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Obama-care? I want hormones soon and sick of waiting :(

Started by FilaFord, June 16, 2014, 10:46:20 PM

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FilaFord

So I work for the US Post Office and after 90 days, I am eligible for health insurance.  However, it is not just 90 days from my start date.  It is 90 days of actual work and that makes it seem SOOOoOOooooo much longer!!

I started on April 7th, and it is now June 16th.  That is 80 days right there, but (I've been keeping track) I have only worked 48 days, so I am just a little over half of the way there.  It seems like torture to have to wait another couple of months before seeing an endocrinologist.

Anyone using Obamacare?  Got any good plans that you are using?  I mainly just want to start some AA treatment while I lose the last 30 pounds. 
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Hikari

Obamacare is simply a system of subsidies for those without employment offered insurance, and exchanges which are markets to buy said insurance.

Basically, if you were interested in what the exchange offered, you would have to purchase it without subsidies (since your employer does offer insurance) and then you would have to ask about specific plans in your state. All in all it seems like it would just be much easier to go to an informed consent clinic even without insurance because the difference between buying insurance on the exchange without a subsidy and getting it from your employer is going to be quite a bit of money, and certainly greater than the cost of hormones without insurance for a few months.
私は女の子 です!My Blog - Hikari's Transition Log http://www.susans.org/forums/index.php/board,377.0.html
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FilaFord

Quote from: Hikari on June 16, 2014, 10:53:40 PM
Obamacare is simply a system of subsidies for those without employment offered insurance, and exchanges which are markets to buy said insurance.

Basically, if you were interested in what the exchange offered, you would have to purchase it without subsidies (since your employer does offer insurance) and then you would have to ask about specific plans in your state. All in all it seems like it would just be much easier to go to an informed consent clinic even without insurance because the difference between buying insurance on the exchange without a subsidy and getting it from your employer is going to be quite a bit of money, and certainly greater than the cost of hormones without insurance for a few months.

Yeah that is what I was afraid of... I already did the DIY route for about a month or two and I just hated it.  I already have anxiety issues and the fact that I was trusting myself to self-medicate was working a number on my anxiety.  I want to do it the right way, but I'm already down almost 50 pounds since the beginning of the year, and I think I am close to the a weight that I can be comfortable with initially (5'9, 165, isnt too fat!) to begin an antiandrogen regimen. 

I'm not at the target yet, but I just want to get it going on now!  I told my parents, I'm telling my friends, and now I feel like it's time for me to make some changes.  I got everything else out of the way, so it is time to woman me up! lol

So I guess it's either hit the parents up for some cash to begin hormones now or just wait until I have the seniority at my job to qualify for health insurance!
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teeg

Employers are obligated to pay full-time employees health insurance on day one throughout their employment. Before I started at my job I had to complete a drug and blood work screening to confirm my eligibility for insurance. The coverage started when the results came back. I've never heard of having to work for a total of 90 work hours, especially with a government job.

Perhaps you're eligible to buy into their insurance plan after you've worked for 90 work days because you're not full-time? Obama care is such garbage legislation. This is why there's so many 32, 36, 38 hour/week jobs, all so employers can skip out of paying for insurance because anything below 40 hours/week isn't full-time.

Obama care was supposed to expand medicaid eligibility, yet in my state they removed half of the qualifications for medicaid because of Obama care. Accordingly, most hospitals offer something called "free-care" mainly for those who can't qualify for medicaid. The % of coverage from a hospital's free-care is depends on income... but if you're really desperate to start HRT, ask a psychologist if they're open to doing an eval (an eval is only a visit or two, not having to pay for visits every week to talk about what you already know) to confirm you're actually transgender and sending a letter of recommendation to an endocrinologist. Call an endocrinologist's office at the hospital you have free-care at and make an appointment. I'm unsure if prescriptions are covered under free-care plans, but hormones aren't all as expensive as people think unless transition isn't your top priority.
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FilaFord

Quote from: teeg on June 18, 2014, 03:52:57 PM
Employers are obligated to pay full-time employees health insurance on day one throughout their employment. Before I started at my job I had to complete a drug and blood work screening to confirm my eligibility for insurance. The coverage started when the results came back. I've never heard of having to work for a total of 90 work hours, especially with a government job.

Perhaps you're eligible to buy into their insurance plan after you've worked for 90 work days because you're not full-time? Obama care is such garbage legislation. This is why there's so many 32, 36, 38 hour/week jobs, all so employers can skip out of paying for insurance because anything below 40 hours/week isn't full-time.

Obama care was supposed to expand medicaid eligibility, yet in my state they removed half of the qualifications for medicaid because of Obama care. Accordingly, most hospitals offer something called "free-care" mainly for those who can't qualify for medicaid. The % of coverage from a hospital's free-care is depends on income...

Yeah, it was supposed to do a lot of things that havent manifested themsleves yet.  I work for the federal government (USA) and after 90 working days then I can buy into my union healthcare program.  I'm over half-way there and the rates are $65/paycheck so it's not a bad deal.  I'm just getting close to the weight I want to be at, and it seems like it is taking too long to get health benefits!


Quote from: teeg on June 18, 2014, 03:52:57 PM
... but if you're really desperate to start HRT, ask a psychologist if they're open to doing an eval (an eval is only a visit or two, not having to pay for visits every week to talk about what you already know) to confirm you're actually transgender and sending a letter of recommendation to an endocrinologist. Call an endocrinologist's office at the hospital you have free-care at and make an appointment. I'm unsure if prescriptions are covered under free-care plans, but hormones aren't all as expensive as people think unless transition isn't your top priority.

My therapist has already told me she would give me the letter, so it's not a concern over that, it's just that I want to have medical insurance first.  I don't know how much an endo visit will be.  As far as "free-care" goes, I am an American, so I don't have a flippin' clue what that means :(
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teeg

Quote from: FilaFord on June 18, 2014, 10:17:49 PM
Yeah, it was supposed to do a lot of things that havent manifested themsleves yet.  I work for the federal government (USA) and after 90 working days then I can buy into my union healthcare program.  I'm over half-way there and the rates are $65/paycheck so it's not a bad deal.  I'm just getting close to the weight I want to be at, and it seems like it is taking too long to get health benefits!
Again you should ask your superiors about this healthcare issue. The major point of Obama care was to require employers to give their full time employees healthcare and force people to have insurance one way or another. If you don't have health insurance you'll owe the government a fine for not being covered. I don't know about unions, but if you're working full time and don't have insurance then something is wrong. If you're not working full time then this is why you don't have insurance coverage yet. Are you working full time or not?

Quote from: FilaFord on June 18, 2014, 10:17:49 PM
My therapist has already told me she would give me the letter, so it's not a concern over that, it's just that I want to have medical insurance first.  I don't know how much an endo visit will be.  As far as "free-care" goes, I am an American, so I don't have a flippin' clue what that means :(
Without coverage my endo visits are around $100 I think. They'll want to do bloodwork which can quickly add up, $300+ for my last one without insurance.

"Free-care" programs are run by most hospitals to help the medical care costs of those who do not currently qualify for any kind of insurance. I had free-care for a while because I didn't have a job that could give me insurance, couldn't qualify for Medicare or qualify for Medicaid. Most states gutted their Medicaid fund to pay for the changes to Medicare Obama care implemented, so good luck meeting one of the qualifications for Medicaid if you go that route.
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LordKAT

Just an FYI

30 hours per week is considered full time.

http://www.irs.gov/pub/irs-drop/n-12-58.pdf

(The 30 hours per week average reflects the statutory
definition of full-time employee in § 4980H(c)(4) and is the
definition of "full-time employee" as used in this notice.)


also in regards to the wait time before offering benefits.

(2) for new employees who are reasonably expected to work full-time, an employer that maintains a group health
plan that meets certain requirements will not be subject to an assessable payment under § 4980H for failing to offer
coverage to the employee for the initial three months of employment;
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teeg

Quote from: LordKAT on June 18, 2014, 10:47:12 PM
Just an FYI

30 hours per week is considered full time.

http://www.irs.gov/pub/irs-drop/n-12-58.pdf

(The 30 hours per week average reflects the statutory
definition of full-time employee in § 4980H(c)(4) and is the
definition of "full-time employee" as used in this notice.)


also in regards to the wait time before offering benefits.

(2) for new employees who are reasonably expected to work full-time, an employer that maintains a group health
plan that meets certain requirements will not be subject to an assessable payment under § 4980H for failing to offer
coverage to the employee for the initial three months of employment;

Is 30 hours/week considered full time for most employers? No.

"an employer that maintains a group health plan that meets certain requirements will not be subject to an assessable payment for failing to offer
coverage to the employee for the initial three months of employment" This is describing tax exempt companies. Do most employers meet these "requirements"? No.
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LordKAT

The article isn't talking tax exempt employers but "large" employers or those who employ 50 people or more.
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FilaFord

Look, I'm not upset that my company isn't offering health benefits for 90 days.  I'm just venting because I wish that healthcare was not a concern of mine.  I'd love to live in a world that has the resources and manpower to offer standards of living suitable for the level of technology that we have discovered.  Unfortunately the "powers that be" want to focus all of those resources and manpower on destroying human life, not bettering it.
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teeg

Quote from: LordKAT on June 18, 2014, 11:38:26 PMThe article isn't talking tax exempt employers but "large" employers or those who employ 50 people or more.
Like I say all the time here it's easy to split hairs on fanciful outlooks in a support community, but the real world we live in is much different.

Quote from: FilaFord on June 18, 2014, 11:44:58 PMLook, I'm not upset that my company isn't offering health benefits for 90 days.  I'm just venting because I wish that healthcare was not a concern of mine.  I'd love to live in a world that has the resources and manpower to offer standards of living suitable for the level of technology that we have discovered.  Unfortunately the "powers that be" want to focus all of those resources and manpower on destroying human life, not bettering it.
The level of medical technology that we have costs what it costs for a reason. Try socialized medicine in Europe and see how that goes (cheers to all the NHS horror stories we get).
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FilaFord

Quote from: teeg on June 19, 2014, 12:00:23 AM
The level of medical technology that we have costs what it costs for a reason. Try socialized medicine in Europe and see how that goes (cheers to all the NHS horror stories we get).

Research and development costs money.  Manufacturing and distribution is cheap, ask the Chinese.

Greed overpowers decency, and I find that to be a fundamental flaw in society.  Altruism and love conquers all! *hippieflower*

I mean, I guess we needed to spread freedom, but what about green energy or curing disease?  I think $30,000,000,000,000.00+ could have been spent in a better way, but maybe that is just me... :-\  http://en.wikipedia.org/wiki/Financial_cost_of_the_Iraq_War

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Kaelin

Your figure probably has one too many zeros, but engaging in wars of choice (instead of performing in a police action against Bin Laden and anyone else we were after in al-Qaeda we felt we needed to get or take down) ranks as one of the least-productive uses of money.

The sense I get from country v/ country health care discussions is that the grass is always browner on the other side.  Every country has its health coverage/care horror stories, and I don't think anyone can make the argument that the US is the "best" unless we're ranking the amount spent per capita.  I get that UK and other developed countries have poor standards with treating transgender patients, but I'm not seeing any data or studies showing the US is the best with TGs or in general, so we probably have room to improve.
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KayXo

Coverage wise, things are pretty good here in Canada. SRS is covered, hormones to a certain degree or fully depending on your situation. Hormone care and treatment is not as good, in my opinion. Still quite conservative and relying on outdated information but slowly improving in some parts of the country.

I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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