This is a letter I just received when I inquired about SRS being covered now that the trans care exclusions were lifted. It seems the lifting of the trans exclusion was just a political ploy and nothing will come of it. I have seen Medicare work when I had Gall Bladder removal surgery. The hospital billed Medicare and the patient was responsible for any shortage or deductible. This letter makes no sense except SRS Surgeons have gotten comfortable with private pay and the fees they charge is my only conclusion. For those of us dependent on Medicare it seems we are still second class citizens with no right to have the appropriate treatment for our condition. Yes, Medicare lifted the trans care exclusion, but if no one accepts it I consider it a public relations stunt. Some things never change. Looks like my dream is going to die. :( My comments in the letter are bold type :(
Hi Jessica:
The whole trans community is excited by Medicare lifting the ban on transgender surgery. Unfortunately, there are several issues that the trans community is either not aware of or doesn't understand completely.
When an insurance company says it is going to "cover" a procedure, it does not mean that it will pay the surgeon's fee in full. (This is true) It means it will pay some amount of money it has assigned to that specific procedure less any copay or deductible associated with the patient's policy. With insurance companies other than Medicare or Medicaid, a surgeon's office can pre-authorize a surgery. Medicare does not allow for pre-authorization of surgery (this is totally untrue. Medicare always pre authorizes surgical procedures). They require the surgeon to perform the surgery and submit for payment. They will review it and if approved, they will pay some amount of money. Medicare's reimbursement is extremely low, and if a surgeon accepts Medicare, he/she must accept what Medicare pays and cannot balance bill the patient (as can be done with other insurance companies)(Totally untrue as I had to make the difference up on my Gall Bladder surgery). So, it is quite possible that a surgeon accepting Medicare can perform a 4,5,6,7 or 8 hour surgery and either not get paid at all, or get paid only a minimal amount of money (total garbage).
We not accept Medicare or any other insurance. We do however "cooperate" with other insurers (Wait, you just said you do not accept Medicare or any other insurance). We cannot do that with Medicare (another untruth). Non participating surgeons cannot bill Medicare for their services, and patients who have procedures performed by non-participating surgeons cannot bill Medicare independently for the surgery (true as surgeons have to be approved to provide services).
I do not know of any surgeons, trained or experienced in gender identity surgery, who accept Medicare.
Wow, that's absolutely horrible... I really shudder to think when I have to go on medicare in 30+ years that I'll have to put up with the bureaucracy and pushback from doctors.
BTW, your new avatar looks good!
I am so sorry, this hurts, hugs.
I know a few girls were talking about it in group last week. They will be very hurt.
Sorry, I forgot to say this letter was from a very large and respected Eastern U.S. Surgery Center. Blonde moment or something. ::)
One of my clients is going to be very disappointed. I think I'll wait a bit to tell her, she hasn't even started HRT yet, do maybe things will shake out better before she gets serious about SRS.
Have to tread carefully with the young transgender mentally ill. I'm not entirely certain she's mentally I'll, though. Could be misdiagnosed GD.
Seems most qualified SRS docs won't even take insurance. My plan will theoretically cover it, but what good does that really do?
Quote from: Jill F on September 11, 2014, 08:45:37 PM
Seems most qualified SRS docs won't even take insurance.
That's what happens when people get into the medical field for the wrong reasons. Once they get used to private pay and have people who will pay it no matter how high the bill, why help us poor people out. It makes me so angry! I had to have two years education and clinical rotations to be a Paramedic. I was out in all types of weather, in hazardous situations constantly, exposed to G-D only knows what chemical and radiological, Shot at, run over, exposed to every pathogen in the world and never knew if I would go home at night. What was the starting salary then in a large metro area with a population of 575,600? $6.15 and hour! Yes, I got into medicine to help people, not become a millionaire several times over. Sorry, but I am so pissed off right now! >:(
This is not drama, but I will not survive long without SRS. It is simply a must for me. I have put my whole life on hold just waiting for it. I may seriously have to bankrupt myself to afford it, but I have to have it one way or another. :(
Welcome to the real world! I've never entertained the idea that any specialty surgery will ever be paid for on the taxpayer's dime, they are squirming under the standard load already. In their purview SRS and FFS and all the things we hold so necessary falls under the same heading as cosmetic. Most insurance policies don't even cover cosmetic surgeries unless you've put your face through the windshield of your car in an accident.
Quote from: Jessica Merriman on September 11, 2014, 08:53:46 PM
That's what happens when people get into the medical field for the wrong reasons. Once they get used to private pay and have people who will pay it no matter how high the bill, why help us poor people out. It makes me so angry! I had to have two years education and clinical rotations to be a Paramedic. I was out in all types of weather, in hazardous situations constantly, exposed to G-D only knows what chemical and radiological, Shot at, run over, exposed to every pathogen in the world and never knew if I would go home at night. What was the starting salary then in a large metro area with a population of 575,600? $6.15 and hour! Yes, I got into medicine to help people, not become a millionaire several times over. Sorry, but I am so pissed off right now! >:(
I think there's some people out there who seriously need a date with a Black and Decker Pecker Wrecker. >:-)
Hi Jessica. A few months ago I requested some information about GCS from the Univ of Michigan gender services group. I was told that they were swamped with requests from Medicare. Presumably that means that they take it. Might be worth an inquiry?
Kim :)
Quote from: Jessica Merriman on September 11, 2014, 08:53:46 PM
Yes, I got into medicine to help people, not become a millionaire several times over. Sorry, but I am so pissed off right now!
I can understand how you feel about the entire situation. It's really screwed up.
It was a public relations ploy, I read into the fine print and I hate how well known trans people (@skylarkeleven) are posting links without reading them.
Quote from: Laura Squirrel on September 11, 2014, 09:00:21 PM
I can understand how you feel about the entire situation. It's really screwed up.
Yup, I so agree. I was trying to save the world from Communism and came home to people who spit in my face and pissed on my pant leg, That't the way it is in the world we live in. Try to do the right thing and they bend you over a log!
Quote from: KimSails on September 11, 2014, 09:00:10 PMA few months ago I requested some information about GCS from the Univ of Michigan gender services group.
Unfortunately even if you have a letters from qualified medical providers per WPATH standards for SRS University of Michigan Gender Services makes you start from square one. You have to go through the entire process with them and their staff. Therapy, HRT, etc. I already tried. Thanks anyway! :)
I think it as so bad that Medicare now covers HRT and labs just to give you false hope of a happy future. Sorry this is turning more into a rant everyone. It was just my concern to get this info out to all who were hoping things would change. Massive depression is now setting in so I better go now. :'(
I Think the doctors will catch up but not many that do a what we call top rated surgeons I see will lag behind.
I think there will be more Doctors to do the surgery just will be that moment of lag.
With demand always come supply.
I am half way through a whole bag of Oreos. :'( :'( :'(
I used the Medicare formulary and had just enough to cover the co pay, airfare and hotel for 14 days anywhere in the U.S. Now it looks like I may as well donate to an animal shelter or something. I feel the dream is dead and I will be stuck with this cruddy birth defect forever now. :'(
well, I was one with their hopes up. just hope for a change in direction.
I've known a lot of medicare patients, and they tend to struggle almost as much as uninsured people do. Paperwork alone sometimes keeps things from happening quickly enough to matter, and like was said, providers are often unwilling or unable to fully treat people who pay that way. It can help to seek out places that offer indigent care and payment plans, as they are more used to getting what they can and providing whatever treatment is most necessary.
Quote from: Felix on September 11, 2014, 10:06:10 PM
It can help to seek out places that offer indigent care and payment plans, as they are more used to getting what they can and providing whatever treatment is most necessary.
I even tried that route, but the problem is none offer SRS. I literally went through the entire listings in the U.S in both gender surgery and plastic surgery, nothing. My fingers are worn out from all the phone calls and E-mails. I wish I had the guts to remove it myself and make emergency surgery mandatory to repair the damage. I have not gotten drunk in 4 years now. I believe tonight that record will fall. :'(
Quote from: Jessica Merriman on September 11, 2014, 10:12:37 PM
I even tried that route, but the problem is none offer SRS. I literally went through the entire listings in the U.S in both gender surgery and plastic surgery, nothing. My fingers are worn out from all the phone calls and E-mails. I wish I had the guts to remove it myself and make emergency surgery mandatory to repair the damage. I have not gotten drunk in 4 years now. I believe tonight that record will fall. :'(
Uh-uh you don't want to go there sweetheart, trust me on this! I'm here for you sis, we can talk and get through this!
Yeah, don't drink. That isn't going to help.
Drinking to excess never makes problems go away. It will just end up adding to the list of your problems.
If you drink, please make sure it's for the right reasons. Trust me on this one- hangovers SUCK.
Quote from: Jill F on September 11, 2014, 10:51:34 PM
Trust me on this one- hangovers SUCK.
I am sort of blessed. I have never had one no matter what. Might come in handy again. :'(
Big hugs, Jessica. Big hugs.
No booze Jessica! :police:
You are one determined lady - keep your hope up and keep trying sweetie. Don't go back to the old ways, you know that there is nothing for you there.
Jessica I'm so sad to hear of this trouble your having. As someone cleared for SRS who is having trouble with scheduling I fully understand where you are coming from, as I had the same problem just finding a surgeon that will take insurance. I even found two close to me but they told me this: "Sorry, we're just not set up to take insurance." So I sympathize wholly. I do know that the Transgender Center in Miami does take both medicare and medicaid tho. Might want to try them. It's a 6-8 month waiting period tho from your first appointment which is why I am again looking for another surgeon.
Sincerely I know I won't survive another year without SRS. And just making it that long will be a struggle. It's a matter of life and death for me. I just can't go on living with what's down there too much longer. I'm praying every night I find another surgeon soon. For I know what awaits me if I don't.
Tomorrow will be sent scouring the web and on the phone. And of course I'll bookmark this thread and keep y'all informed if I find another surgeon.
Jess all my hopes hun.
Huggles :icon_hug:
Ally :icon_flower:
Even the VA is in on the sham as well. You'd think that after being shot and almost getting killed by IEDs for your country they'd at least make you whole. But all they offer is hormone care at the moment, IIRC. No SRS or other surgery.
What I find disheartening is we have 2 GCS doctors that are trans* there selves.
They should know how hard it is for trans* to get the surgery, just to turn there backs on the community.
How's that for all there talk about equality over the years.
It's so bad that money again is over someone's happiness.
Quote from: mrs izzy on September 12, 2014, 07:41:33 AM
What I find disheartening is we have 2 GCS doctors that are trans* there selves.
They should know how hard it is for trans* to get the surgery, just to turn there backs on the community.
How's that for all there talk about equality over the years.
It's so bad that money again is over someone's happiness.
In all fairness though, insurance companies (including the Government) are terrible when it comes to payment for services.
They will negotiate down your rate plus they take forever to pay. With regular doctors I can't begin to tell you how many times I've been sent collection letters because the doctors couldn't get insurance to pay. I had to run around and get everything done before they paid. And this is not some fly by night insurance either, it's supposedly a "cadillac" plan offered to local Government employees. The only one that I get no trouble with is the prescription plan. Most are $0 copay or $5 copay. However when I was prescribed diabetes meds they told me they don't cover that. The primary health insurance does through mail order. At that point I just said "screw it" and decided to manage my diabetes with diet and exercise which has worked out extremely well (even my doctor is amazed, but he is a pill pusher).
They also didn't cover fertility treatment until they tested me and found out I was part of the reason. Even so they only covered two cycles of IVF and even then they did only cover the cheap stuff, which was the monitoring and drugs. It took us 6 to conceive.
Wow... just ...
Wow ...
I don't even plan to have SRS done ... and I still find this incredibly depressing, and strangely distressing even though it doesn't affect me. It troubles me that the medical industry and politicians don't seem to get that trans people have a high suicide rate for a reason. In my mind, we may be the ones pulling the trigger so to speak ... but I feel society is responsible for putting the gun in our hands.
One thing I've noticed since starting transitioning is that our biggest problem isn't really being transgender. It's society as a whole. Everything from pressure to conform from those immediately around us, to those who would gladly murder us with their own hands, to politicians who use us to drum up support for their party but don't actually do anything to help us, as well as those who go out of their way to make our lives even more difficult, to medical treatment to...
I don't like to blame others for problems I face ... but I'm really starting to feel like nearly our entire society from the top down is killing us, and most simply don't care. A few would even be happy knowing this.
Jessica, we don't talk much, but I find your presence on the boards here to be extremely supportive, and you're often a voice of optimism when people need it most. You're extremely sweet, and beautiful on top of that! If you ever need someone to talk to, please add my name to the list of others who like you and look up to you and wouldn't mind if you need someone to say whatever you want to.
Quote from: Amy The Bookworm on September 12, 2014, 09:13:53 AM
Jessica, we don't talk much, but I find your presence on the boards here to be extremely supportive, and you're often a voice of optimism when people need it most. You're extremely sweet, and beautiful on top of that! If you ever need someone to talk to, please add my name to the list of others who like you and look up to you and wouldn't mind if you need someone to say whatever you want to.
Seconded!
Not to be that stick in the mud.
Just was thinking as i do and sometimes it gets me in trouble.
How much of the current changes in gender id rules are a direct effect of the lack of doctors who will perform the GCS under medicare, medicaid? Kinda like a placebo jester.
Ok back in my corner.
I apologize for being so bitter about this everyone. Just imagine though the following hypothetical and tell me how long the public would put up with this.
As a Paramedic I respond to a Myocardial Infarction a legally recognized medical condition like Gender Dysphoria. Upon arrival I confirm they are having a heart attack by signs, symptoms and cardiac strip. I tell them that the I.V. line will be $20,000 an is not covered by Medicare or any insurance and payment must be made before treatment. Furthermore if you want Sublingual Nitro and Lidocaine you will have to have two letters from a Therapist and live one year as a normal healthy patient. Think the public would stand for this? I know this sounds extreme, but this is what they are telling us now. >:(
Quote from: Jessica Merriman on September 12, 2014, 03:18:08 PM
I apologize for being so bitter about this everyone. Just imagine though the following hypothetical and tell me how long the public would put up with this.
As a Paramedic I respond to a Myocardial Infarction a legally recognized medical condition like Gender Dysphoria. Upon arrival I confirm they are having a heart attack by signs, symptoms and cardiac strip. I tell them that the I.V. line will be $20,000 an is not covered by Medicare or any insurance and payment must be made before treatment. Furthermore if you want Sublingual Nitro and Lidocaine you will have to have two letters from a Therapist and live one year as a normal healthy patient. Think the public would stand for this? I know this sounds extreme, but this is what they are telling us now. >:(
Well, I certainly understand what you mean. I think that a lot of people feel the same way that you do. Plus, the fact that you work as a Paramedic, you see a lot of things that other people never will. That speaks volumes in my eyes as far as your viewpoint is concerned versus, say, someone who would have an opposite viewpoint, but had never worked in any sort of medical field whatsoever.
A big part of the problem is that the general (cis) public sees SRS as an optional cosmetic procedure. They don't realize the anguish that we go through and that 40% of us kill ourselves instead of foregoing the "cosmetic procedure."
The VA's attitude is also disgusting. They say they don't cover SRS because most trans don't get it. Well at 20k a surgery, duh!
I am thinking of doing something big. I am going to write and call Medicare and tell them since I have a legally recognized medical issue that I demand treatment and will pay any co pays or I will contact a legal center and file a Federal lawsuit against Medicare and every SRS surgeon as well for not providing and me adequate care for my condition. Too off the wall?? ??? I am seriously pissed off! >:(
I also think that part of the problem is that the general (misinformed) public thinks that a "sex change operation" is something you can just get pretty much anywhere, much like a nose job. I don't think that people realize that it is an incredibly specialized procedure and that there are only a handful of surgeons in the world, let alone the US that are qualified to do this.
Most people think it's just "hack off your wiener" and *BAM*.
Quote from: Jessica Merriman on September 12, 2014, 03:58:42 PM
I am thinking of doing something big. I am going to write and call Medicare and tell them since I have a legally recognized medical issue that I demand treatment and will pay any co pays or I will contact a legal center and file a Federal lawsuit against Medicare and every SRS surgeon as well for not providing and me adequate care for my condition. Too off the wall?? ??? I am seriously pissed off! >:(
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.
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 :icon_flower:
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
Quote from: Jill F on September 12, 2014, 04:01:22 PM
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 :icon_flower:
Quote from: JulieBlair on September 12, 2014, 04:06:40 PM
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. :)
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.
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. :o 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.
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
Quote from: JulieBlair on September 12, 2014, 04:20:00 PM
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. ;D
Crazy and Insane is why I no longer drink or do drugs. >:-)
Quote from: JulieBlair on September 12, 2014, 04:20:00 PM
Politics are influenced by the passionate and the loud. I'm both, so are you
Thank you for the first laugh in days! *giggle* ;D 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! :)
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/
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.
Quote from: JulieBlair on September 12, 2014, 04:33:43 PM
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. ;)
Quote from: Jessica Merriman on September 12, 2014, 04:35:54 PM
Thank you for the first laugh in days! *giggle* ;D 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. ;)
Quote from: JulieBlair on September 12, 2014, 04:42:41 PM
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! ;D 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! :laugh:
Quote from: Jessica Merriman on September 12, 2014, 04:51:47 PM
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! ;D 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! :laugh:
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.
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. :icon_yikes: I believe this will definitely kill any chance of stealth for me! ;D Is it too late to ask if I pass? *giggle* :laugh:
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.
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? :o
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
Who knows, you may become a heroine! :icon_bunch: No I'm not talking about hard drugs honey! :D
Quote from: Shantel on September 12, 2014, 06:11:50 PM
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.
Good girl!!
Trans*rights are Human rights. Nothing more nothing less.
Ok if I forward this to the ERIC legal group? Nicely put, but if you are not trying to make trouble? Nah, you are and I am grateful.
Quote from: JulieBlair on September 12, 2014, 06:19:47 PM
Ok if I forward this to the ERIC legal group? Nicely put, but if you are not trying to make trouble? Nah, you are and I am grateful.
Of course you can Julie. I am in this for the long haul and accept whatever fate is in store for me.
I really don't want to cause trouble, but on the other hand I want them to know I am committed and deadly serious about this. I just hope our community understands this is about me and my personal feelings and beliefs and I know I probably do not speak for them all. If what I do helps us as a whole I am good with that. If this backfires I hope it does not affect others negatively and no one blames me for further problems that they do not need. I think I am more scared of failing everyone here and in the community more than how it will impact me personally.
@Jessica: I don't know about anyone else here, but I'd be honored to have you as our poster girl! Hopefully your letter which is very awesome by the way, will reach the right people and bear fruit. You coud never fail us hun. I'm sure everyone here sincerely appreciates your efforts. I know I do very much so.
@Jess42: Yea I'm thinking about having a few myself. I got a bottle of Jack the seal has never been broken on calling my name, lol!
@Julie@: You are a godsend and all of us are lucky to have you here with us.
My calls earlier today to Orlando and other cities closer to me were all a waste of time. I found two other surgeons that perform SRS, but they too like the one in Tampa won't accept insurance of any kind for the surgery. The Hospital closest to me and where I'd rather have my SRS done is Shans University Medical Center in Gainesville(UCF) does accept both medicare and medicaid however their surgeon who does the SRS retired last March, and I was told they have no plans to replace him. I myself plan to keep looking tho while I make arrangements for Miami.
All my hopes everyone something gets done about this. Jess if there is anything I can do to help just let me know.
Ally :icon_flower:
Quote from: Allyda on September 12, 2014, 06:56:32 PM
Jess if there is anything I can do to help just let me know.
Maybe hide me for a while until the group with torches and pitchforks passes by! ;D
Suddenly I feel like a donut at a Weight Watchers meeting. :icon_yikes:
Quote from: Jessica Merriman on September 12, 2014, 06:59:32 PM
Quote from: Allyda on September 12, 2014, 06:56:32 PM
Jess if there is anything I can do to help just let me know.
Maybe hide me for a while until the group with torches and pitchforks passes by! ;D
Suddenly I feel like a donut at a Weight Watchers meeting. :icon_yikes:
Hee Heee, wait for the hate mail, I use it, proudly, as wall paper
Quote from: Cindy on September 12, 2014, 07:06:42 PM
Maybe hide me for a while until the group with torches and pitchforks passes by! ;D
Suddenly I feel like a donut at a Weight Watchers meeting. :icon_yikes:
Hee Heee, wait for the hate mail, I use it, proudly, as wall paper
Good thing then as I have wondered what color to paint the living room. I was going with pink, but hate is an interesting color with a lot of options! ;D
Quote from: Jessica Merriman on September 12, 2014, 07:08:29 PM
Good thing then as I have wondered what color to paint the living room. I was going with pink, but hate is an interesting color with a lot of options! ;D
Lol, nah stick with the pink. Save the hate for the beurocrats! :icon_censored:
Ally :icon_flower:
First of all, I haven't been on for a few days and your avator is awesome. Your letter and your willingness to fight for what is right is also fantastic. I believe you will find a way. you have the determination and that makes a huge difference.
I have found a top surgeon (not well known but he does good work) who will help with insurance. So, basically he doesn't bill insurance directly and wants me to pay out of pocket but then he will help me with all the documentation I need for insurance. This is the best work around I've found for myself. So, I'll pay using customer care and then repay that when insurance pays me.
He is an "out-of-network" provider but since there aren't any top surgeons within the state who take insurance, treat him like he is a preferred provider. I have to fill out a form to request this, but they stated in writing this is their policy. So, that's my adventure with this issue so far.
Jessica, so sorry for your trouble.
You know, I just read this thread, and seeing it evolve from your original post to its present state, gosh, the only thing missing for me was the heroic musical score building in the background. I am proud of you all! Way to pull together kids!
Oh, btw, love the new pic!
For spending about 18% of its GDP on health and health care, one would think the US would have more to show for it.
Keep up the good fight.
Quote from: Wynternight on September 12, 2014, 05:35:55 PM
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.
When I was planning for HRT I contacted, (and outted myself to,) the human resources director at the private mental health agency I work for. She assured me that I would be treated with respect, but she did not know, and could not find out, what, if anything, would be covered.
After my first endo appointment I checked with my insurance and everything to date, including E and spiro has been covered. Of course, I contacted her again to bring her up to date. She asked me for a meeting which we had last Tuesday morning. We discussed what it means to be trans*, what my medical needs were likely to be in the immediate and near (2 years) future and she promised to keep that in mind while picking next years health plan. She also offered to host a meeting with the management team when I feel comfortable coming out to them.
I'm the only admitted transperson in my agency. Statistically I'm likely to stay that way, at least until our brothers and sisters see how I'm treated. It's hard, tiring work, but rewarding. If anyone feels qualified to work in Mental Health Rehabilitation and lives in lower NY state I would be happy to tell you my employer in a PM.
I'm feeling well cared for, but the insurance for SRS issue is still weighing on my mind. Cudos to Jessica.
Quote from: Allyda on September 12, 2014, 06:56:32 PM
@Jess42: Yea I'm thinking about having a few myself. I got a bottle of Jack the seal has never been broken on calling my name, lol!
I have a gallon but the dude that made it, his name wasn't Jack. this is a lot better and way smoother than Jack. Got it last time I was home. ;)
As for hiding out from the pitchfork crowd Jessica. I know some caves in northern Arkansas that even the CIA couldn't find you there. I don't think you have to much to worry about. Goa ahead girl and stir the pot up, I have your back and many other do to. Sometimes it takes someone like you or anyone that can shine some light on how things really are. Politics are funny and why I really hate it is because they really could care less about anything other than getting or staying in their position. Double talk for sure. :-\
Hi everyone! I am currently flooding the inboxes of my representatives in Washington. I will post a sample here when I am done.
PS-The former church camp director was not all that supportive. Hmmm? ;D
My letter to Congress and Government!!
Greeting honorable ______________,
My name is Jessica Lauren Merriman. I am a former Emergency Services Specialist for 28 years until an injury in the line of duty forced me into retirement. I served with honor and dignity and was highly decorated for my actions. I also belong to a unique segment of society as I am transgender. After fighting a terrible and debilitating medical issue recognized by the medical profession I have begun to transition from male to female. Whether you personally believe we should have rights or access to proper medical care is of course your private decision whether it is religious or personal and I respect that. I do feel like the hundreds of thousands of us deserve to be heard though in this democratic nation.
I would like to bring to your attention something your opponents in the next election will trumpet and use to sway a particular group of voters. That is the lifting of the transgender care exclusions by Medicare. Upon review of this supposed lift nothing contained within supports the proper care people with Gender Dysphoria suffer with. It is a toothless and powerless gesture. I say this because the Specialist's we need to utilize to correct our issue's will not accept it at all. I personally have been turned down by every single Surgeon with the skill and experience to provide myself and others with Genital Reconstructive Surgery or GRS that they need to feel complete and normal. To not feel right in your own skin is a terrible burden to carry and causes other stress and anxiety producing medical issue's. For some it is too much and our community has a 41% suicide rate. In any other group of individuals with this high rate there would be protest's, high profile and the call for action. Sadly that is not the case with our community. All we get are promises and token gestures like the one above.
We will no longer allow this type of action or fake gestures and with the increased publicity our community receives the pressure on members of Government will get worse every day. It is my desire with this communication to open a dialog with you so we can make progress and heal those who suffer greatly every single day. It is my hope you will find support for our medical care even if they conflict with your personal views of the transgender community. All of us in this great nation should make sure that no one group or person goes without fundamental medical care or is relegated to second class status. I want to work with you on a resolution to ensure we have access to medical procedures and Specialist's who will work with us for common decency, not inflated profits while leaving those less fortunate out of the loop. Everyone you and me included should have access to what we need when we need it even if the diagnosis is not considered main stream or different.
This example is extreme, but it is what transgender people face every single day with regard to transgender care and the process it involves.
As a Paramedic I respond to a call for chest pain. Upon arrival I determine by signs and symptoms and cardiac strip that the patient is indeed suffering a Myocardial Infarction (heart attack). I tell the patient before treating him or her that before I start you have to pay $20,000 (average price for GRS) for the Intravenous Line before it is performed. If you pay for the I.V. line before I can give you sublingual Nitroglycerine, Lidocaine and Morphine you have to have two letters from different Therapist's and live one year as a healthy person to make sure you can handle living a healthy life. How long would I last as a Paramedic and how big would the lawsuit be against me and the Emergency Medical Service I work for? Though extreme this is just what our process entails.
According to World Professional Association for Transgender Health this above example is what we deal with. First we have to see a Therapist preferably with gender experience. It will take between 3 months and one year for us to receive a mandatory letter to begin Hormone Replacement Therapy. Names are changed and filed with the respective courts and Government agencies and is costly. Then if GRS is warranted we have to live one year as our target gender and then produce two letters for approval for Genital reassignment. In between some do hair removal (lengthy and very costly), Facial Feminization surgery (very expensive), Voice Surgery (very expensive) and other personal surgical decisions such as Breast Enhancement or removal. None of what I mentioned is covered by the Medicare Transgender Care Exclusion. All we are asking and demanding is the same access to care and medical procedures just like people do for any other medical condition. We do not go through this procedure for entertainment or a fetish, but a certified medical condition. The biggest goal of transgender people is simply to blend in and live. We pay bills, work and have lives just like a majority of the population. We try not to get bitter at the lack of action regarding our care, but that is slowly fading away. Time should have by now accepted us and allowed us a way to exist without constant neglect.
I look forward to contact with you and will provide any information you need to assist our community. Thank you for your time.
Sincerely,
Jessica Lauren Merriman
Nice one. Now get your bags packed for your stay in Alcatraz :laugh:
:eusa_clap:
Quote from: Cindy on September 13, 2014, 02:47:40 PM
Nice one. Now get your bags packed for your stay in Alcatraz :laugh:
:icon_yikes: :icon_yikes: :icon_yikes: :icon_yikes: :icon_yikes:
Seriously? I thought it was a nice tone down from the B*TCH a few days ago. ???
Quote from: Jessica Merriman on September 13, 2014, 02:52:13 PM
Quote from: Cindy on September 13, 2014, 02:47:40 PM
Nice one. Now get your bags packed for your stay in Alcatraz :laugh:
:icon_yikes: :icon_yikes: :icon_yikes: :icon_yikes: :icon_yikes:
Seriously? I thought it was a nice tone down from the B*TCH a few days ago. ???
It is, I thought it was great. In my experience with Politicians, keep hammering at them and present a united front, votes are all they care about, so publicity and awareness can be keys.
I plan to send the letter by E-mail and post every day until I am satisfied.
G-D help them!! ;D
Quote from: Jessica Merriman on September 13, 2014, 03:10:30 PM
I plan to send the letter by E-mail and post every day until I am satisfied.
G-D help them!! ;D
Right on!
you go girl. that's the only way I can get GRS.
Quote from: stephaniec on September 13, 2014, 03:46:56 PM
you go girl. that's the only way I can get GRS.
They will want to pay for them out of their own pockets before I am through with them! Hang in there Sis! ;D
Quote from: Jessica Merriman on September 13, 2014, 04:18:26 PM
They will want to pay for them out of their own pockets before I am through with them! Hang in there Sis! ;D
Jess, I am floored. Your letter is so very well written it has to get some attention for us. I thank you so much for all that you are doing to help all of us have better medical care and have the procedures we so desperately need. Very very well done Sis!
And on a lighter note: You know your always welcome to come down and hide out here as long as you want. I have an empty spare bedroom and you my friend are most certainly welcome! I just hope your not allergic to kitty's!
All my hopes!
Ally :icon_flower:
Quote from: Allyda on September 13, 2014, 04:56:34 PM
[I just hope your not allergic to kitty's!
I have 14 so not a problem. Maybe if I start mailing cat's to Washington I will get a faster response! ;D ;D
Here's my opinion and please don't take this as a slam on what is otherwise a very fine effort. I can offer some advice based on my experience at the state and federal level.
From my experience, politicians do not read long letters like these. The staffers go through them and the congressperson gets a summary, if that. It will be basically x person in y district supports or opposes this issue. They like short and sweet. They basically have the attention span of goldfish.
If we want real results we need to mobilize and flood them with these letters from as many people as possible. Also email is nice but faxes I think are the best OR hand delivering them with either the help of a lobbyist of ourselves.
I'm involved in a few causes and even worked with paid lobbyists and I've seen how it works. Hope this helps.
Well written though!
Quote from: ImagineKate on September 13, 2014, 05:11:33 PM
From my experience, politicians do not read long letters like these. The staffers go through them and the congressperson gets a summary, if that. It will be basically x person in y district supports or opposes this issue. They like short and sweet. They basically have the attention span of goldfish.
This rings true in my own experience and gives credence to the idea that government by representation is a completely failed American experiment. The only thing that will make any impact whatsoever is to have term limits for congress people. That being said, it would be a cold day in hell before that would ever happen because those same people would have to approve it. This is what happens when citizens abdicate and delegate their interests to others.
Go Seahawks, get me another beer honey and a bag of cheetos will ya?
We can always pool our resources, buy a large island, and all move there then sit back and watch as the Government spirals this country out of control down the crapper.
I just had a thought, an all trans country. Hmmmmmmn! Then if the rest of the world destroys themselves we'd be the only survivors. ;D
Ally :icon_flower:
Quote from: Allyda on September 13, 2014, 06:55:18 PM
We can always pool our resources, buy a large island, and all move there then sit back and watch as the Government spirals this country out of control down the crapper.
I just had a thought, an all trans country. Hmmmmmmn! Then if the rest of the world destroys themselves we'd be the only survivors. ;D
Ally :icon_flower:
Don't be giving them any ideas about shipping us all off to some island somewhere like a leper colony...
Quote from: Allyda on September 13, 2014, 06:55:18 PM
We can always pool our resources, buy a large island, and all move there then sit back and watch as the Government spirals this country out of control down the crapper.
I just had a thought, an all trans country. Hmmmmmmn! Then if the rest of the world destroys themselves we'd be the only survivors. ;D
Ally :icon_flower:
That sounds like a really good idea Ally. I'd rather live among normal people anyways. ;)
Quote from: Jaime R D on September 13, 2014, 07:12:45 PM
Don't be giving them any ideas about shipping us all off to some island somewhere like a leper colony...
Is it really that bad of an idea, really? Island living, good normal people that are probably way smarter than the general population anyway? I'll buy the first round of Pina Coladas.
I never figured out why Tom Hanks wanted off that island in "Castaway"? The only time I would want off is during Payless shoe BOGO sale!! ;D
Jessica,
Marcie Bowers has said that she will take/work with Medicare. Did she turn you away?
Quote from: Brett on September 14, 2014, 12:16:05 AM
Jessica,
Marcie Bowers has said that she will take/work with Medicare. Did she turn you away?
I got an e-mail saying no. I will try again. Thank you. :)
Quote from: Jessica Merriman on September 14, 2014, 12:18:36 AM
I got an e-mail saying no. I will try again. Thank you. :)
Wow. Good to know. Sorry to hear that. Hang in there. I read your letter and think it is excellent. Keep fighting the good fight!
Question i have with Marci is she is a OB/GYN. Does she not take medicare patients in her practice?
Would that be ethical to pick and choose?
Just saying.
Quote from: Jessica Merriman on September 12, 2014, 06:41:30 PM
Of course you can Julie. I am in this for the long haul and accept whatever fate is in store for me.
I really don't want to cause trouble, but on the other hand I want them to know I am committed and deadly serious about this. I just hope our community understands this is about me and my personal feelings and beliefs and I know I probably do not speak for them all. If what I do helps us as a whole I am good with that. If this backfires I hope it does not affect others negatively and no one blames me for further problems that they do not need. I think I am more scared of failing everyone here and in the community more than how it will impact me personally.
If at first you don't succeed, try try again. ;) I don't think anyone would fault you or nothing if you failed and if they do, ignore them as much as possible, they're just dealing wit their own Dysphoria and may not mean what they say and if they do mean it, well, that's pretty terrible of them if you ask me. The more of us that step up and fight, the better.
Some doctors will only accept a few medicaid patients because they have to make up the difference with paying patients. Once they have met their limit, they will not take any new ones until one leaves.
Medicaid makes a small payment and the patient cannot be billed for more. Medicare may be different on that, I haven't looked into it as much. I do know they suggest supplementary insurance for all medicare patients.
Quote from: mrs izzy on September 14, 2014, 12:35:15 AM
Question i have with Marci is she is a OB/GYN. Does she not take medicare patients in her practice?
Would that be ethical to pick and choose?
Just saying.
She is an OB/GYN and was obstetrics department head at Swedish Hospital in Seattle many years ago and prior to her own transition. Not long ago she teamed up with Jane Fonda who had asked her to offer reparative surgery to Islamic women who had suffered genital mutilation. I don't know about medicare.
I think an effective strategy would be to find a representative who is sympathetic to the cause and catch their ear. It would be especially good if they're up for re-election and their constituents favor your position. They don't have to even be in your district or state, but it would be better if they were.
In this case you want to talk to those who are sympathetic to LGBT as well as those who may be supportive of healthcare reform. Also not everyone sympathetic to LGBT would care about trans issues as much as they care about, say, same sex marriage, but it's worth a shot.
The President would also be a good person to contact because healthcare reform is his baby.
Quote from: Shantel on September 13, 2014, 05:59:26 PM
This rings true in my own experience and gives credence to the idea that government by representation is a completely failed American experiment. The only thing that will make any impact whatsoever is to have term limits for congress people. That being said, it would be a cold day in hell before that would ever happen because those same people would have to approve it. This is what happens when citizens abdicate and delegate their interests to others.
Go Seahawks, get me another beer honey and a bag of cheetos will ya?
They let the interns go through them. If you were ever a Congressional intern, a lot of what you'll be doing is reading correspondence from constituents.
I once wrote my rep about issues related to the DTV transition. I heard nothing back until a couple months before the election. An intern called me and said, "rest assured rep XXXXX supports digital TV." I asked other questions and basically the intern said, "I will let representative XXXXX know." totally missing the point.
Quote from: ImagineKate on September 14, 2014, 10:34:31 AM
They let the interns go through them. If you were ever a Congressional intern, a lot of what you'll be doing is reading correspondence from constituents.
I once wrote my rep about issues related to the DTV transition. I heard nothing back until a couple months before the election. An intern called me and said, "rest assured rep XXXXX supports digital TV." I asked other questions and basically the intern said, "I will let representative XXXXX know." totally missing the point.
I used to write my Senators and Representatives only to get a mass produced form letter in reply which made it abundantly clear to me that my letter went into the round file after being screened by one of many interns who then dutifully sent the standard reply. I know they get reams of mail each day from their constituents and would hardly be able to answer any of it personally, but this makes it clear how people become so jaded and indifferent to the process because they know it doesn't work and that they don't count.
Jessica,
I just sent your letter to the lawyers and staff I know and will see next week at EEOC in DC. It is on the agenda.
Julie
Quote from: JulieBlair on September 14, 2014, 11:31:27 AM
Jessica,
I just sent your letter to the lawyers and staff I know and will see next week at EEOC in DC. It is on the agenda.
Julie
Always good to have those kinds of connections to get one's foot in the door, good going Julie!
don't forget that Medicare was raped to pay for the "Affordable Care Act". My wife is disabled and they've cut her benefits back. She pays her whole disability check on medical costs. Covering SRS did not work out well for Venezuela. Not trying to be mean but sometimes we girls just have to take care of ourselves.
Have you tried www.gofundme.com (http://www.gofundme.com) ? Just an idea. I was out of work for 2 years and had to put my own needs aside and get retrained. I'm making a very decent living in IT now at one of the top 2 computer companies (dude..should have got a ....). School costs me ~ 12K. The gov will supplement that for you.
Quote from: AriannaRavengirl on September 15, 2014, 10:12:50 AM
Covering SRS did not work out well for Venezuela.
Different country, different priorities, different budget. The issue here is about the interaction between physicians and insurance companies and how that impinges on people depending on them to correct a condition, a condition which if left untreated is potentially fatal. Keep in mind, this is for the common good. The way to fix it is to steer the ship of bureaucracy directly into this gale and hold course till fair winds and following seas prevail.
I just want to say thank you, to both Jess and Julie for what you are both doing for the benefit of all of us. Again, my deepest thanks!
My enemy with regard to SRS is time. I don't have many good years left and I need to have my surgery while I'm still able to get out, be active and do things. I know others have had SRS who are older than I, but I've suffered a horrible accident in 91 that left me with chronic pain and other issues that are only getting worse. If I don't have my SRS soon I fear I won't have time to enjoy life as the whole woman I should have been.
Ally :icon_flower:
I receive SSI, and once had Medicaid along with it. Then I moved from Texas to Oregon for a year. I waited and waited for them to approve my coverage, and then they did as soon as I moved back. So now I have to try to get it again here. I don't know the connection between Medicare and Medicaid (or if there even is one), but I certainly believe that either of them should provide coverage. Not just for SRS, but for all necessary procedures that relieve dysphoria and bring us all to our acceptable physical place. I know that many Conservatives abhor the idea, either because they think being trans is mental illness or that they "shouldn't have to pay" for any of it. I would agree that no one should have to pay into medical coverage if it's only being abused, but that's not what this is. And for someone to even be allowed to receive SSI they have to have a genuine medical condition that prevents them from working. So, what am I supposed to do? I'll be sacrificing a large portion of my benefits to cover HRT and blood work and possibly even electrolysis if I can't get financial help from family. I don't mind doing so, but then I'm left with barely anything for myself. I even had to request if I could skip my rent next month for when I get things going. It sometimes makes me feel like transitioning is actually detrimental to my life. What's the use of being the full extent of myself if I can't afford to express it? Government seriously needs to just self-destruct, because it clearly cannot keep its hands out of our personal lives and needs.
That government you want to self destruct is responsible for you receiving anything like SSI or medicaid/medicare. It may need adjustment, but be careful not to bit the hand that feeds you.
Quote from: LordKAT on September 17, 2014, 05:39:28 AM
That government you want to self destruct is responsible for you receiving anything like SSI or medicaid/medicare. It may need adjustment, but be careful not to bit the hand that feeds you.
I understand your point, and I don't disagree. I'm quite in favour of a Meritocracy which is all about genuine and fair participation of the state to ensure everyone has equal opportunity and proper benefits for those with disabilities. So, it's not that I'm against government in general, I just don't like the one we have. The fact that I get SSI isn't enough reason for me to praise them. We all have to endure the unnecessary cronyism, political correctness and nepotism of modern Capitalist "Democracy", but I believe we'll definitely adjust this flaw in due time. And before anyone might get on my case for being seemingly anti-Capitalism, let me just state that I completely support the liberty of the individual to prosper according to their merit. What we have today is an abomination. Not only do we have increasingly poor health coverage, but class division keeps getting more and more polarised; and clearly, we still allow a bunch of biased and bigoted nutters to decide what is and isn't in our best interest. Medical transition should be considered equally as necessary for mental health as a prescription for an SSRI (which is far more damaging than any trans-related procedure). It's like we are living in Alice's looking glass...
"If I had a world of my own, everything would be nonsense. Nothing would be what it is, because everything would be what it isn't. And contrary wise, what is, it wouldn't be. And what it wouldn't be, it would. You see?"
Been watching this thread and thought it was time I post. I am on medicare and have also been on T for over 10 years. I never had my hysto surgery. couldn't afford it. So, with the medicare ban lifted and given the fact that I deal with a non-profit hospital that accepts medicare, I looked into finally getting the hysto done. I was given a flat out, 'No'. Since they are not dealing with diseased tissue, they refuse to do the surgery. So, this lifting of the ban on surgery by medicare....worthless.
Quote from: mowdan6 on September 18, 2014, 01:20:40 PM
So, this lifting of the ban on surgery by medicare....worthless.
This exactly!! Someone mentioned Dr. Bowers is taking Medicare. I just got a call that is not the case. Funny how she can take it in her O.B./Gynecology practice, but not trans practice. Discrimination from someone who should know better herself?? I suppose all that private pay money is a lot better than what Medicare will pay her. Grrrrr! >:(
I have started getting replies back and it is the same bull cookies. "Oh we would love to help. HOWEVER many other things are taking priority at this time. We are involved in conflicts around the world, a fragile economy, etc.".
In other words, you trans people can suck it! :P
Quote from: Jessica Merriman on September 18, 2014, 02:23:13 PM
This exactly!! Someone mentioned Dr. Bowers is taking Medicare. I just got a call that is not the case. Funny how she can take it in her O.B./Gynecology practice, but not trans practice. Discrimination from someone who should know better herself?? I suppose all that private pay money is a lot better than what Medicare will pay her. Grrrrr! >:(
I have started getting replies back and it is the same bull cookies. "Oh we would love to help. HOWEVER many other things are taking priority at this time. We are involved in conflicts around the world, a fragile economy, etc.".
In other words, you trans people can suck it! :P
Well, it may be time to tell them to go "suck it" back. You know mid terms are coming up? If we could all get on the same page and pencil someone in our areas that do have us in mind or someone that is not "establishment" politicians, that might get their attention. I just really don't see it happening though.
Bull cookies my butt. Call it for what it is:
Stupid ignorant, lying idiots. I bet you thought I was gonna' say something else huh? I bet you were getting the
ban button warmed up. ;D
But seriously it isn't anything new. Snake oil salesmen, forked tounged devils, telling their perceived voting base what they want to hear just to keep their "jobs".
So sorry Sis, but cash is King or Queen even to those who supposedly understand us and are on our side and wish the very best for us.*Note the sarcasm* and until it is recognized that we are legitimately in danger of our lives and it is a necessary procedure in order to enhance our quality of life whether HRT or SRS. We will always be on our own.
BTW. Does Medicare cover cosmetic surgery? Just curious. I have no dealings with Medicare or Medicaid.
Quote from: Jess42 on September 18, 2014, 03:02:19 PM
BTW. Does Medicare cover cosmetic surgery? Just curious. I have no dealings with Medicare or Medicaid.
No on FFS, VFS, BE or anything else. I found the only reason HRT is covered is it is under the drug plan which has totally different rules. Grrrr!
Don't worry about the BAN button sweetie, but the Politicians better get ready for the Jessica B*TCH button to be pressed. Enough is enough!! >:(
<computer entry> B*TCH button initiated. Program running!! ;D I wonder how I will look in Federal prison orange? Will it clash with my blue eyes and blonde hair? ???
Quote from: Jessica Merriman on September 18, 2014, 03:06:48 PM
No on FFS, VFS, BE or anything else. I found the only reason HRT is covered is it is under the drug plan which has totally different rules. Grrrr!
Don't worry about the BAN button sweetie, but the Politicians better get ready for the Jessica B*TCH button to be pressed. Enough is enough!! >:(
<computer entry> B*TCH button initiated. Program running!! ;D I wonder how I will look in Federal prison orange? Will it clash with my blue eyes and blonde hair? ???
Sis. I am hurt. The Jessica
B*TCHES button. I don't even want SRS but I will write and join the fight. Who do I need to write to. I'm not a really political person ya' know. ;D
I don't know hon. Orange goes pretty good with blue eyes and blonde hair. Just not an orange jumpsuit with OKDC on it. I'm a dirty blond with hazel eyes and coral, which is almost orange, looks good on me. Little coral spaghetti strap tank with a white short skirt and white high wedge sandals with coral fingernails and toenails and I'm good to go. >:-)
Just thinking of another approach. Try and get the medics involved, ask them to join the campaign, why will they not accept or take medicare. Get them to state that this is not cosmetic but life saving, go for the human rights issue. We have the medics on side in Aus, they are joining the fight to empower the community.
Ask Bowers, McGinn to fight with you, don't get them offside get them to join.
Dr Bowers has stated her practice is looking into it, nothing more yet. Bottom line is adequate compensation hasn't been hammered out.
Quote from: Jess42 on September 18, 2014, 03:18:02 PM
I don't know hon. Orange goes pretty good with blue eyes and blonde hair. Just not an orange jumpsuit with OKDC on it. I'm a dirty blond with hazel eyes and coral, which is almost orange, looks good on me. Little coral spaghetti strap tank with a white short skirt and white high wedge sandals with coral fingernails and toenails and I'm good to go. >:-)
OMG! I never even thought of what kind of shoes goes with the jumpsuits. ::) I must be losing it! ;D
Quote from: Cindy on September 18, 2014, 03:34:25 PM
Just thinking of another approach. Try and get the medics involved, ask them to join the campaign, why will they not accept or take medicare. Get them to state that this is not cosmetic but life saving, go for the human rights issue. We have the medics on side in Aus, they are joining the fight to empower the community.
Ask Bowers, McGinn to fight with you, don't get them offside get them to join.
That is a good idea Cindy! I have been polite with them so far and have not CAUSED any damage. Hmmmm. I will rethink and develop a new strategy. I knew I loved you for some reason! :)
Quote from: Cindy on September 18, 2014, 03:34:25 PM
Just thinking of another approach. Try and get the medics involved, ask them to join the campaign, why will they not accept or take medicare. Get them to state that this is not cosmetic but life saving, go for the human rights issue. We have the medics on side in Aus, they are joining the fight to empower the community.
Ask Bowers, McGinn to fight with you, don't get them offside get them to join.
Really Jessica. We should all move to Australia. It seems like the Aussies have more things right than we do. No Offense Cindy. I mean OMG, Cindy is a star in Australia. I live in the swam and there are swamps in Australia, or at least they have Crocodiles. Do they taste anything like Alligator Cindy?
Hell Jessica. We could move to places that make us feel right at home. Just gotta' learn the lingo first. Are we Sheilas in Australia? I know what they call us here but Cindy seems to be a star there. Just sayin'.
Anybody that comes up with Foster's I am a fan of.
Seriously though Cindy. How do the Aussies accept trans genders outside of the big population areas like Sydney and Adelaide? I won't lie, I have thought about Australia on more than one occasion and you keep pushing me further south with the interview and how well you were accepted. Nut the small towns in the outback though. How do they think of trans genders? Yeah I know. It sounds like a crazy stupid idea but I am crazy and stupid and kind of looking for a change. A big change. ???
Quote from: Jessica Merriman on September 18, 2014, 03:44:59 PM
OMG! I never even thought of what kind of shoes goes with the jumpsuits. ::) I must be losing it! ;D
Wedges sis. White for sure. Open toed high wedges to show off the coral toenails. ;D I'll never forget. I walked into the TA truck stop just outside of OKC on I40 with cut off short shorts. Coral on my fingernails and toenails. High wedge sandals, hair fixed, a little tank top and some makeup at about 3AM and 4 drivers offered to walk me to my truck. I let one and he was nothing but respectful. We ran all the way to Albuquerque together and he never had a feakin' clue. ::) I mean, c'mon now? No clue? Are guys really that clueless or what? I thought I was gonna' get killed but had a little "high speed chicken feed" in my system so I was really brave. Guys never cease to amaze me or confuse me at least. ???
Australia's lovely if not for the fact that all of the wildlife wants TO KILL YOU RIGHT IN THE FACE!!!
Quote from: Wynternight on September 18, 2014, 04:42:54 PM
Australia's lovely if not for the fact that all of the wildlife wants TO KILL YOU RIGHT IN THE FACE!!!
As long as they do it without transphobic ideation I am so in!!!! ;D
There is a group on FB called Medicare transgender surgery support. Looking into other's experiences. It's a closed group. Don't know more than that as I just joined.
Crocodile is rather tasty, bit like chicken, catching the buggas is a bit of a problem though, you need a hefty fishing rod!
Generally TG are well accepted in most areas. We have strong anti-discrimination laws that help. But we cannot get treatment in our public hospital system, as yet. But someone you know is working on it ::). Along with lots of others
I gave a talk recently to the ANZ Occupational Medicine Society and the head HR person of BHP Billiton was also a guest, he said that if (and they do) have TG people at their mining sites they would have separate and private showers and be treated with total respect and acceptance.
I also recall a message from the regulars in an outback pub to a therapist I work with that thanked him for helping a FtM to transition and that he was a lot happier an no longer got into fights with them in the local pub. So maybe we are winning!
Quote from: Cindy on September 18, 2014, 04:53:50 PM
Crocodile is rather tasty, bit like chicken, catching the buggas is a bit of a problem though, you need a hefty fishing rod!
Generally TG are well accepted in most areas. We have strong anti-discrimination laws that help. But we cannot get treatment in our public hospital system, as yet. But someone you know is working on it ::). Along with lots of others
I gave a talk recently to the ANZ Occupational Medicine Society and the head HR person of BHP Billiton was also a guest, he said that if (and they do) have TG people at their mining sites they would have separate and private showers and be treated with total respect and acceptance.
I also recall a message from the regulars in an outback pub to a therapist I work with that thanked him for helping a FtM to transition and that he was a lot happier an no longer got into fights with them in the local pub. So maybe we are winning!
OK that's it. How do I go about being Aussie?
Wow that is great Cindy. Who do we know that is working on it though. ::) ;D Don't be so humble. My God. ::) I bow down to your greatness. Yeah. I saw the video. ;)
I really don't care too much at this time about public hospital systems. A wild woman in the outback? How would that go over though? FTM I can kind of see but MTF? Would they want to kill me? I know how some redneck places are here in the US and some don't really care too much and each to their own and some have to make some stupid butt statement and try to hurt someone.
Or would it just be better to live in the big cities or towns?
I know you guys have road trains that run across the outback. How do those drivers feel about transgenders? Could I find a job driving or buy trucks to lease them on? Sorry. So many questions I know but I'm kind of looking for a change. Musician/driver, is there any way to make it in Australia?
I ain't worried about catching them as much as frying them up and eating them. Especially before they eat me. ;D
I should just move to Canada. I believe their NHS covers trans-related costs.
No offense but I really think I would prefer Australia. Canada gets too cold in the winter. I don't know. Cindy may think I'm crazy and yeah I am but Australia? I won't mention the company but I drove for a company that hired a lot of "Kiwi" drivers and actually got busted for it. "Kiwi" for Aussie and New Zealand and those were the best drivers, at least one, that I ever knew. Sigh..... He weren't skeered of a transgirl truck driver, for sure. The only time I ever run team. ;)
Quote from: Jess42 on September 18, 2014, 06:18:32 PM
No offense but I really think I would prefer Australia. Canada gets too cold in the winter. I don't know. Cindy may think I'm crazy and yeah I am but Australia? I won't mention the company but I drove for a company that hired a lot of "Kiwi" drivers and actually got busted for it. "Kiwi" for Aussie and New Zealand and those were the best drivers, at least one, that I ever knew. Sigh..... He weren't skeered of a transgirl truck driver, for sure. The only time I ever run team. ;)
I live in Alaska so cold is no bother to me. I love cold and dark winters. Australia would be too hot and lacking in snow for me. Plus the MURDEROUS DEATHBEAST SPIDERS AND SNAKES!!
Seriously, jellyfish the size of pencil erasers that can kill you? Who the f*** comes up with that kind of thing??
Quote from: Jessica Merriman on September 18, 2014, 03:44:59 PM
OMG! I never even thought of what kind of shoes goes with the jumpsuits. ::) I must be losing it! ;D
Yup Sis, your losing your touch. Gotta have the right shoes. Can't run around those places barefoot and besides, as you know, shoes make the outfit, lol :D
Quote from: Jessica Merriman on September 18, 2014, 03:44:59 PM
That is a good idea Cindy! I have been polite with them so far and have not CAUSED any damage. Hmmmm. I will rethink and develop a new strategy. I knew I loved you for some reason! :)
This^^___^^ is a great idea. Getting the medics involved would be a positive step. You tell me what I can do if anything to help. I'm not afraid of Orange either. Maybe we can be cellmates,lol! :D Just as long as I can bring those wedges Jess42 suggested. I want mine in black tho so they'll match my hair. ;D
I was told tho by Miami TG Center at USF on Monday they would take my medicaid as long as I changed my HMO to United or Coventry. If I do this then no problem. It's just the distance I have to travel for consults and such. 5 hours one way plus the appointment will involve a motel room overnight in my case. I'm going to go ahead with scheduling tho cause I know the consequences if I can't have my SRS soon.
Ally ;)
Quote from: Cindy on September 18, 2014, 03:34:25 PM
Just thinking of another approach. Try and get the medics involved, ask them to join the campaign, why will they not accept or take medicare. Get them to state that this is not cosmetic but life saving, go for the human rights issue. We have the medics on side in Aus, they are joining the fight to empower the community.
Ask Bowers, McGinn to fight with you, don't get them offside get them to join.
This I can answer easily. Why would any doctor want to accept less than the procedure costs? Yet that is the amount that medicare is willing to pay. this is true not just for SRS but most medical procedures. They simply can not afford to take medicare patients when they would go broke by trying. Many will take a limited number and offset it out of their profits from other patients.
Even surgeons who know how important it is cannot not afford to do many surgeries at a loss.
Quote from: LordKAT on September 19, 2014, 02:50:23 AM
Quote from: Cindy on September 18, 2014, 03:34:25 PM
Just thinking of another approach. Try and get the medics involved, ask them to join the campaign, why will they not accept or take medicare. Get them to state that this is not cosmetic but life saving, go for the human rights issue. We have the medics on side in Aus, they are joining the fight to empower the community.
Ask Bowers, McGinn to fight with you, don't get them offside get them to join.
This I can answer easily. Why would any doctor want to accept less than the procedure costs? Yet that is the amount that medicare is willing to pay. this is true not just for SRS but most medical procedures. They simply can not afford to take medicare patients when they would go broke by trying. Many will take a limited number and offset it out of their profits from other patients.
Even surgeons who know how important it is cannot not afford to do many surgeries at a loss.
My ignorance of the USA system is showing. What happens here is that medicare pays for a set amount and the medic can then charge a 'gap' fee on top to bring the cost up to their desired level, but the result is still that the client pays less than the full fee. Here in many cases our private insurance (which is just about compulsory) will then cover that gap fee.
So for example I pay 1.5% of my salary in compulsory medical insurance to the government that provides me with any service I need. My private insurance that costs me about $3000 a year covers the gap fees for most procedures. That private fee is on a sliding scale so you can choose what you want to be covered for.
Not sure if that makes sense?
So for my GCS I have to have done privately as the government won't cover GCS in the public hospital system - at the moment, I'm waging war over this ;D - but I can recover about 60% from medicare, my surgeon can charge his fee on top of that which is covered by my private insurance. So in my case the out of pocket expense will be about $8-10k, too much but manageable.
Medicare people are told to get supplementary insurance because not all things are covered. Most do get it but it still doesn't cover SRS since private insurance doesn't usually cover that. that gap isn't exactly allowed. Usually there is a co pay which the co insurance will pay but they can not charge the patient more than the agreed amount which is less than the cost of the procedure.
Damn...reading through this stuff. It makes me thankful that I had my orchi done when I had better health insurance. I'm not gloating by the way. I'm just thankful that it worked out when it did. But, then again, I felt the same way about getting the hell out of high school before all of the school shootings started to happen. Jeez, things are just screwy.
Quote from: Laura Squirrel on September 19, 2014, 01:21:47 PM
I'm not gloating by the way.
We know that you silly squirrel! I am happy for those who have no problems and I think anyone here would be happy as well. When one of us is successful I feel we all share that a little. :)
Quote from: Jessica Merriman on September 19, 2014, 01:26:38 PM
We know that you silly squirrel! I am happy for those who have no problems and I think anyone here would be happy as well. When one of us is successful I feel we all share that a little. :)
Well, they weren't perfect. I remember fighting with these idiots for four months straight over them refusing to cover an anti depressant because they thought that it was "too expensive". Stupid schmucks.
Hi Jessica,
Yes this is a perfect example of why universal healthcare is the only way to go, and okay I'm British and our NHS looks on the surface like a giant black hole of debt, and a burden but it's made such a difference to so many people. Despite this, I am riddled with guilt by my admiration for so many things American, in fact I used to have an aspiration to move to New England and raise a family back when I was probably 14 or so. I was such a dreamer, and I'm so happy I snapped out of it. Okay I'm not familiar with the American way of doing things. Can you lobby the government or something? Are there any trans advocacy groups in the area which you could approach for help? I'm so sorry for you, I wish I could offer better support. Look after yourself chick.
Caitx
Quote from: Wynternight on September 18, 2014, 05:56:02 PM
I should just move to Canada. I believe their NHS covers trans-related costs.
Each province has its own health care system with some variations. Here in Ontario, surgery is covered but there's about a two year waiting list. The good news: Brassard is on the list of approved surgeons :) HRT is not covered yet (until age 65, I believe) but most private insurance plans do cover it. I get 85% of my HRT costs paid for by my drug plan at work, that continues when I retire. For counseling, if you are referred to a psychiatrist by an MD, that is fully covered. My visits to the endocrinologist, blood tests, physicals, all of that covered as well by OHIP (Ontario Health Insurance Plan). As far as our rights, currently they are guaranteed by the governments of Ontario, Nova Scotia, Manitoba and the Northwest Territories. There was a bill that passed in the Canadian House of Commons, but it was defeated in the Senate so it never got Royal Assent and thus there is no federal guarantee as such yet, but I suspect that will be revisited in the not too distant future. As you may already know, marriage in Canada is not restricted to hetero-cis people.
So yeah. Canada is progressing, it's a good place to be trans. Really, the winter isn't that bad.
Quote from: EllieM on September 19, 2014, 02:06:22 PM
So yeah. Canada is progressing, it's a good place to be trans. Really, the winter isn't that bad.
I grew up in the Detroit area, right on the border, and I've seen the houses in Montreal. There's a reason all of the porches and main entryways are on the second floor. Pull the other one! Anyway, it's hard to emigrate. I couldn't pull it off and I'm half Canadian. Dad was born in Toronto and his family's all over western Ontario. Beautiful country, though.
Quote from: EllieM on September 19, 2014, 02:06:22 PM
Each province has its own health care system with some variations. Here in Ontario, surgery is covered but there's about a two year waiting list. The good news: Brassard is on the list of approved surgeons :) HRT is not covered yet (until age 65, I believe) but most private insurance plans do cover it. I get 85% of my HRT costs paid for by my drug plan at work, that continues when I retire. For counseling, if you are referred to a psychiatrist by an MD, that is fully covered. My visits to the endocrinologist, blood tests, physicals, all of that covered as well by OHIP (Ontario Health Insurance Plan). As far as our rights, currently they are guaranteed by the governments of Ontario, Nova Scotia, Manitoba and the Northwest Territories. There was a bill that passed in the Canadian House of Commons, but it was defeated in the Senate so it never got Royal Assent and thus there is no federal guarantee as such yet, but I suspect that will be revisited in the not too distant future. As you may already know, marriage in Canada is not restricted to hetero-cis people.
So yeah. Canada is progressing, it's a good place to be trans. Really, the winter isn't that bad.
I'm Alaskan so winter means nothing but good times to me!
I wonder if there's a need for nurses in Ontario?
here's a starting point: http://ontarionursing.ca/
Sorry to be late to this thread. Reading the how "medically necessary" SRS , FFS or any treatment that is covered by WPATH in their terms.
I too have been taking with Doctors and Medicare Advantage plans in this area. Feeling the same thing no one has a clue how this is to work. How much medicare will cover. It is like limbo ???. No real answers. Some insurances falling back on old polices on these very issues no new updates to what has been set forth. One of the updated 2015 medicare Advantage plans booklets I got said they do not cover sex changes. When I called them and pointed out that medicare covers these now what dose that mean If someone tired to fill a claim with this Medicare Advantage plan " IT WOULD BE DENIED!! >:( This is a very sad time for all of us, but I hope this will be fixed and ANSWERS will come to all!!! ;D
UPDATE:
Well it's official! No one in this %#$@@%^$^$%#%## Government knows what is going on-------at all! Politicians have no clue about what the trans care lifting allows, Lobbyist's don't care because there is no cash in it for them and even Medicare itself is clueless. I keep getting transferred to people even stupider than the one's who answer the phones. I kind of figured this going into this battle, but at least I held out some hope however small. Long story short I will be dead of old age before I am complete. Very angry now, must breathe! :icon_zombie: Still trying though with the E-mails and calls. :(
I guess it will take someone popular to make us visible. Anybody know Brad Pitt or Denzel Washington? ;D ;D
Quote from: Jessica Merriman on October 01, 2014, 03:46:14 AM
UPDATE:
Well it's official! No one in this %#$@@%^$^$%#%## Government knows what is going on-------at all! Politicians have no clue about what the trans care lifting allows, Lobbyist's don't care because there is no cash in it for them and even Medicare itself is clueless. I keep getting transferred to people even stupider than the one's who answer the phones. I kind of figured this going into this battle, but at least I held out some hope however small. Long story short I will be dead of old age before I am complete. Very angry now, must breathe! :icon_zombie: Still trying though with the E-mails and calls. :(
I guess it will take someone popular to make us visible. Anybody know Brad Pitt or Denzel Washington? ;D ;D
Jess, don't give up! Further more, do these two things. Sue Medicare/the government/whoever else needs it coming in order for action to be taken and lastly, try reaching out to trans people who are in the media like that women whose the star of the show called "Orange is the new black." Make sure to ask her if she knows anyone else like her who can help get the media's attention. Hell, for that matter, try taking this up with the news! Really, if a trans woman can get on the news for protesting outside of that mc d's then, shouldn't be TOO hard for you to do the same. ;)
Hang in there and keep us up to date. :)
Laverne Cox is starting a new show "The T Word" a documentary. This one of the changes and hardships we face as well. This should be on her show. ;D Getting to a place in our lives where hope should not die, but delayed is still not a fix. Always hoping for the best and hoping that if this has come this far for many Trans brothers and sisters, like me. Giving up is not an answer but talking to those who can help until we have answer is still the best thing to do. ;D
Quote from: LadyStaci on October 01, 2014, 02:50:54 PM
Laverne Cox is starting a new show "The T Word" a documentary. This one of the changes and hardships we face as well. This should be on her show. ;D Getting to a place in our lives where hope should not die, but delayed is still not a fix. Always hoping for the best and hoping that if this has come this far for many Trans brothers and sisters, like me. Giving up is not an answer but talking to those who can help until we have answer is still the best thing to do. ;D
when does the show air?
http://www.edgeonthenet.com/166590 (http://www.edgeonthenet.com/166590)
ACA Won't Really Cover Trans Surgery
by Winnie McCroy
"Although it is a wonderful step forward that our government has legitimized transgender healthcare, the Affordable Care Act's coverage, through Medicare, pays only a miniscule amount towards that coverage," said Dr. Sherman Leis, a transgender surgeon of international renown and founder of The Philadelphia Center for Transgender Surgery. "Unfortunately, most experienced transgender surgeons cannot even begin to cover basic costs from this reimbursement, let alone earn a reasonable amount for time and experience."
And there's an explanation from Dr Leis as to why he and other surgeons won't take Medicare.. Perhaps the answer is to lean on Medicare and how much they pay. You can't expect a surgeon to operate without covering costs.
Here's the other gotcha- would you really want the doctor who did take medicare (assuming there ever will be any), or even insurance in some cases, to do the most important surgery of your life, or would you rather pay someone more experienced out of pocket to increase the chances a better outcome?
The system is evil for giving us nothing more than lip service.
http://marcibowers.com/ftm/victory-medicare-to-cover-transgender-services/
The implementation of surgical coverage will be complex and deliberate. Contracts with Medicare administrators will need negotiation and roll out. Be patient. This from Dr. Bowers web site if we could get more people talking the answers will come! A letter to the President! ;D
Quote from: LadyStaci on October 01, 2014, 11:57:08 PM
http://marcibowers.com/ftm/victory-medicare-to-cover-transgender-services/
The implementation of surgical coverage will be complex and deliberate. Contracts with Medicare administrators will need negotiation and roll out. Be patient. This from Dr. Bowers web site if we could get more people talking the answers will come! A letter to the President! ;D
That's a load of rubbish. They expect us to wait for something that SHOULD have been implemented a while back? Rubbish. All that is, is an excuse to buy time and push our buttons. Te only thing that's REALLY going to get them to take action is by us taking action, certainly not "patience."
Quote from: Shana-chan on October 02, 2014, 12:46:02 AM
That's a load of rubbish. They expect us to wait for something that SHOULD have been implemented a while back? Rubbish. All that is, is an excuse to buy time and push our buttons. Te only thing that's REALLY going to get them to take action is by us taking action, certainly not "patience."
Yup, more lip service as usual. I wish Dr. Bowers would tell it like it is. The sad thing is that she is on my short list because there is a chance I can get at least some of it covered by insurance. She seems to love the media and portray herself a certain way to make herself the sweetheart of the trans community, but at the end of the day she's all business. At least I know a local surgeon who is up front about his practice being about nothing more than a way for him to generate revenue.
I've inquired at Legacy Community Clinic in the Montrose area here in Houston, and I have to go in for eligibility. They are requesting my SSI reward letter, so I guess by showing them that I'll get a discount. I'm sort of taking a backwards approach by getting my HRT through informed consent, because the therapist I'll be talking to (via Skype) wants me to be on it for at least three months while we discuss dysphoria, how the HRT is affecting me, and the difficulties/challenges of social and family life. That route makes more sense to me instead of having to endure therapy for three months before having access. But for those who have to do that, don't think of it as an obstacle. Either way is just fine so long as you do seek out a gender therapist. Even though some of us may have supportive friends and family, a professional with a background in psychology is very important to have around.