Friday, October 31, 2014

Insurance Part 2

After I wrote yesterday’s blog the Boston Herald came out with this are article,
Insurers unsure on transgender care
Meanwhile patients unable to find docs for procedures
Thursday, October 30, 2014
By: Marie Szaniszlo

Four months after the state Division of Insurance put health plans on notice that denying medically necessary treatment to transgender people is prohibited sex discrimination, insurers are still grappling with what constitutes medical necessity, and patients are struggling to find doctors who’ll treat them.
The answer is easy, what the AMA, APA, WPATH and other medical associations deem medical necessary and not the insurance companies.
On the other hand, he said, Harvard Pilgrim does not want to approve procedures such as facial feminization for transgender people if those procedures would be considered merely cosmetic for other people.

“If we cover them for transgender patients, we would be being reverse-discriminatory,” said Dr. Robert Nierman, medical director at Tufts Health Plan.

But Ruben Hopwood of Fenway Health said facial feminization is not about wanting a “cuter nose.” A transgender person’s appearance is more likely to be the difference between getting a job or not getting one, and walking down the street unafraid or being attacked, Hopwood said.
That’s right, it is not about a face lift, but it is about improving the quality of life for us. It is the same as a person’s who’s face was disfigured because of an accident.

Let the medical community decide what is medically necessary and not the insurance company’s bottom line.

Thursday, October 30, 2014

Insurance

This is going to be a short blog. I have been trying to figure out how to send an email from a form on a website that I manage. It works on one website that I manage but when I copy it to another website it doesn’t work so sent in a help ticket. Grrr… Just the way I wanted to spend my Thursday morning.

Now that we have insurance everyone thought this will be an answer to all our prays… Wrong!

In the Hartford Courant they had an article about healthcare coverage, “Sex Change Insurance Coverage Increasingly Common,” don’t you just love the title, as if that is the only thing that the insurance covers.

The article is terrible misinformed; they say nothing about Medicare coverage,
"There is an evolving professional consensus that treatment is considered medically necessary for certain individuals who meet established … criteria for a diagnosis of Gender Identity Disorder/Gender Dysphoria," John O'Brien, director of Healthcare and Insurance at the U.S. Office of Personnel Management, wrote in a June 13 bulletin to health insurers.

O'Brien's advisory was sent to health insurers that sell policies on the Federal Employee Health Program, a sort of insurance exchange serving nearly 9 million federal employees, retirees and family members. Coverage for federal employees is largely funded by U.S. taxpayer dollars, though employees also pay a portion of premiums.
 The article sound like Connecticut just passed the anti-discrimination law last year instead of 2011…
Within the past year, the legislature amended Connecticut's anti-discrimination laws to prohibit discrimination based on "gender identity or expression." As a result, HMOs and health insurance companies writing individual, large and small group plans cannot discriminate for coverage of treatment for gender dysphoria — the condition in which a person identifies with a gender different from that person's biological sex — when deemed medically necessary, said Connecticut Insurance Department spokeswoman Donna Tommelleo.
Then the article says, “This change is in accordance with guidance from the Connecticut Department of Insurance, Bulletin HC 34, and effective December 19, 2013.” Umm… no, it was the Insurance Commission bulletin IC 37 that did that not HC 34.

The problem now is that insurance coverage is so new that no one really knows what is covered and what isn't. From what I have heard it depends on who answers the phone at the insurance company, one person might tell you the medical procedure is covered while another operator might tell you that it isn't. It also depends upon how the question is asked or how the doctor codes the procedure.

In addition, if insurance does cover Gender Confirming Surgery it will only cover a fraction of the cost. Many of the doctors are out-of-network and they want the cash up front so there is a large out-of-pocket expense that many trans-people cannot afford.

What we must do now is to take the imitative to define what should be covered and not let the insurance companies dictate to us what is covered. 

Wednesday, October 29, 2014

Sometimes They Get It

Many pastors, ministers, and priests say negative things about gays, lesbians, bi, and trans-people but they are not all like that, there are some who get it. One pastor who does is Pastor John Pavlovitz on his website he listed five things you will not hear him saying.
1) If I have gay children, you’ll all know it.
My children won’t be our family’s best kept secret.
[…]
If my children come out, we’ll be out as a family.

2) If I have gay children, I’ll pray for them.
I won’t pray for them to be made “normal”. I’ve lived long enough to know that if my children are gay, that is their normal.
[…]
Above all, I’ll pray to God that my children won’t allow the unGodly treatment they might receive from some of His misguided children, to keep them from pursuing Him.

3) If I have gay children, I’ll love them.
[…]
If my kids are gay, they may doubt a million things about themselves and about this world, but they’ll never doubt for a second whether or not their Daddy is over-the-moon crazy about them

4) If I have gay children, most likely; I have gay children.
If my kids are going to be gay, well they pretty much already are.
God has already created them and wired them, and placed the seed of who they are within them. Psalm 139 says that He, “stitched them together in their mother’s womb”. The incredibly intricate stuff that makes them uniquely them; once-in-History souls, has already been uploaded into their very cells.
There are 3,834 comments on his post they run from “Bless you!” to “How can you call yourself a pastor?”

In Heidi Stevens column she says this about why the pastor feels the way he does,
Pavlovitz, raised Catholic in upstate New York, attended college at Philadelphia's University of the Arts, where he made friends with people in the lesbian, gay, bisexual, transgender community. "That's when I first started to realize, 'These are human beings, not just some reasons to quote scripture,'" he told me. "That opened my eyes to seeing homosexuality not as an issue but as a human story."
When you know someone it is a lot harder to hate them, I realize that not everyone can be out, but one of the greatest experiences in life is to know that you have brought change for the better in a person’s. to hear someone say that by knowing you they have changed for the better the way they think about trans-people.

We Know…



I have been called everything from “That’s a ugly bitch!” to “That’s a F**king Dude!” to having a teenager follow me making kissing noises and rubbing his crotch at a mall. Some men are pigs and the crazy thing is they think it is cool to act like pigs.