U.S. doctors will not take Medicare. UPDATE! I am in deep now!

[Allyda]

I'm in the process of scheduling my SRS now. Yes, I have found the one surgeon in Miami that will take my insurance (as long as I change my HMO to one he prefers). I was supposed to be having my SRS in December, but according to his staff(I forget Dr's name), it will be anywhere from 6 to 8 months from my first consult appointment before I'll have my surgery, February -April and that's if I get in to see them sometime this month. Problem is Miami is 5 hours away and at least $175 in fuel round trip plus the cost of a motel room overnight. My insurance will cover some of these expenses but I'm not sure how much.

So, while I'm still going ahead with Miami I am in fact looking for another surgeon to the east or north of me.

Ally

[JulieBlair]

Sorry to be late to the dance. It is good to be angry, better to take some action.  I have an appointment with Attorneys and staff from EEOC next Friday in Washington DC, guess what just got added to the agenda.  I'll let you know how it goes/what they say.  Jessica litigation takes time, are you willing to be a poster child in a class action? 
Remember...  Breathe....

Julie

[Allyda]

Part of the problem is that there are not enough SRS surgeons.  Apparently they can all pretty much demand cash and stay busy enough to keep them in Champagne and caviar land.

Not if those who have to pay decided to go out of country to Montreal or Taiwan. I know if it comes down to my having to sell my home and pay for my SRS I will in no way support these greedy Doctors here. I'll go out of country.

Ally

[Jessica Merriman]

Jessica litigation takes time, are you willing to be a poster child in a class action?

Julie if it helps out all my brothers and sisters here, YES. Someone always has to be the point person for change so maybe it is my time to step up and fight for us. Things or I may pass before I get what I need, but maybe others will not have the same problems because of what I do. I do understand the public exposure and what it could mean to me personally, but I am prepared to take that chance. 

[Shantel]

I know I sound jaded, but so many surgeons are such schmucks!

Several years ago I reopened a state Labor and Industries claim on a knee injury that had deteriorated to the point I was bone on bone. I was sent by a private GP to a highly recommended orthopedic specialist who ordered a MRI and upon discovering it was an L&I claim he told them that my knee was fine. L&I said that they were refusing to pay and I got stuck with the doctor's bill for 2 grand. I emailed the governor's office and that determination was reversed within a few days. The point is that these government agencies will only pay a smaller amount of the total bill and will not allow the surgeon to bill the patient any more than that paltry sum. This is why fewer and fewer really competent surgeons will operate outside of the private sector.

[Jess42]

I am so sorry you have to go through all of this. It really sux. I am a pay out of pocket patient because my deductible for the insurance I have is really high. Pretty much heart attack or stroke would be worth using it. I even had to pay for a surgery out of pocket because the deductible wouldn't even be met. 4500 dollars I think. Just got a letter that my insurance is going to go up about 70 dollars a month because I have to have, thanks to the Affordable Care Act, all kinds of coverage that pertain to cis women in the way of childbirth. But trans related coverage is nowhere to be found. No coverage for HRT or anything like that, especially SRS. Yeah, like I'm ever going to get pregnant. If it goes up again, I will just pay the fine every year. Heart attack, stroke or cancer? I will just camp out in the hospital parking lot until they have to take me away in a body bag or get arrested for loitering. Make bail and go back until I go to prison and then I can get treated. All for free. I though The Affordable Care Act was supposed to make insurance cheaper, not more expensive with all kinds of stuff I will never be able to take advantage of.

Yeah it's messed up and I think it's only gonna' get worse. Trans coverage, what a joke when no one will provide it unless you pay out of pocket. Political posturing. You hit that nail on the head for sure.

Just hang in there sis. I wonder if you could go get a loan at a bank for the surgery? If Kate is right and 20 grand, that's about the same price as a new car. But getting a loan you would have to have collateral, I'm sure. You could always tell the bank your getting a "new vehicle", you wouldn't have to tell them that "new vehicle" is you.

BTW. You deserve to be bitter, I think we all do because it sure seems like we are left out to dry more often than not.

[JulieBlair]

Jessica,
Me too sweetheart, the bastards will have to take us both on.  If that doesn't scare  them, they are not paying attention.  Also, it is nice to have staff at the EEOC as friends.  If it doesn't work, I have an Airstream, we can sell everything, and hang out in a silver pickle. 

Jess,
If we hang together and work together we can change this.  Politics are influenced by the passionate and the loud.  I'm both, so are you.

Julie

[Jess42]

Jessica,
Me to sweetheart, the bastards will have to take us both on.  If that doesn't scare  them, they are not paying attention.  Also, it is nice to have staff at the EEOC as friends.  If it doesn't work, I have an Airstream, we can sell everything, and hang out in a silver pickle. 

Jess,
If we hang together and work together we can change this.  Politics are influenced by the passionate and the loud.  I'm both, so are you.

Julie

Don't forget the crazy and insane, I fall into those two categories as well as the passionate and loud.

[JulieBlair]

Crazy and Insane is why I no longer drink or do drugs. 

[Jessica Merriman]

Politics are influenced by the passionate and the loud.  I'm both, so are you

Thank you for the first laugh in days! *giggle*  The bad thing is it's totally true. 

I am sending an E-mail to Mara Keisling the Executive Director of the National Center for Transgender Equality informing her of my intentions to pursue litigation against the Government. I will let you know what happens. It is a shame that super sweet Jessica is going to be seen in full B*TCH mode. I promise everyone here that I will be calm and professional and present a good front for us while still letting them know I mean business and this is serious. Wish me luck! 

[Shantel]

My spouse and I have used this when we had some elective surgeries done, they have several payment plans and will offer credit to practically anyone. It's a division of GE.

http://www.carecredit.com/

[JulieBlair]

You might want to wait till I bug the bureaucrats.   I have no idea why they like and seem to listen to me but they do.

[Jess42]

Crazy and Insane is why I no longer drink or do drugs. 

Uh, yeah. I am just naturally both. Drinking chills me out a little. Don't do the drugs part for a long long time.

Thank you for the first laugh in days! *giggle*  The bad thing is it's totally true. 

I am sending an E-mail to Mara Keisling the Executive Director of the National Center for Transgender Equality informing her of my intentions to pursue litigation against the Government. I will let you know what happens. It is a shame that super sweet Jessica is going to be seen in full B*TCH mode. I promise everyone here that I will be calm and professional and present a good front for us while still letting them know I mean business and this is serious. Wish me luck! 

What's that old saying about a woman scorned? Sounds like you're more than scorned, maybe a little POed to the max. Go get em. I always thought you were a little mean under all that sweetness.

[Jessica Merriman]

You might want to wait till I bug the bureaucrats.   

I appreciate that, but the only thing I see changing our situation is with high visibility. As you know I can be a little stubborn. I know, it is so hard to believe!  I feel a calling to do this and even if I don't succeed I will pave the way for others to build on whatever I can get accomplished. The Government has had far too many years without a fly in the ointment on this subject. I am going to call them out to see just how much political posturing this is. I believe we have enough votes to scare politicians in the next election and while they try to appear gracious and concerned about us. I think a little national exposure is just what we need right now. The next politician who desires the highest office in this land will need our votes and I want them to remember my name in their nightmares. I want them to actually provide us with services and treatment that we have a right to receive. Besides, all the public exposure I might just net a cute guy along the way! 

[Jill F]

I appreciate that, but the only thing I see changing our situation is with high visibility. As you know I can be a little stubborn. I know, it is so hard to believe!  I feel a calling to do this and even if I don't succeed I will pave the way for others to build on whatever I can get accomplished. The Government has had far too many years without a fly in the ointment on this subject. I am going to call them out to see just how much political posturing this is. I believe we have enough votes to scare politicians in the next election and while they try to appear gracious and concerned about us. I think a little national exposure is just what we need right now. The next politician who desires the highest office in this land will need our votes and I want them to remember my name in their nightmares. I want them to actually provide us with services and treatment that we have a right to receive. Besides, all the public exposure I might just net a cute guy along the way! 

Sadly, you don't get to the highest office in the land without belonging to one of the two major parties.  One party tends to pander to those who think we are abominations, the other just assumes they have our vote locked up and only has to give us lip service.  Both parties frankly make me want to vomit.  They're owned by the same corporations anyway.

Now I think I want some booze as well.  I already ate all my cookies.

[Jessica Merriman]

The parties can pander all they want to. I am a certified Public Information Officer and know how to work the media as well. I just got off the phone with an old contact with KFOR and he is interested in hearing more about this issue. That is a start because he could have said not interested. Just be there for me when the pissed off me suddenly realizes what she is starting.  I believe this will definitely kill any chance of stealth for me!  Is it too late to ask if I pass? *giggle* 

[Wynternight]

I work for a federal agency that has, as part of its mission statement, that it hires all, regardless of gender identity which I think is wonderful. The problem is that the major insurance we have here does not cover transition related stuffs, a point I brought up to our EEOC folks. I think I may to take it higher now, to the national level.

[Jessica Merriman]

OK everyone, Jessica has entered the deep end of the poo poo pool! This is a copy of my letter to Washington, D.C. The ball is rolling, but why do I suddenly sense a shorter life span? 

Mara Keisling
Executive Director
National Center for Transgender Equality
Washington, D.C.


Greetings Ms. Keisling,


My name is Jessica Merriman and we met recently at the Tulsa, Oklahoma support center. I have an issue an would appreciate any guidance you can offer. I do so appreciate your time and efforts so I will make it short.


I have officially been turned down for SRS by every Surgeon in the U.S. qualified to perform it. This procedure is necessary to my overall physical and mental health as determined by my Therapy team. The official reason given was none of them accept Medicare assignment. I have a documented medical condition recognized as real by the DSM (Gender Dysphoria). Medicare says I have a right to be treated for this condition and will accept claims for the surgery under the appropriate level I qualify for. At this point I consider the lifting of the trans care exclusions to be a political ploy with no benefit except to political powers seeking election. My question is do I have the power to pursue litigation against the surgeons for failing to provide necessary care as mandated by WPATH for a chronic condition or should I concentrate that energy towards fighting Medicare for allowing specialist's to turn down a patient based on insurance for a documented medical necessity? I do not want to be a poster girl for trans rights, but if it helps us as a whole I will accept the burden. I am a certified Public Information Officer and have multiple contacts with local affiliates who I can contact regarding media exposure. One has already been contacted and wants to know more about this issue. I am also a Global Moderator with the largest transgender support group on the internet so people will be following any progress or failure. I am not trying to make trouble for anyone, but we have been neglected for far too long and too many of us have died while false promises are made. I am getting older and my time is running out for a successful operation.


I hope I have not offended you with any of my comments. I am just in a position that does not allow time consuming delicacy.


Sincerely,

Jessica Merriman

[Shantel]

Who knows, you may become a heroine!  No I'm not talking about hard drugs honey! 

[Jessica Merriman]

Who knows, you may become a heroine!

Thanks Shan, but I am not close to being a heroine. I have more faults than the State of California. I am just trying to help myself and make it hopefully easier for others. I personally think the only thing this will do is make my life miserable being so exposed. After sending the E-mail to Washington I broke out in a cold sweat, but I will do what I have to.