But when you throw in gender dysphoria in to the mix it can become a nightmare where even routine treatment is denied.
You are going to have to fight for the coverage that you are entitled to by law! But it is no different than any other insurance claim that was denied by the insurance company, they are just like Mikey who hates everything in the Life cereal commercial, they say no to everything.
Many of us are not used to standing up to big corporations and are easily intimidated, including me, but when it comes to insurance we have to fight them because they are counting on you not to contest them. So don’t be afraid to go to the insurance commissioner or to your state agency that enforces the state non-discrimination laws. Those of you who are covered by Medicare will have to appeal to CMS.
This morning I answered an inquiry from a trans person about insurance coverage for electrolysis on the CTAC email…
Was it in CT, other states as well? Yes, one was in the Torrington area
What was the sex of the person, as insured? She was female on her insurance which I think was important because I heard of others who were denied who were listed a male on their insurance
What were the diagnostic codes, or how was it ‘prescribed’? 2017 ICD-10-CM Diagnosis Code L68.0 Hirsutism -- I think that the doctor writing the prescription can't say anything about gender dysphoria
Was it covered by any specific insurance? I don't know but I think she had either Husky or ACA
What region of hair removal was covered (face/neck, whole body, genital, etc)? Unknown
What method of hair removal was insured (laser, electrolysis) ? Unknown, but I know it was a doctor or electrologist who could bill the insurance company
What was the coverage amount? (100%, less?) ? Unknown
This afternoon I am doing training at a homeless shelter that has a trans resident and the shelter wanted information and training on how they should treat trans residents.
And I just got a frantic phone call from the agency that this afternoon's training just went from a group discussion of about a dozen people to 65-70 and a full blown PowerPoint discussion. Yikes!
Some Health Insurance Companies Still Deny Care To Transgender PeopleThe best advice that I can give is DON’T TAKE NO FOR AN ANSWER!
REFINERY29
By Kasandra Brabaw
August 21, 2017
Last month, an investigation by the California Department of Managed Health Care found that Health Net, a health insurance company in the state, discriminated against seven transgender people between 2013 and 2015. The patients were denied coverage for gender-affirming surgeries such as testosterone injections, bilateral mastectomy, facial feminization surgery, and gender reassignment surgery, according to the San Fransisco Chronicle, because the company claimed the treatments were cosmetic.
Health Net was ordered to pay $200,000 for violating state anti-discrimination laws, and to update their policies to comply with state law by September 30, according to a letter of agreement. It's a huge win for transgender rights to healthcare in California, but also highlights out how difficult it is for transgender people to access gender-affirming treatments.
[…]
Yet, even in a state that has had a law explicitly banning discrimination from health insurers since 2012, transgender people still faced discrimination and restrictions to coverage
.
That can mean that transgender people aren't able to afford hormone replacement therapy that, for example, would deepen a transgender man's voice and facilitate body hair growth. Trans people have also been denied coverage for top surgeries that would augment breasts for a transgender woman or remove them for a transgender man, and other treatments to aid in transition on the misguided idea that these treatments are not medically necessary.
Even health screenings that are considered medically necessary for everyone else, like prostate exams for transgender women and pap smears for transgender men, are more difficult to access once a person has legally changed their gender identity.
You are going to have to fight for the coverage that you are entitled to by law! But it is no different than any other insurance claim that was denied by the insurance company, they are just like Mikey who hates everything in the Life cereal commercial, they say no to everything.
Many of us are not used to standing up to big corporations and are easily intimidated, including me, but when it comes to insurance we have to fight them because they are counting on you not to contest them. So don’t be afraid to go to the insurance commissioner or to your state agency that enforces the state non-discrimination laws. Those of you who are covered by Medicare will have to appeal to CMS.
This morning I answered an inquiry from a trans person about insurance coverage for electrolysis on the CTAC email…
Was it in CT, other states as well? Yes, one was in the Torrington area
What was the sex of the person, as insured? She was female on her insurance which I think was important because I heard of others who were denied who were listed a male on their insurance
What were the diagnostic codes, or how was it ‘prescribed’? 2017 ICD-10-CM Diagnosis Code L68.0 Hirsutism -- I think that the doctor writing the prescription can't say anything about gender dysphoria
Was it covered by any specific insurance? I don't know but I think she had either Husky or ACA
What region of hair removal was covered (face/neck, whole body, genital, etc)? Unknown
What method of hair removal was insured (laser, electrolysis) ? Unknown, but I know it was a doctor or electrologist who could bill the insurance company
What was the coverage amount? (100%, less?) ? Unknown
This afternoon I am doing training at a homeless shelter that has a trans resident and the shelter wanted information and training on how they should treat trans residents.
And I just got a frantic phone call from the agency that this afternoon's training just went from a group discussion of about a dozen people to 65-70 and a full blown PowerPoint discussion. Yikes!
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