It depends, unfortunately, on your insurance. If you need referrals for everything, you need to re-acquire a pcp (you don't necessarily need to be assigned one, but go get an annual physical from one) and, if you don't already have an official dx of gender dysphoria, try to get that during the appointment as well as a referral. Then you need to make sure your referral is in-network & check your insurance requirements for getting top surgery. You can usually call them to figure it out.
Insurance often requires a letter from a therapist stating that you're "mentally stable" (that no dx's impact your desire for surgery). Some MIGHT have a hormone requirement, but that’s not medically necessary & most surgeons don't require it. If you don't need a referral, you can contact a surgeon's office directly, submit insurance info, and ask about coverage.