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Washington Requires Insurance Companies to cover Transition-Related Procedures

Started by katiej, August 16, 2014, 02:24:40 AM

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Tessa James

Quote from: Wynternight on October 17, 2014, 11:08:29 AM
I definitely will.

You Go Girl!  As Shan notes there are big numbers of veterans that are needing resolution of this senseless discrimination.  There is good research out there that indicates the cost to cover our "medically necessary" care is negligible relative to the numbers of insured.  Part of the hang up for many of us is how the various insurance and medical providers interpret medically necessary.  I am currently in the appeal and review process to get what I need.  I was part of a conference call with the director of the Charing Cross clinic in London and while the NHS has some issues the coverage seems very comprehensive, routine and is not busting any banks. 
Open, out and evolving queer trans person forever with HRT support since March 13, 2013
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Wynternight

I sent detailed emails to our local EEOC staff member who also happens to be on the VA National LGBT group. She is going to ask them for direction on this and will get back to me.
Stooping down, dipping my wings, I came into the darkly-splendid abodes. There, in that formless abyss was I made a partaker of the Mysteries Averse. LIBER CORDIS CINCTI SERPENTE-11;4

HRT- 31 August, 2014
FT - 7 Sep, 2016
VFS- 19 October, 2016
FFS/BA - 28 Feb, 2018
SRS - 31 Oct 2018
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Jerri

best wishes with altering the course with the va or AK, wynternight, I have relocated from Kodiak to Bellingham about 20 years past now and have with resistance from many been able to get some treatment locally even if there are laws requesting assitance or non discrimination we have a major lack of people trained or experienced in medical needs of Transexuals, so for the best care a good amount of services require travel to more populated areas. at least here though there are roads that can get me there (tehe). I do enjoy the Northwest and find it very easy to get along socially and with work, but not without having to deal with the same issues as else where just less often

one day, one step, with grace it will be forward today
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- Rachel -

I recently received an e-mail from Equal Rights Washington that stated,

"Earlier today, the Public Employees Benefits Board (PEBB) voted to support transgender inclusive healthcare for public employees in Washington. The PEBB coordinates and purchases health insurance for Washington's 350,000 state workers and retirees.

Beginning on January 1st, 2015, hormones, mental health, and other non-surgical healthcare services will be provided for the treatment of gender dysphoria (a well- recognized medical condition in which the sex a person is assigned at birth does not match the gender they know themselves to be). Beginning on July 1, 2015, coverage will include benefits for surgical services for the treatment of gender dysphoria..."

WooHoo!

"Never be bullied into silence. Never allow yourself to be made a victim.
Accept no one's definition of your life; define yourself." -- Robert Frost
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Wynternight

Stooping down, dipping my wings, I came into the darkly-splendid abodes. There, in that formless abyss was I made a partaker of the Mysteries Averse. LIBER CORDIS CINCTI SERPENTE-11;4

HRT- 31 August, 2014
FT - 7 Sep, 2016
VFS- 19 October, 2016
FFS/BA - 28 Feb, 2018
SRS - 31 Oct 2018
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Beth Andrea

Quote from: - Rachel - on October 20, 2014, 08:22:03 PM
I recently received an e-mail from Equal Rights Washington that stated,

"Earlier today, the Public Employees Benefits Board (PEBB) voted to support transgender inclusive healthcare for public employees in Washington. The PEBB coordinates and purchases health insurance for Washington's 350,000 state workers and retirees.

Beginning on January 1st, 2015, hormones, mental health, and other non-surgical healthcare services will be provided for the treatment of gender dysphoria (a well- recognized medical condition in which the sex a person is assigned at birth does not match the gender they know themselves to be). Beginning on July 1, 2015, coverage will include benefits for surgical services for the treatment of gender dysphoria..."

WooHoo!

Link, or more info? The city I work claimed (~2 months ago) that they are exempted because they are self-insured...I don't want to change policies but I might have to!
...I think for most of us it is a futile effort to try and put this genie back in the bottle once she has tasted freedom...

--read in a Tessa James post 1/16/2017
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- Rachel -

I also was denied hormone coverage after the original announcement and filed a complaint with the insurance commissioner. My complaint was forwarded to the insurance company which used the same lame excuse. The State was self-insured, so the State didn't have to obey state (of Washington) laws. I was ready to seek legal advice for filing an appeal, when I read this:

"Transgender state employees in Washington will soon be assured of getting health coverage, including office visits, hormonal treatment and mental health care.

Coverage could begin as soon as January 2015 under a plan approved by a state board Thursday. Coverage of surgical needs will have to wait another six months, to July 1.

The unanimous vote by the Public Employees Benefits brings an end to exclusions that some employee health plans used to deny services for transgender people. The vote drew immediate praise from advocacy groups, including a few people who attended the meeting and broke out in applause when the vote was recorded."

read the whole article

Here's another article about the announcement

edit: Here's the PDF of the press release

"Never be bullied into silence. Never allow yourself to be made a victim.
Accept no one's definition of your life; define yourself." -- Robert Frost
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Shantel

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Venus

Moving to Washington has always been my endgame. Ever since Twilight (don't hate me) I've wanted to move there because of the weather. I mean, definitely not to the town that was filmed in... way too may crazy fans... but somewhere in the general area. I love overcast and weather that isn't too hot or too cold, so it's pretty much ideal. And it's super liberal there in the NW part, so that's awesome. I don't fit in at all in Oklahoma with everyone being super conservative religious fundamentalists... it's super scary living here as a transgender too.

I'm looking for a job here in Oklahoma right now but after I get one and save up a bit of money I'll move to Washington, probably in the Seattle area. Definitely gonna have to find a roommate considering how high I hear the cost of living is over there.

I've got a question for all of you girls transitioning in Washington... What all is covered? I found this which lists medically necessary procedures...
QuoteWhat Medical Treatments are Required?

According to the World Professional Organization for Transgender Health, medically necessary procedures transsexuals usually must undergo include

  • Psychological counselling, for the initial diagnosis, for guidance through the transition, and to obtain the letter required for surgery
  • Hormone Replacement Therapy (HRT) to adjust their body to their new gender role
  • Doctor's office visits in support of HRT. This includes lab work and other monitoring of the HRT.
  • Permanent facial hair removal for transsexual women. This will usually include laser treatments and/or electrolysis on the face and neck, and possibly on the body.
  • Breast augmentation (or prosthesis) for trans women.
  • Bilateral mastectomy and chest reconstruction for transsexual men..
  • A hysterectomy may also be medically indicated for trans men.
  • In many cases, genital reconstruction (also called sex reassignment surgery) is also indicated for both trans men and women.
  • Skin flap hair removal.
  • Penile and testicular prostheses, as necessary for trans men.
  • Certain facial plastic reconstruction as appropriate to the patient.
Nongenital surgical procedures are routinely performed... notably, subcutaneous mastectomy in female-to-male transsexuals, and facial feminization surgery, and/or breast augmentation in male-to-female transsexuals. These surgical interventions are often of greater practical significance in the patient's daily life than reconstruction of the genitals. [Monstrey S, De Cuypere G, Ettner R,.(2007) . Surgery: General Principles. In Ettner R et al (eds) Principles of Transgender Medicine and Surgery. New York:Haworth Press:2007.p.90.] These procedures are not optional, but may be required to save a life. They are also required by mosts states before personal documentation, such as the drivers license and birth certificate, can be updated with a new gender marker, permitting the person to live a normal life.

Are hormones, doctor visits, lab work, breast implants, hair removal, facial feminization, and SRS all really covered?
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Mariah

Some things are. For me that means SRS, Doctor's visits (co pays), lab work, HRT (co pay), therapy, and if I wanted a BA they would cover that. You maybe able to find some that cover other things on the MtF side but you would need to look around. Each company handles it differently. Hugs
Mariah
If you have any questions, please feel free to ask me.
[email]mariahsusans.orgstaff@yahoo.com[/email]
I am also spouse of a transgender person.
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