Health Insurance Coverage

[Nadeest]

This link was shared with me over Facebook, and I thought that everyone might be interested in it. http://www.advocate.com/News/Daily_N...Gold_Standard/
I hope that Google is joined soon by a lot of other companies. Hopefully, more and more companies will stop denying us care soon.

[Corkey]

Originally Posted by Nadeest

This link was shared with me over Facebook, and I thought that everyone might be interested in it. http://www.advocate.com/News/Daily_N...Gold_Standard/
I hope that Google is joined soon by a lot of other companies. Hopefully, more and more companies will stop denying us care soon.

Awesome if one works for google. I'd like to see it applied for all employers and the federal gov.

[Linus]

The articles says that more companies will follow suit but the reality is that it will be a long while before many do follow to even half of that amount.

[Nadeest]

I hate to say it, but I'm afraid that you are right, Linus, especially with the cost-cutting trends that are going on now. I hope that I am wrong, however.

[theoddz]

What I'd like to see happen is this:

A person who has medical coverage/insurance would be able to elect to substitute certain coverages based on his/her personal situation. In other words, a transperson would be able to, for example, substitute maternity coverage for transition medical and surgical services.

Of course, there are those people/couples who want to have children and would like to keep maternity coverage, but there might be other coverages that they would never use, so why make them pay for those while denying them coverage for something they really need and want?? It makes sense to allow "substitutions" in incidences where costs need to be contained.

Incidentally, the VA has an official policy now of providing trans Vets with services ranging from psychological counseling to hormone therapy. The only thing they will not do, as of now, is Gender Reassignment Surgery (GRS/SRS), though I have heard, not too long ago, that the San Francisco VAMC was doing some MtF procedures (not sure exactly what they were doing, tho). This is a huge step in the direction of equal care for trans Veterans. Just a few years back, the VA didn't have a policy for equal treatment of transgendered/transsexual Veterans. It was, pretty much, very open to interpretation of just exactly what the VA would do, if anything, for us. Five years ago, when I started Testosterone therapy, I had to have a physician outside of the VA prescribe my Testosterone and only then could I go back to the VA, present the prescription (under the "continuum of care" provision), and get the VA to issue me my T and injection supplies. I had to even switch doctors in order to get a VA physician who was sympathetic to my plight and would agree to write the prescription. There was no official mandate requiring her to do so, at that time. I'm lucky to have found my physician and she's given me top notch (and respectful) treatment. I couldn't ask for more!!! It is a great relief, though, to me now, because I don't have to worry about my doctor quitting the VA and me having to find another physician to care for me as he/she would for any other Veteran.

Anyway, I do think that the idea of "swapping" things like maternity care, which I would never use, for trans services is a good one. It addresses, specifically, those who would say that trans coverage would "drive up" costs for those who didn't need it. Maternity coverage surely drives up costs for those of us who don't ever need or want that, but yet, are still forced to pay for it to cover others who do.

~Theo~

[Galahad]

I'm trying to start therapy with the only trans supportive psychologist in my area. She isn't covered by my insurance, and I have no out of network coverage. Mental health transferred me to CHIPA for a single case payment application. I'll hear next week if it's approved.
Does anyone know of other things I could try to see this particular therapist? All of the others in the area are very conservative, religious, traditional marriage and family practice oriented.
Sorry, hitting reply is the only way I can post.

[DapperButch]

Originally Posted by Galahad

I'm trying to start therapy with the only trans supportive psychologist in my area. She isn't covered by my insurance, and I have no out of network coverage. Mental health transferred me to CHIPA for a single case payment application. I'll hear next week if it's approved.
Does anyone know of other things I could try to see this particular therapist? All of the others in the area are very conservative, religious, traditional marriage and family practice oriented.
Sorry, hitting reply is the only way I can post.

I don't know what you can do to see this particular therapist, unless she is willing let you pay on a sliding scale. Which personally, I think she should if she is actually a gender therapist, as she should give a crap about the lack of resources in her community for trans people (sorry, it just bugs me).

Do you feel that you have exhausted all resources to find a gender therapist?

Here are some places. In all of these places, the therapist themselves has to apply to be placed on the list. None of them are vetted as good therapists, but I think at least you know they know about trans issues. I would start with the WPATH link, since that is the group that determines the Standards of Care and in order to be a part of the organization, you have to pay $200/year. I think it shows a level of commitment to doing this work.

My suggestion is that even if you are not near any of these therapists, call the closest ones and see if they know anyone.

www.wpath.org

http://www.drbecky.com/therapists.html

https://www.susans.org/links/Healthc...ounselors/USA/

[Galahad]

Thank you for the links. I didn't have the WPATH one. I need to use my insurance unfortunately. I finally found a therapist nearby nearby who takes lgb clients at least. She hasn't cancelled the appt yet.

[DapperButch]

Originally Posted by Galahad

Thank you for the links. I didn't have the WPATH one. I need to use my insurance unfortunately. I finally found a therapist nearby nearby who takes lgb clients at least. She hasn't cancelled the appt yet.

I wrote you back in the other thread, with the assumption you were seeing a "gender therapist". This is not the same as someone who works with lesbian, gay, bi clients, but I am sure you know that. Sexual orientation has nothing to do with gender. LGB is certainly better than nothing, though!

So, did you call any of the therapists on those lists who are closest to you and ask for a recommendation? I assume you asked the therapist you talked with if she knew someone. Sometimes the insurance companies don't have their in network provider list up to date on your insurance web site and you should call.

You know, WPATH standards no longer require a therapist letter for T. Some docs will give it through "informed consent", only. Did you look into that? Meaning, did you call the place where you plan to get your T and ask if they need a therapist letter in order to start T?

[Galahad]

I haven't found any therapist on the list close by. I must use my insurance and from the bits I read, they require a therapist for two years before surgery. I thought the T letter wasn't necessary anymore, but I have not looked at the insurance any further. I am hoping this therapist will work out ok. The others are a 3 hr bus ride away. Not something I can do right now. I will ask her for recommendations if it turns out she doesn't want to work with me. I can even apply for the CHIPA again.

[dreadgeek]

I work for a software company. We are headquartered out of San Francisco but Engineering, where I am, is all in Portland. In 2015, I was all ready to go. By this time last year I had my primary care physician, who is head of Kaiser's gender clinic here, referral along with the two surgery letters. Kaiser kicked the referral back and it was only then that I came to understand that the California based Kaiser plan covered GCS and all associated costs but the Oregon-based plan did not. My doctor said that might happen and that we could appeal.

I decided that I would appeal as last resort but I would write HR and make an argument based on parity. As it turns out, the Oregon Blue Cross/Blue Shield plan did cover GCS but I grew up on Kaiser and so whenever that is on offer, that's the plan I take so I didn't realize that. I said I *could* switch my coverage to BC/BS but that I strongly preferred staying with Kaiser. HR said that since we were in the middle of negotiating this year's coverage they'd get it added.

In October, just before the open enrollment period began, HR sent me an email giving me a sneak peak, if you will, at coverage for GCS which is quite generous--at least for MTFs but I'm not sure for FTMs. My doctor would like me to advocate them doubling it to $150,000 which I'll definitely do. Not only is the surgery covered but the pre-surgery electrolysis is *also* covered which was a very pleasant surprise.

Yes, this is something that is happening in software companies (I don't work for an outfit anywhere near the size of Google or Facebook) and it isn't happening in every industry. But it *is* happening and for someone who had thought she was going to have to pay out of pocket, suddenly having this covered is the most amazing thing!

Cheers
AJ