Your insurance company requires letters of support from your hormone provider in order to approve coverage for your surgery. You must be on Hormone Therapy (HRT) for at least 12 months continuously prior to surgery. Our office requires this letter to be on file prior to scheduling your surgery date. Please note that your letter must be signed by your provider with their license number and printed on their letterhead. The letters cannot be written by an intern, even if they are co-signed by their supervisor.