It's my hope to post entries here about my life and experiences as a trans-woman who also happens to have bipolar disorder. This is my way of making my voice be heard, and bringing attention to the issues that myself and others like me, face every day.

Thursday, May 27, 2010

Indecision Day

Today was more like indecision day than judgement day, as I had taken to calling it yesterday. I called the insurance place to see about getting surgery covered. On the first call they told me that it was excluded from my plan unless I could get the doctor or surgeon to call and talk to them to say that I needed it. So, I decided to call Dr McGinn's office to see if that was something I could possibly get her to do. They told me that they don't do pre authorizations because she isn't contracted with any insurance places, so I would have to schedule the procedure first before she could make that call. So in other words I would have to pay for the initial consult and surgery deposit before I find out if insurance might cover it. They also told me that a few people had managed to get their insurance to cover things before, but it was never anything cut and dry and they had to kind of fight for it a little.

I decided to call a different number at the insurance place and ask again about an orchiectomy instead. I got the same answer I did for SRS on that too. A doctor has to call and talk to them so they can determine if it's necessary. I talked to a friend of mine that suggested seeing if my psychologist could make the call. I called them back at the insurance place for a 3rd time to ask specifically about that. They told me that it had to be a medical doctor, not a psychologist or psychiatrist to make the call. So basically it's like they're telling me maybe on the coverage question. They didn't say yes and they didn't say no either.

I could try to get my doctor from the clinic to call, but she's technically just a nurse practitioner. They gave me the impression that they want to hear from a full MD doctor. At this point I'm starting to think my best option is to check myself into the mental ward at the nearest hospital after making a few cuts on my arms and drinking a bit and complain that I'm seriously depressed. Maybe then I can get a doctor to make a phone call to my insurance place and say I need an orchi before I attempt to perform one on myself. I'm not actually at any kind of suicidal stage, but I can fake it if it helps my cause.

At this point I'm just going for an orchi. I'll be the first to admit that I'm not in a decent enough financial situation to handle the post op care for SRS. I also think I have a better chance of getting insurance to cover a $4300 procedure as opposed to one that's over 17 grand. It gets me halfway there and saves me money on meds in the long run. I've heard all the stories about shrinkage and stuff, and honestly if I were to lose a couple of inches on depth for later SRS I'll be fine with that. Six inches is the ideal, but I've heard that the average for post op trans women is around 5 anyway. I've head of people who were less then that and way more than that, so I guess it's just going to depend on the person. I'm lesbian anyway, so a couple extra inches won't make much of a difference to me. I care first about functionality and how it looks more so than how much I can shove in it. That's the one that I feel is least important, though still important none the less.

I don't know what's going to happen in regards to surgery and insurance, I guess only time is going to tell. I'm going to make another appointment to see my therapist next week and see where she thinks I should go from here. I'll decide after that if I need to commit myself for any length of time in order to convince anyone that I need this. I'm ready to put up a fight to get this. They never told me they won't cover it, so until I get a definite yes or no I'm going to keep trying.

I also heard from an ex girlfriend of mine last night. We dated before I started transition a few years ago, and I've been hearing from her off and on lately. Things haven't been going so well for her from what she told me last night, so I told her that I had never stopped caring about her and that I was still here for her when she needs me. We talked a good bit and then some more today also. She admitted last night that I always had a place in her heart and that she had really cared about me and wasn't sure why things ended like they did. Today I told her I thought I was an idiot for saying it, but that if she ever wanted to give things with us another try that I was willing to. She told me that I wasn't and said it's possible, but that she wants to take things slow since she's happy about us talking again.

I don't know where that's going to go, but I'm hopeful. She's always been supportive of me transitioning since I've known her, and she obviously still has some feelings for me on some level. I was only 6 months out of high school and she was in 10th grade when we dated before, so I'm hoping us both being a few years older might help things work better if we do give it another try. We both went to the same school, and she's not that far away, so my chances are good. I guess all I can do is keep the lines of communication open between us and hope for the best.


Ryan said...

Give 'em hell kid about getting SRS and good luck with you're ex. I hope everything works out for you.

Melissa said...

Insurance companies are in the business of taking as much of your money as they can, and paying for as little of what they have promised you, as possible. It's a racket, but unfortunately a legal one.

Get a letter from your therapist, stating that you are indeed a transsexual, and that you would benefit from GRS. Give that letter to your doctor, and ask him to contact the insurance company to authorize your GRS. God, how I hate this whole stupid system of gatekeepers we are subjected too, and the infernal hoops they make us jump through!

Melissa XX

Sage Fallon said...

@Melissa: I couldn't agree with you more. I've jumped through all the hoops I've needed to just to get this far, now I have a whole new set. I'll figure something out I guess. They have to make an exception if I continuously get committed to the psych ward because I can't get the surgery I need. I'm talking to my therapist next week, and if nothing she can do will help I'm going with my plan.