North Carolina shp insurance situation

Hey all,

Well, my friend just had the privilege of being a test case - as of 10/15/25 the North Carolina state employee insurance no longer covers "gender-related treatment". My friend had a top surgery appointment soon after this date and insurance sent a denial letter right before surgery.

IF YOU ARE ON THE NORTH CAROLINA SHP and you are on the schedule for top surgery that insurance was going to cover, call the surgical practice NOW and see if you can transition to a self-pay/cash discount.

I'm trying to be vague about numbers here because our surgical practice was actively fighting with the insurance company about pricing, but the cash price wound up being about twice what the deductible would have been. It beat the quoted price at many self-pay-only plastic surgery offices. My friend WAS able to finance it, it really sucked, but it wasn't impossible and they didn't lose their time slot and have to start over.

If you are in the same situation start working on it now. The clinic we were working with was awesome, but because it was a hospital-based clinic, they had to wait for permission from an off-site finance office to do self-pay and we almost lost our spot on the schedule over it. Good luck, may the odds be ever in your favor, sorry that this is happening.