Insurance issue

[Emileeeee]

I was under the impression that my insurance would cover trans-related healthcare based on some supporting documentation I found, which makes no mention of individual states of origin. Turns out it was just a general guideline provided that you actually have it in your policy and it's explicitly excluded from mine. So now I've been at this company for roughly 7 years and I'm in a situation where I have to consider leaving my job for coverage. Are there any other options? Is there maybe a way to turn down my company policy and get one from elsewhere that would cover it? Twenty grand out of pocket is a lot to muster up when you're the sole supporter of a family.

[Jenna Marie]

There's some back and forth, but a lot of ACA ("Obamacare") policies do cover trans care now. I signed up for one in CT with Blue Cross that does explicitly cover trans care up to and including surgery, at least if there's an appropriate diagnosis on file and all the hoops have been handled. (I was able to find this out before I signed up, too; the exclusions and everything were available online.) As I understand it, it *is* possible to opt for the ACA even when one's employer offers coverage; at least, I did that, as well. My policy is $700/month for two people, which isn't bad, and it's also not the cheapest they offered.

[Emileeeee]

Hmm I'll have another look. I did look at the ACA stuff for my area, but none of them seemed to cover it. Maybe I was missing something. $700/month though? It told me I didn't qualify for any discounts, but the most expensive one that came up was for $400/month for two people, which is comparable to what I have at work, but with twice the deductible.

[Jenna Marie]

The prices can vary pretty widely by state. Mine is a very expensive insurance state in general, unfortunately. (My employer's insurance is $1200/month for the two of us.) There have been some pretty recent changes in the ACA relating to trans care, too.

[JLT1]

Hi,

The general guide doesn't mean anything. Except that there may be other policies available with different levels of coverage.  You should check on that.

If there are no other policies, you can start making waves if you feel it's necessary.  Talk with your manager and hr.  Talk with your states insurance board.  They cannot out and out lie.  Something somewhere has to resemble what they say (or even don't say).

You may forward a copy to me of both if you like.

Hugs

Jen

[Emileeeee]

Okay I'll do some more digging tonight. The page I found, I found from a link from a trans site about insurances that covered it. I did a separate search and found the same link. I know Anthem California is what covers it and this page was for Anthem, but the page itself made no mention of any states. My company is headquartered in Fairfax, Virginia unfortunately, so it's Anthem Virginia. The policy itself sounds promising until I get to the exclusions at the bottom. About halfway down, as if to hide it in a spot where it would take me the longest to get to it, it specifically lists any and all transgender care as not being covered.