Just Found Out!!!!!

[Suzanne F]

I was reading an article that said in California that transgender services are now covered. I thought that can't be true. My insurer expressly did not cover either HRT or SRS. So I thought why not call. They now cover both!!!!!! I am so relieved.
Suzanne

[arbon]

Nice! In about 50 years maybe idaho will to.

[Jenessa]

Yeah, I'm not seeing Montana being in any big hurry either:straightface:

[Annaliese]

That is great news, It will never happen here in Utah, Some day may have to move to California.

[Rachael Leigh]

Just curious does it have to be deemed medically neccsrssry first?

[kimdl93]

Congratulations, Suzanne!

[SassySal]

When are you scheduling yours?

[Suzanne F]

I must have request from endecrenologist and letter from therapist. My psychiatrist and therapist both have already assured me that I will have their full support when I decide to go forward.
Suzanne

[Aimee20]

It's mainly up to the individual states' department of insurance to require certain things be covered. But this fight for equality in health insurance should start to move soon since a few months ago Medicare began covering transitional health care. The general rule is whatever Medicare does it's what everyone else does. To exclude certain coverages that the federal healthcare system deems medically necessary really opens a company up to claims of discrimination.

[PretzelGirl]

I agree with Aimee. I believe the Medicare determinations was the start of pushing the snowball down the hill. Even those of us in Idaho and Utah can have hope.

Leigh, do you mean a diagnosis of medically necessary? I am sure a letter from your therapist and one from your HRT administrator and you are on your way.

[Rachael Leigh]

Yes, that's what I'm asking, it does open up for many things and my concern as a consumer is the many things that are now deemed to be covered will continue to increase cost to all of us.

[SassySal]

This sounds great!! Now you can all get SRS at tax-payers expense. Now that is "equality".

[Aimee20]

Sal, I'm not sure how my private insurance through blue cross blue shield that I receive no subsidies on the premiums for would qualify as tax payer expense. Most members here I believe are either on private insurance or a group plan.

[Badtranny]

Texas is one of those states that doesn't participate. One of my Project Coordinators who has several kids, is able to get a better deal through the feds than our company offers. A single working mom should absolutely have access to decent healthcare, don't you think? The math is favorable to working people. I will gladly pay a few dollars more per paycheck to help out working moms who make half my salary.

How about a working TS woman? Does she not deserve decent healthcare?

[Barbara Ella]

this is positive in every sense. Please study up, as many studies have shown that when health insurers change their coverage to provide for transgender services, the increase in premiums is miniscule, so the consumer is not hit for this (no I don't have the citation for this right now). Well deserved and overdue.

Barbara

[arbon]

This sounds great!! Now you can all get SRS at tax-payers expense. Now that is "equality".

Oh please! Is it a medical condition or is it not?

And it hardly at the tax payers expense in most cases.

[PaulaQ]

This sounds great!! Now you can all get SRS at tax-payers expense. Now that is "equality".

Trans healthcare adds pennies to the price per month of insurance. If you think about it, there are good reasons for this:
1. There aren't very many of us, particularly compared with nearly any other medical condition
2. Yes, GRS is expensive at say, $37,000. Other, more common conditions, such as cancer, heart disease, even complications from diabetes can cost large multiples of this.
3. Most of the treatments we receive, especially surgical ones, are generally one shot deals. We feel better, our problem with GD mostly gets better. We're done.
4. Our ongoing cost, HRT, is dirt cheap. Compare it with say treatment for HIV, MS, any number of other chronic conditions. It's nothing.

Our care isn't going to break anyone's budget. We've been excluded for a long time by insurers mostly because of social prejudice, not economics or science.

[Suzanne F]

I am trying to steer clear of politics. I do believe everyone has a right to good health care. Please notice I called my insurance company to ask if it was covered. Insurance that my employer provides as part of my compensation. I will not be costing taxpayers anything. Finally, insurance isn't meant to only cover what we will need. Part of my premium may pay for leukemia treatment. However, I hope I never have leukemia. Spreading out costs is the purpose of insurance!

[Rianna Humble]

This thread was about someone's insurance covering their medical needs for the first time.

It is not an invitation to ignore the rule that bans politics from these forums.

Neither is it an invitation for certain members to make baseless provocative remarks in the hope of creating an argument.

The thread will not be closed at this time despite the best efforts of some to cause that to happen, but the next person who tries to make this about US politics will get an infraction and perhaps more.

Rianna Humble
Moderator, Transsexual Forums, Safe Haven and Media

[Brianna_H]

This is awesome news. I'm in California, too. Just starting therapy, so I don't know what my needs will be, but Kaiser here covers treatment and has experienced people on staff. That was a big relief, given that other aspects are turning out to be more difficult and expensive than I'd hoped.

Good luck, Suzanne. Love your posts.

[SuzanneS]

Awesome! I LOVE visiting California! If I only lived there.... You are so lucky Suzanne.

Suzanne

[Michelle789]

@SassySal - This isn't going to cost tax dollars more than a few dollars per year per person. Why do you think that people, whom you identify with, should have to pay out of their own pocket, to get treated for their medical condition.

[Kathryn Martin]

Hi Sal,

you wrote:
This sounds great!! Now you can all get SRS at tax-payers expense. Now that is "equality".

I think this a red herring and must have been intended as one. I am in Canada where SRS is now covered by in 5 provinces. Quebec was the first province to cover and there are some interesting statistics that support some conclusions. SRS prevalence is roughly in 1:31500 with full coverage of the procedure. Since Quebec also covers pre SRS assessments fully, as well as other health care for transsexed persons this is a fairly undistorted view of TS prevalence. More preliminary numbers from other provinces seem to confirm the numbers. For instance in my Province the estimated number of SRS surgeries (both MtF and FtM) is anticipated of 8 per year.

Because the Provinces contract with the only surgeons in Canada, the Provincial Medical Insurance authorities are able to reduce costs of surgery significantly.

Every medical insurance scheme (no matter what for) is of course the distribution of costs to all participants in the scheme (whether it is a company or a country) so as to make it affordable to everyone. This is not a matter of equality. Remember that historically Corporations as a legal form were founded on the principle that the risks of operation should be shared among the many shareholders so as to not expose the one to unreasonable risk. Corporations and Insurance are the quintessential capitalist form of dealing with risk, This with all respect has little or nothing to do with equality.

This is precisely the reason why States or Medicare have bought into coverage of SRS. It is the least risky and most cost saving way to address a condition that could cost taxpayers a hell of a lot more money if not so addressed. California just happens to be on the sharp edge of responsible government on this.

The idea that people will be flocking to the surgery tables is ludicrous as can be seen from the statistics of every country that covers them.

And Suzanne, this is great news.

P.S. This is not a capital P political question nor is my answer intended to. It is, however, always a small P political question but more with societal organization point of view. I just really hope this thread survives, this is an important discussion.

[donnalee]

I'm glad to hear that this has made it's way to private insurers; I think it's going to prove cost effective for the insurers in many ways and, hopefully, will become common practice in the future.

[Marleena]

Just an observation here. There are certain individuals that attempt to get threads closed on a regular basis if they don't agree on the content. Some have it down to a science by agitating to get a negative response from others.

As for the topic of SRS being covered by government health plans etc., I think it is a great thing since it will help reduce the number of suicides prevalent within the TS community. Quite often TS people are already living in poverty due to their own circumstances of risking it all. I'm just lucky enough that my wife's health plan covers my T-blockers, estrace and progesterone partially (a sliding scale). I see the cost of the drugs and there is no way I could afford them without her coverage. I burned up all of my savings after a work injury and live on a small fixed income. Also keep in mind that here in Ontario each of us pay for health care in our taxes. A recent article I read states we pay about 41% total in some type of taxes based on our gross income. So the health care here is in no way free. I also think that not everybody that would like SRS can actually get it through the government health plan.

[Mary Lee]

My understanding of Medicare paying for SRS/GRS is on a review process of each persons needs. Also It will be a few months before that is available; rules and paper work.
Those on SSI will be included; so if age under 65/66 the person will still be able to get needed surgery. Medicaid is Federal and State funded so the Feds and the states have to work that out for those on SSI. My understanding is that the President wants private insurance providers to pay for SRS/GRS.
I wonder how long it will take for the V.A. to start providing the surgeries. As many know the V.A. provides pre and post medical support for Transgender Vets.
I am 67 with Medicare and I am a 100% disabled Vet. I am in the V.A. trans care program.

[Cheryl123]

Medicare will now cover SRS if a doctor states it is medically necessary. With Medicaid, it depends on the state. California and Oregon used Medicaid funds to cover SRS, New York has just rejected the idea. These programs only cover a small number of people. Most people are covered by private insurance. Several states -- California, Vermont, Colorado, Connecticut and Washington, D.C. -- require insurers to cover SRS if it is deemed medically necessary. The trend is for more states to require coverage. Fortunately there is very little opposition to this from social conservatives which is good news.