I post this as the Exec Secretary of ANZPATH.

Important Message for Australian Trans* people contemplating surgery.

Private health funds have recently initiated changes which have the
potential to impact on our trans-identified patients undergoing surgery in
the private sector in Australia. Previously, health funds accepted claims
based on the current Medicare item numbers. For example, chest
reconstruction surgery was listed under item numbers for bilateral
mastectomy. Genital gender affirmation surgery was listed under item numbers
for orchidectomy, penectomy etc. BUPA and Medibank Private have now moved
to a coding system called DRG (diagnostic related groups). Under this system,
gender affirmation surgery is now classified under gender dysphoria which
the health funds define as a psychiatric condition. Many patients have
exclusions in their cover e.g. obstetrics, psychiatry etc. It is now
essential that patients have psychiatric cover for proposed gender related
surgeries. The ANZPATH executive met this morning and unanimously agreed
that as a short-term measure we would advise all ANZPATH members to be aware
of these changes and advise patients accordingly. We recommend patients
takeout top hospital cover with no exclusions. In the meantime, ANZPATH will
initiate negotiations with the health funds on this matter. BUPA and
Medibank Private have initiated these changes and it is likely the other
funds will follow.

So what's behind this? Do they believe they are about to be swamped by claims or something? Is it likely to be reversed?

We think it is a sly but legal way of avoiding paying.

I have reported it to Tim Wilson, the Human Rights commissioner, as it is unclear if cis people have the same restrictions.

If a cismale needs a penectomy or a cisfemale needs a hysterectomy how is that covered?

After a few days of feeling ill, a bout of depression and dealing with other issues I am going to nail these funds. I've had enough of being abused/ignored/forgotten for being trans*.

Wrong place to say this maybe?

I am a trans sexual woman, I am transgender. And I am proud to be me.

You know something? I'm over Gay Pride - how about Transgender Pride!!

<sorry feeling angry >

They're a sneaky pack of @$$ holes that's for sure. Will try to get out of paying everything and anything, just like the vast majority of insurance companies...

I wonder what happens to the exclusion period for preexisting conditions? You know you have a psychiatric condition, but of course your not insured for it.

Do you change your cover to include this then find out you're not covered due to it being a preexisting condition?

thanks for the info Cindy... whilst they may not effect me immediately, but in the future they certainly could.

I realise this is a side issue , but as we need clearance through a psychiatrist to obtain HRT  and Medicare covers this, then why do we have to foot the bill for electrolysis.
A life with a beard and boobs is mentally destructive and not a lot have the necessary funds to pay the extreme cost involved.
I would think that SRS and electrolysis are " ESSENTIAL " to the mental wellbeing of us.

I had private insurance when I had my orchi done, but I was turned down by my insurance company because I was transgender, - never mind that the op was done because I was having severe pain due to tissue inflammation and problems caused by earlier surgery I'd had inflicted on me when I was a young teenager.  Nothing would shift the b@stards from their ruling that the surgery was elective and therefore non essential.

So yes I'm quite sure the changes have been made by the insurance companies in order to wriggle out of having to pay for claims by transgender clients.  With the present heightened awareness of Transgender issues in the media I can hazard a guess that urgent meetings were held in board rooms in an effort to fend off the coming 'wave' of transgender surgical claims that are about to descend upon them.

I'm in contact with Tim Wilson, the Aus human Rights commissioner who I have met previously and we are investigating this as an affront on human rights for several reasons.

But write to your MPs.

I have met a number of politicians and have been told that they will not do anything unless there are formal complaints.

We will not gain any traction with Politicians unless we keep hitting them with mail and meetings. OK lots of people have issues with meeting Politicians and arguing with them. I don't! But I and other activists need the ground swell to back us.

So write, email and complain.

Trans rights are human rights , never forget it!

Cindy

Best wishes for a favorable outcome!!

Trans rights are human rights!!