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Srs, transgender healthcare, employment and insurance companies

Started by Noelle, September 30, 2012, 12:15:28 AM

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Noelle

Ive been wondering and havent rlly been able to find any answers.

Here in the US, which companies provide transgender healthcare to their employees that would cover SRS?

Also.. which insurance providers would actually cover SRS for transwomen?

Looking for solid answers here.. Any help will be greatly appreciated.
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JoanneB

Safe to assume it will not be for most private employers. Most policies specifically exclude TG care from therapy to SRS
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Kelli

"Aut inveniam viam aut faciam" (I will find a way or I will make one!)
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Noelle

Quote from: Kelli on September 30, 2012, 12:57:31 PM
Try this link. It has a listing of all the insurance companies who are pro-transgender treatment.

http://www.hrc.org/resources/entry/finding-insurance-for-transgender-related-healthcare

TY so much! if anyone else has good links or info keep them coming :)
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blueconstancy

Generally speaking, there aren't any insurance providers guaranteed to offer coverage for any transgender care - because it's possible for a given employer to purchase a specific exclusion (rider?) for their individual policy. For example, Blue Cross has paid for GRS for at least two of our friends, but both my company and my wife's bought BCBS policies that exclude not only "sex reassignment surgery" but any treatment intended to prepare for that. (Both do cover hormones, endocrinologist visits, blood tests, etc. as long as it's not billed as care aimed *specifically* at GRS. Which, since she's now had it done by paying out of pocket, shouldn't be an issue in the future!)

Unfortunately, it can be fiendishly difficult to get HR or even the insurance company to provide a FULL legally binding copy of the policy, exclusions and definitions and all. I fought with them for months on that one, and this was in the case of employers we'd already been working for. In other words, your best bet is to ask directly when you have a target company in mind, and that's obviously fraught with its own risks.
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Noelle

Quote from: blueconstancy on September 30, 2012, 04:23:11 PM
Generally speaking, there aren't any insurance providers guaranteed to offer coverage for any transgender care - because it's possible for a given employer to purchase a specific exclusion (rider?) for their individual policy. For example, Blue Cross has paid for GRS for at least two of our friends, but both my company and my wife's bought BCBS policies that exclude not only "sex reassignment surgery" but any treatment intended to prepare for that. (Both do cover hormones, endocrinologist visits, blood tests, etc. as long as it's not billed as care aimed *specifically* at GRS. Which, since she's now had it done by paying out of pocket, shouldn't be an issue in the future!)

Unfortunately, it can be fiendishly difficult to get HR or even the insurance company to provide a FULL legally binding copy of the policy, exclusions and definitions and all. I fought with them for months on that one, and this was in the case of employers we'd already been working for. In other words, your best bet is to ask directly when you have a target company in mind, and that's obviously fraught with its own risks.

Are you saying that health care provided through your company is not guaranteed for srs or TG care? or that Health cares that claim to cover it can still deny it for whatever reason?
If i was trying to begin insurance coverage with a provider, and specifically asked them if they cover SRS and TG healthcare would that be wise? I know there is no more pre-existing condition thing any longer, so would it hurt if i asked?

Im willing to pay out of pocket for my own healthcare i suppose, if it could cover therapy hrt and eventually SRS it would be well worth the monthly fee.

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jesse

covered or not the srs surgeons do not take it so u will have to pay first then try to get reimbursed can someone link the sticky bev posted that has the lists and other info i dont know how
like a knife that cuts you the wound heals but them scars those scars remain
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JoanneB

Quote from: krysha on September 30, 2012, 09:21:39 PM
Are you saying that health care provided through your company is not guaranteed for srs or TG care? or that Health cares that claim to cover it can still deny it for whatever reason?
If i was trying to begin insurance coverage with a provider, and specifically asked them if they cover SRS and TG healthcare would that be wise? I know there is no more pre-existing condition thing any longer, so would it hurt if i asked?

Im willing to pay out of pocket for my own healthcare i suppose, if it could cover therapy hrt and eventually SRS it would be well worth the monthly fee.
Insurance companes offer man many policies to get the right price point for customers and will vary about anything to do so. Just because  Company A does havea plan somewhere out there that covers TG's that plan is the rare exception. I have had BCBS a few times in teh past and currently. My current plan, like past ones, like others with Aetna, Horizon, and a few others specifically excluded hormones, and SRS. My current plan even goes a step further with therapy
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(ROCK) ---> ME <--- (HARD PLACE)
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blueconstancy

Yes, I meant what Joanne clarified (thanks!) - it isn't worth looking for an INSURANCE company that has transgender care or GRS coverage when you're considering an employer-covered policy, because the employer can override that for themselves.

If you're looking for an individual policy, yeah, that's different. :) I don't know offhand of any insurance companies that do offer such a policy, but I don't *think* it would hurt to call and ask (since if they say "yes" they shouldn't punish you for wanting it), as long as if they say "no" you're not going to use them anyway. I'm not an expert and I don't work in insurance, though!

I do know one unemployed woman who's been trying to find an insurer willing to take her because she wants her wife and daughter to have insurance, and so far three have rejected her for being trans, baby and all. So you probably shouldn't call and disclose unless you ARE willing to walk away if transgender care isn't covered; if you're looking for basic health insurance first, you could risk being rejected outright.

For what it's worth, I have had zero problem with the insurance company refusing to pay for things it did say it covered. That kind of crap happens to people all the time, so this is partly just luck, but in the past 3 years BCBS hasn't been any more difficult with me about transgender care than anything else.

Incidentally, I also have a close friend who went to Kathy Rumer, and that doctor DID take insurance - Blue Cross paid all but about $2000 of it to the doctor directly. I mention it only because I think Rumer's an exception, but she's out there.
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JoanneB

If you're out insurance shopping on your own it "should" be easy enough to get a copy of the policy, or policies, to read beforehand. It is afterall what you are buying, not the fancy color brochure. THen you can look for yourself to see what is or isn't covered. No need to ask beforehand about TG coverage, and no unintended disclosure of a "pre-existing" condition by saying I want a policy to cover my GRS
.          (Pile Driver)  
                    |
                    |
                    ^
(ROCK) ---> ME <--- (HARD PLACE)
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