Community Conversation > Transsexual talk

Grrr, why is this so complicated?

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amberwaves:
So in a change from my initial plans when deciding to transition, a few months ago I realized that I desire to fully transition, including GCS.  I wasn't in too big of a rush, but lately I've become impatient.  This is partly due to a change in financial circumstances and the realization of just how much trans related care my health insurance covers.

So I began to look into surgeons and all the hoops that I will need to run through to make this happen.  I am unable to privately afford this so insurance is a must.  I downloaded a copy of my policies transgender care requirements.  Ostensibly they are derived from WPATH v7.  However, there are a few vaguely worded sections that I have been trying to receive answers for.

First, electrolysis of the vaginoplasty donor site is covered.  However, it does not state if I have to have locked down both of the therapist letters first.  Fine, I call and the lady (who was very clueless) basically just read the policy back to me verbatim.

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Jailyn:
Well knowing how sales go in general. You got a minion of the company phone lines that is not one the underwriter or the manager. I would ask for one of those 2 people to explain it or clarify their policy better. Also you could ask a lawyer  to read over it see if he sees anything about it in there. I am not a policy expert so that is where I would try myself. Or find a doctor to see if they know whether your insurance will cover it or what you will have to do. Doctors are generally well versed in how insurances work and what hoops they have to go through as well. Good luck!!!

amberwaves:

--- Quote from: Jailyn on September 26, 2017, 10:16:46 pm ---Well knowing how sales go in general. You got a minion of the company phone lines that is not one the underwriter or the manager. I would ask for one of those 2 people to explain it or clarify their policy better. Also you could ask a lawyer  to read over it see if he sees anything about it in there. I am not a policy expert so that is where I would try myself. Or find a doctor to see if they know whether your insurance will cover it or what you will have to do. Doctors are generally well versed in how insurances work and what hoops they have to go through as well. Good luck!!!

--- End quote ---
Yeah, I understand that I'm speaking with the lowest level of support.  It's just frustrating because I am suddenly very impatient to start the process.  I was very "meh" about my transition for a long while as hormones did their thing.  Now, it seems like it's "do everything now".  I understand that everything is still quite a ways off, but I would prefer to be actually doing something other than phone tag sorting details.

A lawyer would be overkill in this scenario.  I understand technical and policy writing pretty well.  Honestly, that familiarity is how I was able to discern this was a particular concern that I should verify first.  A doctor would likely be as uncertain as I am, since this policy change is only a year old, they likely haven't dealt with this particular nuance yet.  I am just trying to verify their interpretation of the unclear language rather than getting saddled fighting a bill later.  It's a patience thing, and getting to speak to the correct  person(s) at this point.  Patience has never been my strong suit.

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amberwaves:
Okay so this is getting ridiculous.  Last week the lady took my question and told me she would get back to me with an answer.  All week passes with no response.  I called back today and basically started over.  No one can give me a freaking answer apparently.  I understand that the policy is relatively new.  I understand almost no one understands <poo> about LGBT. Holy <poo> am I getting sick of explaining everything.  I would think you would have at least heard the term LGBT and I wouldn't have to explain it.

The question isn't even that complicated.  The policy states that two referrals from mental health providers are required.  What it doesn't state is whether one from a masters level therapist and one from a doctoral level is fine.  It shouldn't be a hard question to answer.  Also, whether or not I started this process with my GP is irrelevant.  I have an endocrinologist who treats me and is qualified.  This is not relevant to the question at hand.  I am getting so sick of banging my head against a wall talking to people who don't even understand basic medical terminology.  So frustrating.

Why is it that, every time I try to go through proper channels to make sure everything is in order, it seems I get stymied.  This isn't limited to trans care.  Even to deal with my frickin ADHD that I've dealt with my whole life I ran into the same <poo> for 6 months.  This is why I chose to pay out of pocket to see my endo.  A specialist who focuses on LGBT issues.  God I can just imagine how messed up everything would be had I tried to remain in network.  If I was independently wealthy I would just pay for this too, but I am not.  I hate bureaucracy and the morons who fill their ranks so damn much.  Very frustrating and demoralizing.



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Roll:
You think that's bad, I've been trying to get ahold of Medicaid to ask about what they do and do not cover regarding gender issues and it's just an endless cycle between two automated numbers, I can't even get to the point they don't call me back. :D Literally I call the number on my card, it has no menu options that go to a person, then says "for all other issues call 1-888-whatever" super quickly and hangs up. So I had to go back through it, being quick to grab the number. I call that number, it goes through a few other menu options that don't lead to a person and then does the same thing for the first number! I then called social security and they said they can't answer any questions about medicaid, and the only numbers they had were the ones I already tried. At this point if I could just get through to an overseas call center I'd be happy. :D

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