Health insurance?

[Shynoir]

I'll be upfront and honest. I have absolutely zero understanding of how legal and financial things work. I just recently begun crawling out of my little shell, so yes I'm pretty much clueless.

What is the advantage in having an health insurance versus paying out of your own pocket? I'm afraid don't really understand the concept of insurance policies, or perhaps I never tried to understand them. I safely ignored it's existence. However, right now I'm looking for a lot of backup options. Over a span of eight years I managed to earn just about enough to fund my transition (should therapies confirm I do that), recently though I was kind of pressured into buying a new house so that the money doesn't sit idly in my bank. My parents tell me that the house belongs to me and that I can sell or pledge it whenever a genuine need arises. However, they look so happy in this new house, and I really don't have the heart to take it away from them. It's really kind of difficult having no college degree or a regular job.

I could put a 110% into freelance work again for the next three years, but unlike in the past... there are just too much competition nowadays and the market is pretty much over saturated with many unemployed people jumping into the freelance world. Going through another 16 hour per day work schedule would be exhausting. I'm not sure I'll be lucky this time around, so I've been looking at alternative funding options and health insurance caught my attention. I've seen many mention here in the forums that "my insurance covers this," "my insurance cover HRT, SRS, and top surgery" etc... what exactly is this?

I do understand that insurance companies pool all the funds, but I'm not so sure how it all works. So here are my questions:

1) In simple terms what is a health insurance from your experience?

2) Does being under a insurance create a medical history that can be traced? does that mean the end of any possible stealth?

3) What are the limitations? does being tied to an insurance mean the element of choice of surgeons no longer exist to you?

4) Does paying out of pocket provide more freedom compared to a health insurance?

I'm not really sure if I asked everything I need to know, but yes this is all that's on my mind right now.

[K8]

I don't know where you live, Noir, but I live in the US.  I have health insurance through the government because I used to work for it.

Different insurance plans cover different things, at least here in the US.  All of my counseling was paid for.  Most of my prescription costs were paid for.  I did SRS out-of-pocket because I was afraid to disturb the beast (the nexus of the federal bureaucracy, the military, and the insurance companies).   Insurance would not cover hair removal.

Insurance can limit your choices – it depends on the plan.

I have no idea if stealth is even possible these days.  I have had to tell at least 8 government agencies that I was male and am now female.  I've also had to tell a couple of dozen companies with which I do business.  If someone wanted to look, I'm sure they would be able to dig it up although it would be easier to just ask me.  The court order declaring me female is, I believe, public record (meaning anyone can see it if they ask).

I believe that those in the UK can go private if they don't want to wait for NIH (the government system), put it costs.

I hope this helps at least a little.

- Kate

[Shang]

My insurance is through the military and it does record what you go through, but it doesn't leave the hospital and can't be seen by family members without your knowledge.  Your choice of surgeons might be limited to the insurance plan; I can only go to approved surgeons or doctors with my insurance, unless I want to pay extra.  I've never had to pay out of pocket so I don't know if that gives you more freedom.

[lilacwoman]

Here in UK we have the National health Srrvice that provides for all our medical needs - funded by $7 gas and $220 television licences - so lots of people don't bother much with insurance.  The NHS is doing all my srs.

But there are commercial health insurance schemes that people can pay into in addition or instead of the NHS so that any care they need will be done quickly and in small very nicely run clinics.

My boss finally went to doctor with a mole on back of her leg that had gone nasty and was shocked to learn it was pre-cancerous and rather than wait several weeks - perhaps up to maximum of 18 weeks to get treatment in a NHS hospital - she was able to get seen in just two weeks because her husband's job provides him with commercial health insurance that includes top doctors and surgeons at a new small clinic.  The treatmenta nd follow up she got was quicker than NHS but the actual standard of it was just as thorough and all proper tests etc were done but quicker than a big NHS hospital could do them.

If you think you will need some medical needs to transition you need to look around at health insurance schemes NOW and get paying into one NOW because the small print of them is that you have to be in for perhaps 6 months or more before you are allowed to make a claim.
But mainly you need to know which company will cover  transition and srs.

[Shynoir]

Kate, I'm currently residing in India. Any possible government health care is only for those who can't normally afford it. Different classes and whatnot it's all very silly. Being in a family that I am, there are no needs as far as the government is concerned. So my only choice (if it is one) lies with private health insurance companies. I don't know the specifics of these companies, but so far I have yet to find any that lists GDI, related medical, or even surgeries as their coverage. Limitations of choice are what I'm afraid of, because I'm pretty choicey when it comes to therapists, endo, and surgeries. It would be great if they even partially cover something. It will kind of reduce the financial blow, so to say.

Stealth is difficult to achieve but I'm kind of lucky for the most part. The only government issued ID I have is my Voter's ID (not that I vote) which I got as a prerequisite for getting a passport. No driver's license or anything for that matter. My schooling was pretty much private, and everything can indeed be changed. The birth certificate does pose a problem. I didn't wasn't a medical history to tell the world "hey, look she was not born a girl!" in big letters. I don't want to get trans-friendly treatment, but rather a good treatment for a nice young girl. If possible I don't want anymore than my GP and endo to know that. Well something to think about. Thanks.


Lukas, thanks for your response. As per your plan you can get those that are not approved if you pay extra? does that mean they will at least pay a partial amount towards your choice even if those are not approved? even if you choose a surgeon or treatment abroad? In my case I have made a list of ten therapists and five other non-gender specific ones. I will be doing them all, so its scattered all around the world. Same with the surgeries between U.S (FFS, SRS), UK (FFS, SRS), and Japan (If going for BA stemcell-lipotransfer).


lilac, if only this country had something like NHS. Considering how my father was required to pay 50%-60% of revenue in taxes in his time, it seems awfully unfair. The more I read about it, the more I feel like I want to move out of this country right away. >.<' That would be bad though, seeing as it will create even more IDs and documents that need to be changed later. *sigh* Yes, you got a good point of getting it started ahead of time. I've marked 24 years old as a turning point, and a decision time. If I do plan to rely on health care insurance, it does make sense I get started before the due time. Thanks.

[Cindy Stephens]

Have you looked at HealthinsuranceIndia.org?  Took me about 3 seconds to Google.  Looks like a pretty informative site.  Lots of info because HI is such a broad area.  May just have to spend some time drilling down to get the info you want.  Look for areas where you can ask questions, etc.  Hope this helps.  Note: I went back to site to make sure that copying the address would work, It does, and did a search of site using srs, and a few other items that didn't report any but "sex change" did.  Do your own investigation but I think it is similar to US in that it is a specific exclusion, at least from the first two examples it returned-there were a lot more that I didn't read, so maybe some companies don't exclude.

[Shynoir]

Thanks Cindy. 

Yes, I'm looking through that and several other sites as well. There are very few health insurances that support "sex change" and those that do don't seem too promising when I look through their financial reports. Several of them have a circulation of 100,000 INR ($2000) - 300,000 INR ($6000) premium per month, and their reports show that over 80-94% claims are made every month. From those stats I believe they may only cover inadequate sloppy $1000/$2000 SRS from within the country. Which isn't what I'm after. I may be dysphoriac, but I do respect myself (mind/brain) enough to actually use it and wait it out until a better option for care comes through.

So, yes. I'm trying to understand how they will logically manage to cover more expensive private care with that limited pool of funds each month. 

[Cindy Stephens]

I am an accountant myself.  I don't know about Indian accounting rules, though I suspect they are similar to the Brits -Chartered accountants.  BUT, Insurance has really weird accounting.  It is almost impossible to decipher unless you have experience in that specific industry.  In US Hospital insurance pay out runs 80-90%, but they figure it in strange ways.  I buy a large policy for the co. I work for and use 3rd parties to analyze each company's ability to survive.  I don't want the company going bust after one of the owners has had a really expensive operation or treatment!  I'm not pushing it, just giving a word of warning.