Oregon Insurance coverage

[Patty_M]

In case anyone in transition and who lives in Oregon hasn't heard this...

The state has ruled that transgender/transsexual people must be treated the same as other patients. 

Rather than post the entire five or six page bulletin you can download it here: 

http://googlesearch.cbs.state.or.us/search?q=transgender&restrict=insex&ie=&site=insex&output=xml_no_dtd&client=dcbs&lr=&proxystylesheet=dcbs&oe=

Insurance companies are no longer permitted to:

Deny, cancel, limit, or refuse to renew an insurance policy.

Demand different rates or premiums.

Classify "gender identity disorder" or "gender dysphoria" (GI/GD) as a disqualifying pre-existing condition.

Deny coverage for a procedure that is provided for the treatment of other conditions of illness (such as hormone therapy, mastectomy, or vocal training).

Categorically deny coverage of GI/GD.

Deny mental health coverage for GI/GD-related issue in adults.

Deny sex-specific care (such as pap smears and prostate exams).

I wish this sort of thing had been in effect when I had my SRS ($$$ out of pocket).  Its sure to be a boon to those coming up behind.

[Beth Andrea]

...And to those of us who are seriously thinking of moving to OR's officially weird city...

[Patty_M]

That's Portland all right.  .

Weirdness is one of the things that makes this such a great city!  Where else can you find fifteen unicyclists in a group on the road?  A car full of zombies?  Sixty year old hippies complete with tie-dyed t-shirts and beards long enough to keep their chests warm?

Now, when Oklahoma's insurance regulating people issue the same kind of ruling THAT will be a day to celebrate because that state will probably be among the last to recognize transition as medically necessary.

[Beth Andrea]

Some of the states will probably have to be dragged, kicking and screaming, into the future...

Here, OK, have a binky...

[Kelly-087]

That's good to hear~ As I live in Oregon, and fully intend to stay here. Yet another reason to stay in this state.

[Felix]

We've yet to find out how these rules affect medicaid. I'm assuming that because OHP contracts with CareOregon, Verity, etc, all private companies, the ruling will be important to all of us. Either way I've already contacted my doctor. I was ready to sue over denial of trans-related care and this just puts more fuel in the fire for me. If I can go to a dermatologist over a stupid rash that won't go away or a gynecologist for birth control I should be allowed to get top surgery. It would save them money on mental health treatment in the long run anyway.

A lot of my medicaid approvals are tied into my being an indigent caregiver for an ssi patient though, and that may complicate things.

[jojoglowe]

AWESOME! I'm planning to move to the west coast from ohio this year. My first thought was somewhere near Seattle, but then a friend suggested Eugene, OR. One more reason!

<3

[Patty_M]

Jojo, I lived and worked in Seattle for four years and have been to Eugene many times.  Between the two Eugene wins an any factor you can name.

Seattle is famous for its rain.  The whole Pacific Northwest west of the Cascades is rainy (the east side is actually dry) but Seattle weather is beyond anything you can imagine.

True story: One day, after living in the Seattle area for a few years, I was in my work truck looking up some technical data when the sun broke through the clouds.

The sudden brightness was startling!  It had been so long since I had seen sunshine that it actually took a few seconds to realize what had happened. As a child of the 50s my first thought was that this was a nuclear attack!

Again, true story: Seattle is the only place where I have ever seen a line of cars at a car wash when it was raining!

[jojoglowe]

wow, thanks for your story Patty_M. Yesterday evening I told a close friend about having my sights set on Eugene. Turns out her dad wants her to attend a meditation camp there sometime this year. So sounds like I'll have an opportunity to make some new and cool friends there. I still have to see when she's heading over there and when I'm heading over there but can't wait!

True story: One day, after living in the Seattle area for a few years, I was in my work truck looking up some technical data when the sun broke through the clouds.

The sudden brightness was startling!  It had been so long since I had seen sunshine that it actually took a few seconds to realize what had happened. As a child of the 50s my first thought was that this was a nuclear attack!

^priceless

<3

[Zumbagirl]

In case anyone in transition and who lives in Oregon hasn't heard this...

I wish this sort of thing had been in effect when I had my SRS ($$$ out of pocket).  Its sure to be a boon to those coming up behind.

Wow the times sure are a changin', and for the better too. Gid is delisted, more companies cover transgender services, heck my employer announced transgender coverage last year. I guess I am just another survivor of the dark times when everything was out of pocket.

[Tessa James]

Hey Patty_M,

Thanks for sharing about the changes in Oregon trans care law.  It is especially important to me with my first appointment coming up.  Those glasses really work for you!  My true Seattle story was driving down from Issaquah after living there for 8 months and seeing the Olympic Mountains for the first time across Puget Sound.  I love visiting though and still prefer our Portlandia!  All great cities to be "out" and about on a bike.

[spacial]

I wish this sort of thing had been in effect when I had my SRS ($$$ out of pocket).  Its sure to be a boon to those coming up behind.

Firstly, apologies for not responding earlier. I have been trying to avoid matter specific to US politics. I wish you all well of course, but as a Briton, lack the knowledge and experience to interfere.

Here, the problems of funding are different of course, but the social aspects remain.

I see so many new laws, rules and recognition. There are many times, I will admit, even still, that I get that pit of my stomach, agonising why it took so long. I so wish, even the recognition that I'm not insane, had existed when I was growing up.

But you know something Patty? You, me, others, we're doing ourselves a disservice here. The world is better now. But it's better because you and I and those like us made it so.

Paraphrasing King: We get to the top of the hill, but it's for the next generation to walk down into the valley.

[Felix]

Wow the times sure are a changin', and for the better too. Gid is delisted, more companies cover transgender services, heck my employer announced transgender coverage last year. I guess I am just another survivor of the dark times when everything was out of pocket.

Everything is still out of pocket for most people. Sadface. I'm struggling hard with the fact that I'm not allowed to save money enough for top surgery. I get audited every fiscal quarter and if I have too much more than 1k in hand then I lose services until the money is used up. I understand they want to keep people from abusing the system, but medicaid doesn't cover trans issues. That means I have to either keep my money secret or waste a hundred dollars or so every month on discretionary spending that could go toward a top surgery fund if I weren't being watched so closely. If I go over the income requirements I can get food stamps back pretty easily after time without, but if I lose my health insurance I may not get it again through the lottery system.

I'm still thinking about suing for coverage. By treating trans care as low priority (and hence never high enough on the government prioritized care list to be paid for) they've put me in a position where I'm more of an expense and a burden on society than I would be if we were treated as equal to "normal" men and women. They waste so much money through incompetence and they treat their clients like garbage and so poor people stay down. I didn't ask to have a kid and I always tried to do the right thing but I still can't afford my own healthcare and I don't know how to climb out of this.

I shouldn't get to ranting. I'm just frustrated. I have a bad ankle and can't play basketball or rollerskate or hike like I used to, and that makes me feel pathetic. If I could go swimming I could get some exercise without hurting so much, and if I had top surgery I could go swimming. And I could feel better about myself. I gotta figure something out.

I'm scheduled for a surgical evaluation in a couple of weeks. I might need prophylactic mastectomy. There has been a ton of breast cancer in my family. I hope it goes well.