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Help! Insurance company or my employer more transphobic?

Started by Aazhie, May 29, 2015, 03:46:44 PM

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Aazhie

So until today I was assuming my FTM top sx and ovary removal would be covered by my insurance.  I work at Saint Joesph in California and have been assured that they don't discriminate.  Now the surgeons office emailed me saying there's an exclusion that won't cover my case and now I have to pay out of pocket.  I am wondering if anyone has advice of what kinds of people I need to be talking to to resolve this.  I will be seeing an employee health and HR reps asap, but they are pretty small and local departments.
You build on failure. You use it as a stepping stone. Close the door on the past. You don't try to forget the mistakes, but you don't dwell on it. You don't let it have any of your energy, or any of your time, or any of your space.
Johnny Cash
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suzifrommd

Many corporate policies have exclusions that don't cover GRS. Mine wasn't covered either. It's not been ruled legally to be discrimination.

If it's true, the people to talk to would be your HR folks, to try to get it covered, though that's probably going to be a long road.

Sorry I couldn't be more encouraging.
Have you read my short story The Eve of Triumph?
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Aazhie

Quote from: suzifrommd on May 29, 2015, 05:52:41 PM
Many corporate policies have exclusions that don't cover GRS. Mine wasn't covered either. It's not been ruled legally to be discrimination.

If it's true, the people to talk to would be your HR folks, to try to get it covered, though that's probably going to be a long road.

Sorry I couldn't be more encouraging.

It's fine, thanks for the assistance.  It's really just disheartening because of the initial idea that it would be covered... the office took their time processing my paperwork so I assumed it was alright. :C
You build on failure. You use it as a stepping stone. Close the door on the past. You don't try to forget the mistakes, but you don't dwell on it. You don't let it have any of your energy, or any of your time, or any of your space.
Johnny Cash
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tgchar21

If I understand correctly anti-discrimination laws mean that an employer cannot legally refuse to hire you, fire you, or treat you unfairly on the job like they cannot do because of your race or religion (for example). They do NOT mean that they have to cover transition-related procedures under their health insurance.

Before anyone complains (even though I understand my opinion may be unpopular on a personal level here), remember that unlike laws that prohibit discrimination on the job because of particular characteristics, there is a tangible reason why a company should not be forced to pay for medical procedures that are not of an urgent medical necessity.

Another example is that a company cannot discriminate against a Jew on the job, but there is no requirement that their health insurance pay for the circumcision of their workers' sons. The same logic can apply to smokers as well - IMO companies should not be allowed to refuse to hire, fire, or treat you differently on the job because you're a smoker (as long as you don't violate the company's policy against smoking on their premises or at their functions) but I'd support them allowing smokers to be charged more for their health insurance.

When it comes down to an ENDA passing by a razor-thin margin, I think it should not be written to force employers to have another additional tangible expense that would not exist otherwise. (Deep down I think we need to completely eliminate the connection between employment and health insurance, but that's a discussion for another time.)

ETA: It appears in your case it's the company's non-discrimination policy rather than a law - but the same principle applies.
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Aazhie

Quote from: tgchar21 on May 30, 2015, 08:22:13 AM
Before anyone complains (even though I understand my opinion may be unpopular on a personal level here), remember that unlike laws that prohibit discrimination on the job because of particular characteristics, there is a tangible reason why a company should not be forced to pay for medical procedures that are not of an urgent medical necessity.

I can't really disagree with you, to be honest I wouldn't have been able to consider surgery without the job.  It was just panic inducing that after the office had said it all was covered to hear that they hadn't actually gotten the stuff officially approved.  I just wish they'd given me actual estimates rather than saying it would all be paid for my insurance altogether so I could have been planning these last four months and specifically stashing money for it!

Thanks for the clarification, it does help a lot
You build on failure. You use it as a stepping stone. Close the door on the past. You don't try to forget the mistakes, but you don't dwell on it. You don't let it have any of your energy, or any of your time, or any of your space.
Johnny Cash
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