It Is A Nightmare!

Healthcare for me isn’t that bad, I haven’t faced any discrimination, just normal every day harassment from the insurance company. But for many trans people it can make the difference of life or death.

Health Insurance Companies Are Even More Horrible If You're Trans
Here's how the Obama administration is trying to fix that.
Mother Jones
By Molly Redden
Sep. 8, 2015

Last week, the Department of Health and Human Services proposed new rules to crack down on pervasive healthcare discrimination against transgender men and women. The draft rules address forms of discrimination that were banned years ago on paper but remain a constant feature in many transgender individuals' real-life dealings with doctors and insurance companies—from being refused basic services such as blood tests to not being reimbursed for health care screening such as Pap smears or prostate exams.

If approved, the rules would force many health care providers and insurers across the country to provide trans patients with the same medical treatments and level of care they provide to non-transgender people—parity that most insurers never even approach.

I have been getting all my healthcare needs met, healthcare professionals have treated me as any other patient. I have been getting the testing and the prescriptions that I need.

My problem is with the insurance company, because the dosage of my hormones is greater than those allow I have to get a wavier each year. But I also get hassled each time I get a refill, they deny payment and the pharmacy has to do a song and dance to get it covered. Also my annual PSA test gets denied and it takes months to straighten it out.

But for some it is a nightmare,

Thirty-seven-year-old Seth Marlow's medical history reads like a catalog of such abuses. Marlow works in healthcare IT and is well-connected in trans advocacy circles. But even he has struggled to get basic medical care. At one point, Marlow says, he was unable to have routine blood work done because a doctor he visited said his Christian faith prevented him from treating Marlow. His previous insurance company refused to pay for a fertility clinic to extract and freeze his eggs—which was one of the insurer's covered benefits—seemingly because he identified as a man.

The other problem that I see is insurance companies behaving like insurance companies, their favorite answer is “NO!” they reject everything and we have to learn to advocate for ourselves. I was talking to a trans man who was denied insurance coverage for his top surgery, when I asked him if he appealed the decision he said no.

Part of his problems stem from the fact that until this year, the Obama administration did not define what discrimination specifically means. That definition was originally left up to the states, and only a handful have applied the protections in the Affordable Care Act to trans people.

The same thing has happened here, the insurance commissioner issued a bulletin saying that insurance companies cannot discriminate against trans people, that if you offer a treatment for non-trans people you have to offer it to trans people.

The insurance companies say that breast reductions are cosmetic surgery and deny it to trans men. But they actually do cover breast reductions if they are medically necessary. So we have to fight back to make sure the doctor uses the proper insurance codes and we have to advocate for ourselves to make sure that the insurance companies do not try to label it cosmetic surgery. Here are some of the codes that can be used for trans people and for people who have Medicare you can find information here.