Tuesday, October 07, 2014

The Simple Truth

We now have insurance, but… it is hit or miss. I know some trans-people that had insurance company say Gender Confirming Surgery (GCS) is covered while some trans-people with the exact same insurance company are told that it is not covered.

It depends on who answers the phone at the insurance company and how you phrase surgery. If you say you are having GCS you usually get denied but you will have better luck is you list the surgeries that make up the GCS. If you are covered then you run the problems that an article in the EDGE points out,
The transgender community celebrated the groundbreaking U.S. Government's recognition of gender dysphoria and its coverage of transgender surgery under the Affordable Care Act (ACA). But as the law begins to be implemented and real transgender people attempt to use its coverage, they are starting to discover its acute limitations, even to the point where many believe that transgender surgery is little more available now than it was before the law.

"Although it is a wonderful step forward that our government has legitimized transgender healthcare, the Affordable Care Act's coverage, through Medicare, pays only a miniscule amount towards that coverage," said Dr. Sherman Leis, a transgender surgeon of international renown and founder of The Philadelphia Center for Transgender Surgery. "Unfortunately, most experienced transgender surgeons cannot even begin to cover basic costs from this reimbursement, let alone earn a reasonable amount for time and experience."
And therein lies the rub, if your insurance will cover GCS they will only cover a mere fraction of the actual cost.

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