About:

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.

Friday, May 28, 2010

Insurance is Pissing Me Off!

I called and set up an appointment today to see my psychologist next Tuesday. I’m giving her a shot at the insurance company to see if anything she says can persuade them, if not I may have to put my plan in motion. As it stands now, my only option would be to schedule a date for surgery and then hope that insurance bails me out of the majority of the bill at the last minute. If they don’t I’d be either stuck with a huge bill that I can’t pay off of or I lose over 600 dollars that I would have already spent and cancel it. I don’t like either option involved in going that route.

I looked at on their site last night for something that one of the people I talked to told me to look up. It was the online version of the member handbook. It said that it didn’t cover anything related to “gender transformation”. Don’t you love their wording on that one? Everyone I talked to said it wasn’t covered unless I could get a doctor to call them up and convince them that I needed it. So it’s sounding like my chances are good if I can just get a doctor to somehow be on my side and convince them for me. That’s just to find out if they will cover it or not, I would still have to find out if I could get it through Dr. McGinn like I want to.

I don’t want to go the route I’m thinking of, but I may have to. If nothing else works I’m making a few cuts on my arms, drinking a bit if I can manage to spare some cash for alcohol, and taking 8 or 9 tylenol and checking myself into the mental ward at the nearest hospital on a 72 hour hold. That should be just enough to not cause any physical damage to me but convince them that I’m depressed and suicidal. If I go in there and say I want someone to get the growths out of my body that have been poisoning me with testosterone before I do it myself, someone will listen. That should get a doctor on the phone to my insurance company pretty quickly. I’ll do it a few times if I have to.

They picked the wrong trans girl to attempt to screw over. I have no job and a ton of free time to check myself in and out of the hospital and cost them all kinds of money. Their decision is going to be either pay for an indefinite amount of time to hold me in the hospital or pay for $4300 surgery and have no more problems with me afterwards. I have not yet begun to fight for this. If they want to play hard ball then that’s what I’ll do until I get some straight answers from them. If I have to I’ll throw a few pretty powerful acronyms their way too, such as AMA, APA, ACLU, and lawyer! I’m sure there’s nothing more that a very TG friendly ACLU lawyer would love more than a crack at an insurance company that’s trying to stone wall me. That’s a pro bono case if I’ve ever heard of one.

I’ve never been in the military myself, but the trans girl who originally helped me out was a former army ranger. I picked up the phrase one hundred percent and then some from her, and that’s what I’m doing about this. I’m putting everything I’ve got into it and then some. I’m sick and tired of stingy intolerant insurance companies denying us what for the last 15 years has been considered a medical necessity by the AMA and APA. If a fight is what it’s going to take to get this then I’ll fight and I’ll win! They haven’t heard the last of me, not by a long shot.

3 comments:

Anonymous said...

Sage:
Be very careful about establishing a history as a mentally ill person. The Benjamin Guidelines say you must be stable other than the Gender Identity problems.

Once you are labled as mentally ill, you multiply your problems.

Melissa said...

Sage, please be patient dear. You are still very young. You have plenty of time to get this done properly. Please don't act impulsively, and do somthing you may regret later.

I think you once said you are covered by CIGNA. I am retired from DuPont, and CIGNA is our insurance company too. I just recently found out that DuPont's health insurance covers transdgender care, including GRS. So, your chances are probably good, as long as you do it the way they want you too. I don't see any reason why your therapist can't give you a letter of recommendation for GRS to take to your Doctor, and he/she can then convince CIGNA that it's necessary. You will still probably have a significant deductible to pay, but
you can worry about that when the time comes.

Please dear, no wrist cutting, or combining Tylenol with alcohol which of course can be extremely toxic to the liver. You deserve to enter womanhood healthy, and with your full functionality intact.

Melissa XX

Sage Fallon said...

@Melissa: Unfortunately I don't have CIGNA, I'm under Anthem. Supposedly from what I looked at online they deemed SRS medically necessary, but for some reason my plan is being weird about it.

I'm not going to do anything too drastic, I'm really hoping my psychologist can help me out. The worst I'd really do is a few small cuts on my arms that aren't very deep and say I'm depressed. That's what got me committed before, so I learned how to play the system a long time ago in order to get out. I'm saving it as my last resort right now, it's going to require quite a bit of acting and putting my psych research to good use.