida Blue Member Shares her Mayo Clinic Knee Replacement Story, HRT Day : Starting Transgender Hormone Replacement Therapy, What Is The Best Over The Counter Hormone Replacement, How Long Does It Take For Testosterone Gel To Work, Where Can I Buy Estrogen Over The Counter, What Supplements To Take To Lower Estrogen, Does Blue Cross Blue Shield Cover Testosterone Therapy, What Causes Breakthrough Bleeding When On Bioidentical Hormones, Does Melatonin Cancel Out Birth Control Implant. That is why insurer clients agree to receive partial compensation to cover their medical expenses. Some price lists include special offers for regular procedures that are not covered by the insurance. Covered diagnosis codes for 11980 and S0189, Internal Medical Policy Committee 1-22-2020 adopting policy for diagnosis coding, Internal Medical Policy Committee 7-22-2020 Annual review, no clinical content change, Internal Medical Policy Committee 7-22-2021 Annual review, no clinical content change, Internal Medical Policy Committee 1-20-2022 Updated experimental/investigational statements, Internal Medical Policy Committee 1-26-2023 Annual review, no clinical content change. As mentioned before, with Part D, this can help pay for the hormone replacement therapy drugs partially if not fully. Please note: Clinical criteria for orals or self-injectables can be found in our Searchable drug lists within the Drug List Search tab. From Hormone Therapy to Acute Care, our medical clinic is now virtual. They absolutely have to be treated differently, said Laura Edwards-Leeper, a child clinical psychologist in Beaverton, Ore., who works with transgender adolescents. It doesnt cover hormone therapy medications at all, even those for menopause. The new standards state that clinicians should facilitate an open exploration of gender with adolescents and their families, without pushing them in one direction or another. Select a State Policies, Guidelines & Manuals We're committed to supporting you in providing quality care and services to the members in our network. I dont want any young person to go without the care that they need, Dr. Anderson said. If you notice something unusual, start a conversation. Our resources vary by state. The following insurance carriers have available plans without blanket exclusions for transgender surgery and other trans-related healthcare. Depending on the insurance company, these conditions can include the following: Other conditions, like having had a prostatectomy, may also preclude you from needing tests to prove low testosterone. The average age for women entering menopause is 51. Children and teenagers struggling with their gender identities did not get much attention from the medical community until the 1990s, when two contrasting models emerged. In an emergency: If you have immediate concern for your childs safety, do not leave him or her alone. That focus on psychology set a lasting precedent, experts said. In short, the answer is, it depends. No health plan is created equal. This plan covers prescription drugs, including those for hormone therapy. A common concern among individuals who seek hormone replacement therapy is how theyre going to pay for it. In another model, which was developed in Canada and is now considered a form of conversion therapy, children were pushed to live in the gender they were assigned at birth, in order to avoid drugs or surgeries down the line for those who might later change their minds. You can see the list of whats not covered and available alternative options for Standard Option and Basic Option. Its basic philosophy: Minors should be able to live out their gender identities freely, without clinicians or parents imposing unnecessary delays. Members are now eligible for a spectrum of gender transition services along the treatment continuum. $15 copay, after $5,000 deductible After you spend $5,000 in medical costs this year, your therapy sessions will cost $15 per session. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Some plans may want to approve a treatment plan in advance. Antihemophilic Factor (Recombinat [Pegylated]) [Adynovate, Jivi, Eloctate, Esperoct]. This medical option can help treat hormone imbalances like menopause and thyroid. All clinical criteria are developed to help guide clinically appropriate use of drugs and therapies and are reviewed and approved by the CarelonRx* Pharmacy and Therapeutics (P&T) Committee. Hormone replacement therapy (HRT) using formulas in subcutaneously implantable pellet form is an alternative to hormone therapy by injection or oral ingestion. He works in Albany, NY and 6 other locations and specializes in Obstetrics. Moreover, there are many factors that can influence the levels of the female hormones found in the body and it is known that the absence of certain key macro- and micronutrients will affect hormone release by inhibition or causing an over secretion leading to hormone levels away from the expected norm. $15 copay, after $1,000 deductible After you spend $1,000 in medical costs this year, your therapy sessions will cost $15 per session. Hormone therapy was once the most commonly prescribed treatment in the United States, but in 2002, a major study raised serious concerns about its health risks, causing many doctors and patients . Follow a healthy diet, exercise regularly, avoid tobacco and, most importantly, don't let menopause consume your day-to-day. If you are considering using these new health insurance benefits to transition, contact your health plan first and see exactly how they are going to handle the benefits. Most health insurance providers will cover the majority of the cost of testosterone replacement therapy for men, as long as you can demonstrate a need. 2023 Blue Cross Blue Shield of North Dakota, Please wait while your form is being submitted, Directory Validation Instructions (No Surprises Act), Recredentialing & Credentialing Applications, Treatment of primary hypogonadism (congenital or acquired) due to testicular failure from conditions such as cryptorchidism, bilateral torsions, orchitis, vanishing testis syndrome, orchiectomy, Klinefelter syndrome, chemotherapy, or toxic damage from alcohol or heavy metals and who have documented testosterone deficiency as defined by. Medicare Part C or Medicare Advantage is a plan that replaces Original Medicare Part A and B, and usually adds benefits like prescription drug insurance coverage. Coverage is subject to the specific terms of the members benefit plan. Federal Employee Program members (FEP) should check with their Retail Pharmacy Program to determine if prior approval is required by calling the Retail Pharmacy Program at 1-800-624-5060 (TTY: 1-800-624-5077). We also offer flexible hours and multiple locations, giving you the ability to get therapy when and where it best suits you. Likewise, if your practitioner is a preferred provider, youll pay your regular copay. Dont Miss: Does Blue Cross Blue Shield Cover Testosterone Therapy. While it depends on your specific plan, it is unlikely that Blue Cross Blue Shield will cover couples counseling. Anthem Blue Cross includes transgender services language in new Evidence of Coverage documents. And medicine has this idea that they usually want to give you HRT, hormone replacement therapy. 3 0 obj Yes, the vast majority of Blue Cross Blue Shield plans cover therapy. Before discussing any medical treatment, they say, adolescents must get a comprehensive assessment led by mental health providers, and must have consistently questioned their gender identity for several years.. Factor IX (Recombinant [Fc Fusion Protein]) [Alprolix]. Antihemophilic Factor (bispecific) [Hemlibra (emicizumab-kxwh)]. Certain travel expenses incurred by the Member, up to a maximum $10,000 Anthem payment pertransgender surgery or series of surgeries , will be covered. Today there are more than 50 such specialty clinics in the United States, she said, up from just four in 2012. Contact us: contact@healthyhormonesclub.com, HRT Day : Starting Transgender Hormone Replacement Therapy, WellPoint sued an ENTIRE STATE to increase profits, Orgovyx: New FDA Approved Hormone Therapy | 2020: The Year In Review | Mark Scholz, MD, What Is The Best Over The Counter Hormone Replacement, How Long Does It Take For Testosterone Gel To Work, Where Can I Buy Estrogen Over The Counter, What Supplements To Take To Lower Estrogen. According to the Williams Institute at the UCLA School of Law, 21 states introduced such bills last year. Another avenue is a Medicare Advantage Prescription Drug. Keep the lines of communication open. Benefits are provided according to the terms and conditions of this Agreement that apply to all other medical conditions, including Medical Necessity requirements, Precertification and exclusions for Cosmetic Services. One of CMS most heavily weighted pharmacy measures is the utilization of potentially High-Risk Medications in the elderly population. Of course, the amount that your insurance covers varies from provider to provider, and it also varies based on your specific health plan and other variables, like your deductible. As moreexperience and data has been gained, we discovered hormones do not preventdementia or cardiovascular disease as previously hoped. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. Dr. Zwerdlinger graduated from the University of Colorado School of Medicine in 1995. These are the top 10 symptoms on a survey of menopausal, pre-menopausal symptoms. Obstetrics & Gynecology. During the episode, the doctors share a lot of information. Puberty blockers, for example, can impede bone development, though evidence so far suggests it resumes once puberty is initiated. The incorporation of transgender health reassignment benefits applies to all individual, family, small group and large group plans. We are inching our way toward full disclosure and transparency in the contracts between the insurers and the members so that consumers can finally see what is truly covered in their health plans. Factor IX (Human) [Alphanine SD, Mononine. Provider Policies, Guidelines and Manuals | Anthem.com Find information that's tailored for you. Consequently, I dont have all the EOCs for all the individual and family plans offered in California. And some doctors have also argued that waiting several years to initiate medical treatments could itself be harmful. Given these risks, as well as the increasing number of adolescents seeking these treatments, some clinicians say that teens need more psychological assessment than adults do. Sometimes, teens have unusual bleeding because they arent ovulating regularly. Even men are helped when they use bioidentical hormone pellets. Anthem Blue Cross doesnt make the EOCs easily available, but as an agent I can download Blue Cross EOCs attached to an existing client. Scientific evidence of safety and efficacy has not been proven. Fargo, N.D., 58121. Your policy may cover traditional hormone therapy but not bioidentical hormones. With kids, youre more conservative, said Dr. Being trans isnt a mental health problem, he said. While clients may sometimes benefit from services rendered outside of the therapy office, such as a client with an eating disorder needing support in the grocery store, or a client with a phobia of driving needing support in the car, these services are not likely to be covered by insurance and must be paid for out-of-pocket.