I am very fortunate in my situation. I live in a state that has a lot of transgender protections, including requiring insurance companies to pay for transgender care. The only negative right now is I work for the Department of Defense which as we can all see is rolling back things due to Trump, and they are the only employer that can supersede the state law for medical care.

That being said, I am leaving the DoD at the end of June. My hubby is starting a new job with good medical (actually same medical we currently have, so we will just be transferring our insurance plan). So I don’t have to worry about any transgender “riders” on the insurance.
Our current and soon to be current insurance does assign people a transgender case manager to help with all the hoops you have to jump through. We have been assigned a very wonderful lady named Rae. The incredibly great part about this is she is the same one that helped my husband through his FtM process, she is the sweetest person and will fight to get you what you need.
She has already set me up in the system, and gave me a referral to a mental health specialist. This one disadvantage is the insurance company requires me to get a sign off before they will pay for HRT, voice training and implants. The implant possibility will happen two years after I am on HRT. This is to see if enough growth has happened, and if it hasn’t they will approve it.
The insurance may start covering other things like facial feminization, and laser hair removal in the future and while I will probably have my beard lasered off before then, I want everything else. I am still debating SRS at the moment (bottom surgery) but I want to see how things progress before making that choice.

Rae has just been on it for me. She is so great she even gave me a list of specialists that are in favor of informed consent. Not all are like the advertise and I will complain about that in a future post.
Informed consent means you are given HRT once you have shown you understand the possible consequences of receiving it. You are basically just acknowledging you understand what its effect on you may be and you give permission to proceed.
A lot of specialists still require you to have endless sessions and they still may decide not to approve you for a variety of reasons. This is a form of gatekeeping to determine if people are “trans enough” and unfortunately a lot of times their decision isn’t based on the person they are caring for, but their own outlook. I don’t want to waste my time doing this because someone needs to get inside me and know me deeply. I only allow my husband inside me… or maybe someone really cute.
Dear god, I am 46 years old. I have been like this my whole life.
So I have gotten an appointment with the same specialist that worked with my hubby and who believes in informed consent. The specialist was awesome to hubby, and the specialists is already being awesome with me. If things work well, I will go a week from Tuesday (the 27th) and an hour after that I will have the sign off so I can make an appointment with a doctor to get HRT.
Oh, another cool thing that Rae has done is set me up for voice training lessons, even before I saw the counselor. This caught me off guard as the speech office called me up and asked when I wanted the appointment. At first I had no idea what they were talking about until they explained what was going on. That made my day right there.
I am pretty excited (and anxious) so much is happening so soon, the insurance process has started!