Saturday, September 22, 2007

Insurance Discrimination

The big talk on the campaign circuit is about some form of a national insurance plan but I want to talk about insurance polices that affects me.

Most insurance companies do not cover anything that has to with transgenderism; they do not cover any mental health visits (even though it is required by the Standard of Care.), any office visits neither for hormone treatments nor for the hormones and they do not cover any surgery.

The treatment for Gender Identity Disorder (GID) is recognized a mental disease (Whether we in the community like to admit it or not.) that is listed in the DSM IV (Diagnostic and Statistical Manual of Mental Disorders) with the code 302.85 and has a recognized treatment (The Standard of Care). The AMA policy on transsexualsim states: ‘The AMA opposes the denial of health insurance on the basis of sexual orientation or gender identity.” Also in the state of Connecticut it is against the law to discriminate against anyone with a mental illness as defined by the DSM and also against anyone with a disability, GID has been ruled so by the Connecticut Commission on Human Rights and Opportunities(CHRO).

All of this I talked about before, so what is new? Well there is a report that was released from San Francisco Human Rights Commission that defines what the cost/patient were since 2001 when San Francisco initialed coverage for transsexuals.

Bay Area Reporter
Community pushes for TG health coverage
Published 06/21/2007
by Zak Szymanski

According to San Francisco Human Rights Commission investigator Marcus Arana, in the first four years after the city's transgender benefits passed, the city's own health plan (managed by United Healthcare) collected an extra $1.70 per month per insurance member for a total of $5.6 million, and paid out just $183,000 for 11 transition-related surgeries. Data from the private insurers' HMO plans is more sparse; HealthNet reported paying $3,300 for hormones and psychological care during a one-year period between 2004 and 2005, for 14 of its transgender members….
… I told them, that's not what this [health coverage for transsexuals] is about: if you were a non-trans employee of San Francisco and needed hormonal treatment, a mastectomy, or a hysterectomy, you would get that coverage, and yet a transgender employee in need of that identical medical care was being denied."…

Now is the time for change! Employers have been using the excuse that it is way too expensive to include health care coverage for transsexuals. This discrimination has got to stop because it is an out in out violation of the anti-discrimination statues.

But you say the Human Rights Campaign (HRC) list 195 companies with a perfect score of 100% but less that a handful offer full coverage for transsexuals. How can that be if so many companies have a perfect score? Well lets look at how the scores are figured, this is the HRC policy on scoring gender identity…
# Non-discrimination policy, diversity training & benefits – gender identity

3. Insurance includes access for transitioning individuals for at least one category* (5 points)
At least one: Counseling by a mental health professional; pharmacy benefits covering hormone therapy; medical visits to monitor the effects of hormone therapy and other associated lab procedures; medically necessary surgical procedures such as hysterectomy; or short-term disability leave for surgical procedures

That is right; they only have to offer only one category to get the 5 points and a perfect score. Most companies offer mental health coverage for any reason; Bingo you get 5 points.
Why does the HRC score this way? I can think of three reasons: first because the HRC likes to boast about the number of companies that have a perfect score; two, a lot of the big companies donate to the HRC and three the HRC itself would not get a perfect score. Hun? Yup, the HRC does not offer full coverage to its employees; they would only score a 95. A little embarrassing don’t you think. So as not just to single out the HRC the other national Gay and Lesbian organizations do not offer it either.

I do not think the HRC is a bad organization, they have done much good. But I think that they have to be watched closely to make sure the honor their promises and mission statement.

3 comments:

  1. Very good Blog entry! The insurance industry has discriminated against Trans individuals far too long. Often the exclusions is right next to "acts of war". Past excuses were that it was "cosmetic." Now Trans medical treatment is just excluded with no explanation. The reason they can do is this is that there is virtually no one who will stand against the insurance industry in support of the Trans community.

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  2. I cannot understand why it can be considered a mental disorder and then NOT be covered. It's outrageous!

    The HRC should be ashamed. I support them, but I agree that they are not perfect.

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  3. The next time you give to HRC just ask them to do more for us. To continue their full support of the federal Hate Crime and ENDA bills with gender identity and expression, and to push for full medical insurance coverage.

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