Community Conversation => Transitioning => Topic started by: AnamethatstartswithE on February 16, 2018, 06:42:34 PM Return to Full Version
Title: A name that starts with E's insurance odyssey
Post by: AnamethatstartswithE on February 16, 2018, 06:42:34 PM
Post by: AnamethatstartswithE on February 16, 2018, 06:42:34 PM
So I started seeing a therapist who specializes in LGBT issues November of 2016. My insurance has always covered those visits. I started Hormones in August of 2017, and my insurance covered that. However in November when I did my 3 month checkup to get my hormone levels checked my insurance company denied my hormone level check. Then when I came back in January to get my levels checked again, they denied both the doctors visit and the hormone test.
The EOB on all three said "Condition not covered." I figured they must not be covering transgender related care, so now that open enrollment has been coming up at my job, I decided to ask HR if they could get a condition added. They sent me to their Anthem rep. I told her it was for Gender dysphoria, and sent her the EOB's and she said she would look into it.
Meanwhile, yesterday, the time had come for me to get my hormones refilled, so I dutifully texted refill to walgreens, before getting a weird error message that they couldn't refill my prescription. I thought, "my god, I said too much and they're cutting me off." Technically I can afford to pay out of pocket, but it would hurt, and that would just make it harder on anyone else coming after me. I could sue them, I could become an activist, they didn't know what kind of an enemy they were making in me, I'd show them...
Anyway, later that day I got a text that my prescription was refilled. Then today I got an email from the anthem rep that they had no idea why those claims were denied, and that it would be fixed within 5-7 days.
Never mind.
I guess the moral of the story is never ascribe to malice what can easily be explained by stupidity, and if you're going to fly off half cocked, at least be sure you're doing it for the right reasons. I think it's an important thing to remember.
TL;DR - I thought my health insurance was screwing me over, it turns out it was just a bunch of small errors at the same time.
The EOB on all three said "Condition not covered." I figured they must not be covering transgender related care, so now that open enrollment has been coming up at my job, I decided to ask HR if they could get a condition added. They sent me to their Anthem rep. I told her it was for Gender dysphoria, and sent her the EOB's and she said she would look into it.
Meanwhile, yesterday, the time had come for me to get my hormones refilled, so I dutifully texted refill to walgreens, before getting a weird error message that they couldn't refill my prescription. I thought, "my god, I said too much and they're cutting me off." Technically I can afford to pay out of pocket, but it would hurt, and that would just make it harder on anyone else coming after me. I could sue them, I could become an activist, they didn't know what kind of an enemy they were making in me, I'd show them...
Anyway, later that day I got a text that my prescription was refilled. Then today I got an email from the anthem rep that they had no idea why those claims were denied, and that it would be fixed within 5-7 days.
Never mind.
I guess the moral of the story is never ascribe to malice what can easily be explained by stupidity, and if you're going to fly off half cocked, at least be sure you're doing it for the right reasons. I think it's an important thing to remember.
TL;DR - I thought my health insurance was screwing me over, it turns out it was just a bunch of small errors at the same time.
Title: Re: A name that starts with E's insurance odyssey
Post by: Denise on February 17, 2018, 06:38:08 AM
Post by: Denise on February 17, 2018, 06:38:08 AM
Good lesson.
I have a few "rules that I love by." One has held true every time.
Hope for the best; plan for the worst. Reality will be somewhere in the middle.
I think your experience falls into the area of reality WAS the best.
Sent from my LG-H910 using Tapatalk
I have a few "rules that I love by." One has held true every time.
Hope for the best; plan for the worst. Reality will be somewhere in the middle.
I think your experience falls into the area of reality WAS the best.
Sent from my LG-H910 using Tapatalk