Do you think it is discrimination that most health insurance policies do not cover any part of transitioning?

Well, health insurance is a discrimination against those with diabetes and little people and everything else. I am not very happy with the state of healthcare.

True! It's all a horrible corporate conglomorate scam.

Insurance will be crap even it will cower it
For example here where I live I have covered SRS, something like 3/4 price of HRT, tracheal shave, voice surgery and therapy.
But I still pay more to insurance than if I have no insurance and pay all care myself.
It is same for all insurance, it is business, almost everyone must pay more to insurance than you get from it, they must have profit

Quote from: Chermarie on June 16, 2011, 09:42:43 PM
Do you think it is discrimination that most health insurance policies do not cover any part of transitioning?

Yes, and it's killing people.  The result, for too many people, of being unable to access medical care is death.  And transitioning care is vital medical care.

I'm not generally happy with the US health care system (I'm assuming you are in the US) - we shouldn't have people getting rich off of people's illnesses.

I agree. But I guess that's why they call it the "medical business ".

You think trying to get SRS coverage out of existing insurance is discrimination? Try imagining what it is like for people such as I who transitioned long ago applying for individual health insurance. Unfortunately I am not some 35+ year old engineer with a cushy corporate plan, and neither are most of us. However whenever I ever hear about people complaining about insurance trans issues thats all it is.

The cost to add trans related medical coverage to typical group health insurance plans is miniscule.  The primary reason so many group health plans don't cover trans related surgeries is because, according to the American Psychiatric Association (APA), Gender Identity Disorder (GID) is a MENTAL disorder.  Therefore, you need therapy, not hormones or surgery.  And there is no intention by the APA to remove GID from their Diagnostic and Statistical Manual of Mental Disorders (DSM) anytime soon, only to rename it "Gender Incongruence" (GI).

So the answer to your question is "No, no one is discriminating against trans people."  As long as therapy is covered, your employer, or whoever is providing health care insurance for you, is taking what the professionals say and offering to help cure you of your mental problem.

Even though some of the medical field still consider it a mental problem I think the majority of doctors now know better. Some insurances do cover therapy, trans-related doctor visits, HRT and some surgeries. It all depends on the insurance company and the plan decided on.

I believe the majority of insurances doesn't cover trans-related health is because of the stigmatism. Insurance companies can play off of that and save money by not covering it. They'll use any excuse to not cover something.

My insurance company will not cover any trans-related medical expenses in my state no matter what plan you have. The reason? I live in the U.S. South. 'Nuff said.

However, they do cover my psychologist visits since he codes them under anxiety & stress as well. Actually, my insurance even refused to cover therapy for GID until this year. They used to cover my T (I don't know why) but have now cracked down on that.

I'm going to say this now- America's downfall will be the declining state of healthcare and health insurance. It's hard for the common man (who are the ones who truly contribute to the workforce and economy) to do their job when they're sick and/or dying. As countless political scientists have said, a country is only as strong as it's middle class. We are being destroyed by our own country and corporations.

If your medical insurance coverage is part of your employment package, it's your employer who decides what will or won't be covered.  The state or federal government, or even your insurance company, have nothing to do with it.  No insurance company will say, "Oh, you want that coverage too?  Sorry, we don't do that."  They will simply increase the premium accordingly.

While it's true the stigma is behind the lack of medical coverage, that most doctors know our condition is medical and not mental (if that is a fact) does nothing to change our insurance coverage.  The people fighting to prevent us from having the same rights and privileges as everyone else often go to the DSM to prove their point: "People who are mentally disordered should not be treated like everyone else."

Even the AMA says it should be covered.

Quote from:  AMA Resolution 122.15  RESOLVED, That the AMA support public and private health insurance coverage for
16  treatment of gender identity disorder (Directive to Take Action); and be it further
17
18  RESOLVED, That the AMA oppose categorical exclusions of coverage for treatment of
19  gender identity disorder when prescribed by a physician (Directive to Take Action).

Quote from: Janet Lynn on June 21, 2011, 10:35:48 AM
Even the AMA says it should be covered.

Yes, Janet, and they even made a statement to the insurance companies it should be covered.  But that has mattered little.  It has to be removed from the DSM, completely and entirely or little will change.

I saw a documentary on the gay revolution the other day and one man, talking about the dark days of being gay, said, "Back then it was considered a mental disorder to be gay."  And back then the public opinion of gays was they were all pedophiles, molesters and trying to turn the youth of this nation gay.  Sound familiar?

That's how the average person processes things when they think you are mental.

Quote from: Julie Marie on June 21, 2011, 11:26:06 AM
Yes, Janet, and they even made a statement to the insurance companies it should be covered.  But that has mattered little.  It has to be removed from the DSM, completely and entirely or little will change.

I'm on the fence with this one.  If it's removed from the DSM, that may give insurance companies carte blanche to deny any and all coverage because a medical establishment views us as normal (which I think is right... we're simply a variant on the normal human condition, and variation is the most natural thing of all).  If it's not removed from the DSM, then we carry the stigma of mental illness, and research is beginning to show quite clearly that transsexuality is not simply a mental condition.  And yet, it's not the only biologically based condition in the DSM.  The DSM also contains bipolar disorder and schizophrenia, the medical treatment of which are most definitely covered by many insurance plans.  However, insurance companies often cover the biological treatment while denying the psychological treatment (oh, to have mental health parity).

So what's the answer in our case?  I don't know, but I think it's more complicated than DSM inclusion or exclusion.

Quote from: Julie Marie on June 21, 2011, 10:29:05 AM
If your medical insurance coverage is part of your employment package, it's your employer who decides what will or won't be covered. ...your insurance company, have nothing to do with it.

I'm not quite sure on this. The letter I got said they will no longer cover T without "proper" reason. It said this was for all BCBS policies in my state. If you changed your BCBS plan then your doctor would have to submit the approval application again.

They've also made it clear they will cover no cost for "sex changes" (their actual term) in their plans. Just this year did they announce statewide that therapy would be covered for GID. Like you said, an employer can insist on it and most likely get it, but they'd probably have to pay out of their ass for the premiums. It wouldn't make business sense for them. Therefore, I think the insurance company's default is not covering transition medical expenses. But, I've heard from others who have BCBS in a different state that some things were sometimes covered. So I'm not quite sure what to think.

Maybe we are better off that the surgical proceedures are not covered by insurance. If insurance covered it, how much do you think it would cost for those that were uninsured? Insurance IS the problem with the ehalthcare system, NOT the solution!

Quote from: JessicaH on June 27, 2011, 01:51:41 PMMaybe we are better off that the surgical procedures are not covered by insurance. If insurance covered it, how much do you think it would cost for those that were uninsured?

Well, some U.S. insurances cover all or some surgeries and some countries cover them in their socialized healthcare. So, I'd say the prices would stay about the same. The hospitals & doctors want their money. As long as they get it they don't care who pays them.

Quote from: Radar on June 27, 2011, 04:51:59 PM
Well, some U.S. insurances cover all or some surgeries and some countries cover them in their socialized healthcare. So, I'd say the prices would stay about the same. The hospitals & doctors want their money. As long as they get it they don't care who pays them.

In the US, surgeries that are generally paid for out of pocket are WAY cheaper than surgeries paid for by insurance.  OTHER PEOPLES MONEY(OPM) ALWAYS drives up cost. The same thing happened to college education with easy money of student loans.  Without student loans and govt grants, we COULD afford to pay cash to send our kids to school it work and pay out way through school.

If insurance covered SRS, it would be unaffordable for  those without insurance without leaving the country.

If you work for a company that wants to include GRS in their employment health insurance package, that company will choose an insurance company that has that coverage.  The BCBS of Michigan decision not to offer coverage of gender reassignment surgery in its single payer insurance program back in 2009 also included other cuts.  At the time they were obligated by law to insure all patients regardless of pre-existing conditions.  So rather than violate the law, they just changed their coverages.  But, to the best of my knowledge, this was only BCBSM.  I don't know how the new health care reform bill effects their 2009 decision.

A friend of mine found out her employer (she worked for the government) was fazing out GRS.  So she bought out the last 7 years of the 22 required for retirement and retired before the change went into effect, thereby ensuring she would be covered when the time came she was ready for GRS.

The increase in insurance premium costs to include transgender health benefits is, on average, almost negligible.  A report done in 2004 (LINK) gives one a pretty good idea of what the real costs are.  Considering what the actual percentage of people desiring medical treatment for transgender related conditions is, you can see why the monetary impact is so low when averaged over all employees in a given company.

The stigma, that GID is a mental health problem, seems to be our greatest obstacle to broader medical coverage.  And for those who worry they won't have their GID related therapy covered, look in the DSM and you will find plenty of disorders to choose from that apply to whatever problems you need to address in therapy.  As far as medical coverage, I would expect that to happen much more rapidly if GID was removed from the DSM.  We already have the AMA on our side.

Quote from: AprilAero on June 29, 2011, 03:09:15 AM
it bothers me that  companies who provide insurance get to pick and choose what stuff will be covered. it seems like that should be illegal because they are discriminating against their policy holders. It does not cost much to include it. Its just not fair.

It is insurance, like insurance for car, you can choose product what you want

Realistically, even car insurance isn't quite "free market".  I can't reasonably buy car insurance that covers my car in case of nuclear attack, for instance - that insurance just doesn't exist for most mere mortals (sure, someone with resources can sell a policy at Lloyds, and get it insured - I can't).

Health insurance is even less of a free market.  I get what my employer selected.  Sure, I could personally buy insurance in addition to that, but realistically, it's not a real option for me or most other people.  I'm not going to pay twice for insurance - I don't have the money to do that.

The free market works best when both sides of a transaction need each other equally badly.  Those are transactions that don't need regulation.  When I sell a car to a private person, they need the car, and I need their money, so it's going to generally be a fair transaction - I hurt myself if I try charging too much.  Something like electricity is the exact opposite - my $50/month payment to the electric company isn't enough to change how they set their rates.  If they set them too high and lose my business, but get enough other business to make up for the lost (maybe 20 fold!), they would raise the rate.  They don't need my payment as much as I need their service.  That's why we regulate utilities.  Where the needs of the two sides are unbalanced, abuse can easily occur.

Insurance is typically one of those things where people need it far more than the insurance company needs an individual person's business.  So they set the terms, not me, and certainly not me and them negotiating it together to find a mutually acceptable deal.  I have to take or leave what they offer.

I believe in the free market, but only when it is truly free.  Having multiple companies selling a product isn't enough to make it free, however.