My understanding:
Yes it counts toward your deductible and OOP. Only copays are the BS icing on the cake. And you can go to anyone who takes insurance, you’ll just pay the different rate depending on if they’re in your network or not. I believe if they’re out of Network or don’t accept insurance at all though, it’s up to you to submit paperwork to insurance and all that Jazz. I could be totally wrong though! 
this stuff is confusing for sure.
With my PPO HSA, I basically pay for everything that’s not mandated full coverage (e.g. yearly physical is free) straight out of pocket. I’ve only ever had co-insurance on a small handful of lab claims; things like urgent care visits or physical therapy have been completely uncovered. Once I hit my deductible (never actually done it), I’m supposed to pay co-insurance on things like urgent care, and then once you hit the OOP max it’s supposed to be completely covered. Everything I pay goes towards my deductible and my OOP max.
YMMV.
I’ve never quite understood how coinsurance fees work when I’ve had plans that list that. I had a zero copay/zero prescription fee plan for a few years just so I didn’t have to think about it 
Nods Makes sense @diapasoun
It seems likely/possible that between prescriptions and therapy, we would hit the deductible, but it’s made a little less painful by the 1.4K the company puts into the HSA per year.
I just looked up my current plan. It has a super low deductible ($250) but a super high OOP Max (over 7K). 
I’m seeing myself at a point where I may or may not do HRT or maybe top surgery but at the very least some therapy where I want to Find The Right Person.
The Partner plan makes sense then I think.
Oh! Yes. I pay fully OOP for virtually everything (Although negotiated insurance rate, so it still helps) until I hit deductible, then I pay at the coinsurance rate. Hopefully that clarifies things lol.
I have a HDHP with HSA and employer contributions.
There are usually “contracted” rates with preferred providers which are lower than uninsured rates, however I pay entirely out of pocket before I meet my deductible. What I pay is usually counted towards said deductible.
After that, coinsurance kicks in. My rate is 15% in-network, I believe. That coinsurance counts towards my out of pocket max cost.
My prescriptions are the same way, although routine “preventative” services are usually free.
Yes, once you meet your deductible, you can see any provider you want at the higher coinsurance rate if they’re not in your “preferred providers” network.
Partner’s health insurance does not cover top surgery, but does cover therapy for gender and HRT.
This is disappointing. 
Next up is confirming what my work (current) plan covers in print rather than just over the phone and making a decision on with which coverage I think I’ll be able to get the best care.
I wish there were an existential angst emoji LOL.
Not an emoji but this is the best thing I found searching for existential angst on giphy:
I’m sorry that navigating our healthcare system is so much work.
Bleh. That sucks, but maybe your insurance will have a nice surprise regarding coverage.
If they also don’t cover it, would you consider medical tourism? I know people do that, but I find that very intimidating.
In which I write things out because AHHHHH
Current Health Insurance (HMO)
Partner’s Health Insurance (PPO)
Currently I’m considering staying on my current insurance.
Do you have a doctor or practice group identified that you want to work with? If they take both insurance plans - it isn’t as relevant. But if one insurance covers more practitioners you might use, it could be a factor.
DISCLAIMER: I HATE trying to figure out insurance issues, coupled with the slow billing, various coding options, etc. I have never tackled an issue like this because it is so much work with so much perceived uncertainty.
So my current primary care doctor and the therapist I have scheduled would NOT cross over. They are for my specific plan only.
I do know that my current primary care doctor does do HRT and offered it to me, so I would need to get a letter of need from a therapist first, then get a prior authorization from my primary care doctor for her to write the prescription for it to be covered.
#fun
If I do this on Partner’s insurance I would need to find new people.
ETA: Partner’s insurance would cover more flexibility in theory, as it’s a PPO so anyone who takes that insurance could be approached.
ETA2: I’m not particularly attached to my current primary doc. I’ve seen her once. LOL. 
I messaged my primary doctor to talk about what the process would be to start (very very gentle microdosing) HRT and was told to make an appointment. She confirmed I would need a letter from a therapist to start the meds, but talking with her in person about risks, confirming my own research, etc. seems like a good idea.
Made the appointment for a month from now to give myself time to think further.
In some locations Planned Parenthood will write you a prescription for HRT without a therapist’s letter (though this may not be an issue if you’re interested in seeing a therapist anyway)
That’s awesome and really good to know!
I want to see a therapist anyhow for gender unmuddling but also for anxiety etc. nods But I’m glad that PP is continuing to show what a good place it is.
I’m glad I give them a paltry $10/month
My doctor’s appointment to discuss low dosage HRT is in a few weeks. In the mean time, I’ve been full on obsessively reading everything I can.
Not just about HRT but also about nonbinary experiences with transition, medical and otherwise.
This site has been really helpful: https://genderqueer.me/
The blog writer is Micah, who was AFAB (assigned female at birth) but identifies as nonbinary and legally changed his name and gender to male.
He also did/does low dose testosterone and has blogged about his experiences, and went through top surgery back in 2011.
While reading that site and specifically reading the blogs about Micah’s top surgery, I also started to do basic research on the types of surgeries out there. It’s all under the “top surgery” heading but there are a lot of different ways to do it. And some ways do not match up with what I want.
Micah’s surgery was a “inverted T” variety and that or a very very aggressive breast reduction style surgery (similar technique) are what interest me versus the classic double incision.
Pics below. You’ve been warned. Before and after pics, NSFW
Here’s an example of an “aggressive breast reduction” surgery. It looks to me like the inverted T technique but can’t be certain without more info. I like the curved lines of the scars-- the straight DI (double incision) scars don’t appeal to me and make the chest look too flat imo. I am interested in flattness compared to a female presenting chest, but honestly want something… neutral.
And here’s a classic double incision free graft style surgery. This is one of the better looking examples I’ve found. I have to admit a lot of the classic DI ones look “pancake flat” instead of “chest with muscles in it” flat. My guess is that this person is on T.
(2) weeks until I talk to my primary care doc about options for HRT microdosing.
(5) weeks until the first therapy session where I want to discuss gender shit (and see what I need to do to get a letter from the therapist saying I know what I want for myself).
I really like the first set of pictures. Looks natural.
