Transgender inclusive insurance could out me at work.

[Ellieka]

I work for an international aerospace company and love what I do for a living but I'm facing a small issue concerning my insurance.

I will be celebrating my one year anniversary with this company next month and while I have had insurance, and really good insurance at that for the last nine months. My company is self insured so they have the ability to decided specifically what they will and will not cover. However I feel that it is not a fair policy. Here's why.

My policy does cover things such as:
Mental health including psychiatric counseling and medicine.
Gastric bypass/stapling for weight loss (not always medically necessary)
Smoking cessation
Adoption.(not medically necessary)
Fertility treatment including in vitro fertilization.(not medically necessary)
Birth Control.(not medically necessary)
Sterilization (vasectomy, hysterectomy, etc...)(not medically necessary)
Abortion.(not medically necessary)
RU486 (morning after pill)
Reconstructive cosmetic surgery for trauma and illness,
      i.e. breast implants after mastectomy due to cancer or traumatic injury to other areas of the body.(nice, but not medically necessary)
Corrective surgery due to anatomical defects at birth such as ambiguous genitalia.
Treatment of erectile dysfunction (Viagra)(not medically necessary)
Menopause
AND... coverage of domestic partners, legally married or not.(not medically necessary)

It specifically excludes any and all conditions related to Gender Identity disorder   

Here is a direct quote from my policy:
Section 6 – Exclusions

"...Sex-change surgery including medical or psychological counseling and hormonal therapy in preparation
for or subsequent to any such surgery..."

Their reason? "It's not medically necessary." As of now they are covering my hormones but that is only because the insurance division does not know of my trans status. My I.D. Gender marker is female even though I'm pre-op.

I have reason to believe that I could fight this and actually have it covered but herein lies my dilemma. If address this issue with Human Resources and and the insurance division I will out myself and I fear that I would most likely lose my job. In The state of Indiana you can be terminated without cause. It's an :"At will state" and even though I work for a union... well our union is pretty worthless. I worked for another company previously and at the time of my hiring they did not know that I was transgendered but as soon as it came out I was quickly terminated. Every job that I have had since then I have kept my gender status a secret and have excelled.

I guess what I'm looking for here is advice from anyone that has been in a similar situation and how did you handle it. What was your outcome? 

[Miharu Barbie]

Hi Cami,

I have had similar issues working with, for and around the Catholic Church.  Even though there are specific laws in my city, state and county that protect those with gender identity issues, and even though based on these laws I might be able to challenge what I perceive as unfair restrictions that the sisters put on health coverage profiles, I have chosen to keep quiet and fly under the radar as much as possible.

It did happen once that a therapist I was seeing several years ago took it upon himself to submit a diagnosis of gender identity disorder on an insurance claim.  The insurance company immediately stopped paying for my hormones and began to challenge every medical procedure I presented for.  When I contacted the insurance company (administered by a large female religious organization) I was told that gender identity related services were excluded from my insurance plan.  I told them that the diagnosis was a mistake.  They demanded full access to my therapy files.  I flatly refused.  Rather than fight with them, I just started paying out of pocket for my hormones and limited my doctor visits.  Every time I picked up my medications from the pharmacy, the pharmicist would tell me that the insurance company denied my claim; I would say, "I know" matter of factly, and pay for my drugs. 

This went on for about 10 months. And then suddenly, without any explanation, the insurance company started paying again, and they stopped challenging my every medical claim.  They never told me why the change or heart, and I never asked.  I never went back to that therapist, and no question of my gender identity has ever come up again with the insurance company or with the sisters.

Your mileage may vary, but I choose to keep this information very much to myself, and I choose my battles very carefully.

Good luck to you.
Miharu

[Ellieka]

Thanks for your reply.

I very much agree with you. I feel at this time it's just wise to keep quiet. This job is too good to give up.

[Rachel85]

It must have been awful to have had the floor pulled out from underneath you like that Miharu but you've landed on your feet so I guess it all kinda worked out in the end.
I'm starting to think how to deal with the work thing too Cami. In Australia, particularly the state that I live in, we have laws the protect against discrimination on pretty much all matters (gender, sexuality, religion, disability and preferences of any nature really) and also separate laws for transgender people but that doesnt meant that it still doesnt happen. I asked my GP when he told me about the tg laws and I asked him "So that means there is additional protections there? That has to be a good thing". He laughed it off. Not a good sign imo hahaha.
Also, our medical system with insurance etc. is different again so I can't relate with your there sorry.
One thing I totally understand is considering work stability over transitioning. I work in a fairly public place in health care and work with the public a fair bit, not to mention that some "clients" are less than open minded and depending on the area some are blatantly homophobic (which apparently to non-tg folk is often the same thing! Really?!) and dangerous.
I've already started considering my career in terms of where I want to be and how transitioning will impact on this, there's a lot of unknowns to work with but frankly it worries me despite the law being on my side.
I spoke with a friend not long ago regarding this and she started to talk about getting the unions in, lawyers etc. and I said that I just want a job, I dont want to have to go to court just to prove that I have been discriminated against. Then again, if push comes to shove that may be necessary.
We'll just have to make sure we get someone who knows the "chewbacca defense" from south park.

Cynthia

[CybilB]

If you have a sympathetic doc who knows how to work the insurance system, they can get you hormones for the purpose of "Hormonal imbalances" and for treating depression. I think for trans-people, both are very true, and I wouldn't call either bending the truth. Of course, if your insurance doesn't cover hormones under any circumstance, I don't really know what recourse you have.

[Ellieka]

Fourtantely my doctor is very adept at wording and I am able to get my hormones but the surgery is going to be a whole other matter. At any rate, I'd rather stay stealth at work for many reasons. Mostly my safety. I lot of guys there would probably want to harm me if they knew... Mostly the ones that have been hitting on me.