Now I’m reminded of the old Don Martin cartoon from Mad Magazine, where a guy walks up to a “CHANGE” machine, puts in a dollar bill, and…
Unhelpful, thoughtless, insensitive, and unfunny.
Paul Fitzroy
When faced with the cost of counseling, hormone replacement therapy, and the various surgeries, some mtf transexuals come to the same conclusion. They castrate or emasculate themselves using kitchen knives and other unsafe, unsterile household items.
Dilators
AFAIK, dilators aren’t used to prevent collapse, but tightening (OTTOMH IIRC stenosis) and shrinking of the neovagina. Dilators are medical devices. However, after the surgery has healed sufficiently, appropriately sized fingers, dildoes, vibrators, and penises are recommended by many doctors.
PaulFitzroy, your comment was rude and uncalled for.
Consider yourself formally warned.
Cajun Man
for the SDMB
Oh no. I like everybody as they are (and so do they).
I was just curious. I knew it wasn’t cheap. I think insurance should cover some of these costs. Even if a person had to pay a high premium, it would still be a lot cheaper than having to foot the entire bill.
Dealing with insurance companies all day, I know one of them could come up with some kind of policy.
IBM. SBC. Microsoft. The City of San Francisco. Kaiser Permanente (for its own employees; not necessarily for all of its covered individuals). AT&T.
This is just a sampling; there are many others.
Every Blue Cross/Blue Shield of Illinois PPO contract I’ve seen provides for coverage of SRS at the out-of-network rate.
The classification of SRS as “elective cosmetic surgery” was recently shot through pretty badly by a recent IRS ruling that effectively establishes that (for tax purposes) SRS is not elective cosmetic surgery when the SoC is followed. That ruling will have significant influence on further rulings in insurance matters.
Unless you know something I don’t, this IRS ruling isn’t binding on insurance companies. The ruling was strictly concerned with the eligibility of SRS as a covered health expense for Health Savings Accounts. The IRS gets to say what is and isn’t eligible for these accounts because they have taxable income implications.
The HSA can be administered by any number of different organizations, financial institutions, insurance companies, employers, etc. To that extent an insurance company administering a HSA would have to follow the IRS guidelines, then, yes, this ruling is binding. To the extent that this ruling affects what coverages a health insurance company offers, it does not.
It may become influential in establishing coverages, but it cannot(*) force them. The IRS makes psychiatric benefits eligible for HSA coverage, but my health insurance does not. What coverages you get is mostly a matter of economics – are the premiums high enough to recoup the costs of extending coverage for that type of service. IOW, you get what you (or your employer) is willing to pay for.
Take IBM, for example. They have 330,000 employees. If the rate of 1:100,000 is accurate, then that’s 3 people they have to cover. It would be a drop in the bucket for their health plan(**), so they can afford to cover it.
My company is much smaller, so it can afford to cover less. Since about half the workforce is employeed by small businesses, this is a significant portion of the potential populaiton.
*Again, to the best of my knowledge.
** The numbers quoted here are in the same realm as multiple-bypass surgery, which IBM covers a lot more of.
Forgive me if I seem dense, but only Kaiser is an insurance company, and I was thinking of companies that offer it as their “standard level” of coverage. And although I do not have them myself, the benefits book I have from Kaiser (since they send me all the benefits books for the various plans I have access to) says that transsexual-related treatments are specifically not covered. Scanning through the PDF, I see the other 5 companies I have access too also all have a denial for that as well. These are all big-name companies too.
Like I said, I think a lot of it has to do with the negotiated plan between the company and the insurance company. If the company is willing to pay for it, then the insurance company is willing to oblige, I imagine.
That rate is almost certainly wrong. Opinions vary, but the rate is probably somewhere between 1:1000 and 1:25,000.
In a lot of cases, the reason for not including the exclusion is that the company does business in a location which forbids gender identity discrimination in employment.
As I previously mentioned, Blue Cross Blue Shield of Illinois seems not to make an exclusion for reassignment surgery, at least on its PPO plans. Neither my prior employer’s plan nor my current employer’s plan have exclusions. I know a few people who have successfully obtained compensation from BCBSIL for SRS.
Getting prepayment is as much an issue with the surgeons as with the insurance company; no insurance company will not pay in advance of services being rendered and all SRS surgeons require at least substantial payment in advance.
What is and isn’t covered isn’t solely up to the insurance company, it’s also up to the customer. And the customer in this case isn’t you, it’s the employer buying insurance.
SRS is something that can be excluded from coverage in an attempt to lower premiums without pissing too many people off. One in 25,000 might be furious, but the other 24,999 will either not care very much, or not care at all. And the employer spends a fraction less on those premiums, which are rising every year.
If an emloyer wants to offer the coverage, though, the insurer will do so - for a price determined by actuaries to yield enough money to cover the increased costs. For a big employer, this price increase is probably a much smaller fraction of the whole than for a small employer.
Well, I work in a huge company in NYC, and our insurance carriers (Aeatna and Oxford) definitely will not pay for any sex-reassignment related procedues. I checked, believe me, the brochures. It’s considered “elective cosmetic surgery.” Idiots.
But you are fully post-transition, aren’t you, Eve?
Not that you wouldn’t still be interested, of course…
Yes, but I am thinking of the Younger Generation–with a thousands of employees, this surely impacts on one or two of my coworkers or their dependents.