Transgender people cannot be denied sex-reassignment Medicare coverage

[Olivia P]

Lauren Gambino in New York
theguardian.com, Friday 30 May 2014 21.24 BST

Transgender people receiving Medicare cannot be categorically denied coverage for sex-reassignment surgery, the Department of Health and Human Services (HHS) review board ruled on Friday, ending a decades-old ban.

Since 1981, such surgeries were excluded from procedures covered by Medicare, on grounds that they were still "experimental" and had a "high rate of serious complications".

"That coverage exclusion is no longer reasonable," the HHS departmental appeals board wrote in its decision on Friday.

http://www.theguardian.com/society/2014/may/30/transgender-people-sex-reassignment-medicare-coverage

[Hikari]

So, correct me if I am wrong, as I am no lawyer, but can this not be seen as a basis for insurance compaines to be required to treat SRS as an actual medical situation like Diabetes or Cancer? I mean if medicare covers it, certainly it is a reasonable treatment for the condition right?

I really hope that in the US the only things we will be going out of pocket for would be FFS and laser (even though tbh those are treatments to the condition too, so surely it should be as covered as HRT is, but that is a fight that I doubt would ever be won).

[Megan Joanne]

My mom saw this news a couple hours ago when I got off of work, so she read it to me. Sounds like progress to me, maybe our dreams can all be sooner realized than later.

[mrs izzy]

So, correct me if I am wrong, as I am no lawyer, but can this not be seen as a basis for insurance compaines to be required to treat SRS as an actual medical situation like Diabetes or Cancer? I mean if medicare covers it, certainly it is a reasonable treatment for the condition right?

I really hope that in the US the only things we will be going out of pocket for would be FFS and laser (even though tbh those are treatments to the condition too, so surely it should be as covered as HRT is, but that is a fight that I doubt would ever be won).

Its only time now. Things are moving slowly but they are moving.


Izzy

[Ginny]

I was so happy when I read this article on Yahoo.  However, what displeased me were all the negative comments, which made me so sad that other people can still be so ignorant. Some providers already provide SRS coverage, but I have a feeling that this will have other providers not already participating, revisiting their policies. A lot of people think that this is just being given to us free of charge, and I'm pretty sure thats not how insurance works. It would just be a 80/20 or other common percent just like other procedures. And its cheaper than other types of necessary surgeries.

Would love to have FFS and hair removal covered, but I do realize those are more "cosmetic" and a great many other people besides us would benefit from those, thus increasing the pool for liabilities.  For SRS I think you've pretty much shown that you are commited to your transformation as you've had to jump through so many other hoops.

~Jen

[Miss_Bungle1991]

I was so happy when I read this article on Yahoo.  However, what displeased me were all the negative comments, which made me so sad that other people can still be so ignorant. Some providers already provide SRS coverage, but I have a feeling that this will have other providers not already participating, revisiting their policies. A lot of people think that this is just being given to us free of charge, and I'm pretty sure thats not how insurance works. It would just be a 80/20 or other common percent just like other procedures. And its cheaper than other types of necessary surgeries.

The comments by the idiots on Yahoo are nothing compared to the other negative reactions that this has got on some of the more "far out" types of sites. There are people out there that believe that the "transgender agenda" is out to corrupt the children. That ->-bleeped-<- doesn't exist: It's actually a CIA/Mockingbird 'plot'. All types of whacked out stuff.

I'm sure the reality of it is that it's just your basic 80/20 stuff as far as insurance is concerned. But the wankers will always have their BS theories for what is what. People that exhibit that level of stupidity can't be reasoned with at all. 

[LordKAT]

There will still be very  few covered I think. Whatever excuse they want to make for denial will be used. It only says that you can now be considered for covereage, not that you will be. Nothing else is covered.

The title is misleading.

[Shana A]

Here's a fact sheet from National Center for Transgender Equality

http://transequality.org/PDFs/MedicareFactSheet.pdf

[Dee Marshall]

This may have no effect upon private insurance at all. Medicare/Medicaid covers quite a few treatments that nothing else does. That's why disabled people often end up with them instead of private. It's actually a bit disturbing as the current trend is to push people away from Medicare and into a managed care "equivalent". Many of my clients then find themselves with treatments that are not covered.

[Felix]

I don't want to overgeneralize medicare stuff to medicaid, but in most states there is some level of subcontracting. Even if a treatment is covered, the private corporation with the contract may not cover the treatment, or may require a lot of additional squeaky-wheeling to authorize payment.

And then, as I know I've complained about before, there are issues of prioritized lists and of finding doctors willing to be known as having provided hormones or surgeries. I've been asked too many times to keep it quiet that I was given healthcare.

This is important news and I look forward to seeing how it takes shape.

[LordKAT]

The FAQ's thing said it doesn't include medicaid. So if you aren't a senior citizen, forget it.