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I saw this today and the information leaves me confused.
Cosmetic:
The following surgeries are considered cosmetic when used to improve the gender specific appearance of an individual who has undergone or is planning to undergo gender reassignment surgery:
Reduction thyroid chondroplasty
Liposuction
Rhinoplasty
Facial bone reconstruction
Face lift
Blepharoplasty
Voice modification surgery
Hair removal/hairplasty
Breast augmentation
Does this mean I need to wait until 2014?
Comments
Depends...
What were you wanting done? Honestly I MOSTLY agree with that list... Except FFS related ones, which are:
Rhinoplasty: change the shape and/or size of your nose.
Facial Bone Reconstruction: just what it sounds like. Breaking and putting back together the bones of your entire face in a more female arrangement.
Face lift: cutting a bit of skin behind the hairline and lifting your entire face.
Blepharoplasty: changing the shape of your eyelid.
I also think that Hair Removal shouldn't ALWAYS be considered cosmetic. It's quite necessary for me. I'd be considered an Ape-Man even as a man... But EVERYONE considers it cosmetic anyways. And always will. Us Apes are just too rare for them to ever consider otherwise.
SRS is NOT on that list, which means they DO cover SRS.
Abigail Drew.
No need to wait
From what you wrote, "individual who has undergone or is planning to undergo gender reassignment surgery" there is no difference between doing it before or after.
On the other side, there is often difference between insurance policy. Read your very carefully to see what is or isn't cover.
Best of luck to you :)
Peace, Love and Happiness
tmf
i was planning on getting it if i could get if covered
was looking at getting hair removal now instead of waiting
hugs :)
Michelle SidheElf Amaianna
It's Cosmetic....
Going by the fact that it uses the word Cosmetic.... I'm going to say they will not cover it now, nor will they cover it after SRS... They consider it "cosmetic" which is the medical way of saying "optional" or "not needed".
-Piper
thats not right
and it shouldn't be constutional http://www.judicialwatch.org/blog/2012/01/laser-hair-removal...
its not cosmetic, it should be medically necessary, will call my doctor on Monday
Anyway the WPA says it is, I don't know whether to be angry or depressed
hugs :)
Michelle SidheElf Amaianna
I'm going to ask my doctor
Are insurers being honest when they classify transition-related care as “experimental†or “cosmetic�
No. The idea that transition-related care is experimental or cosmetic reflects assumptions that are out of step with medical knowledge. For more than half a century, medical professionals have researched and provided care to support gender transition that is safe, effective, and necessary for many people. The American Medical Association has specifically rejected classifying transition-related care as either experimental or cosmetic, and the U.S. Tax Court has likewise held that transition-related care is not cosmetic.
hugs :)
Michelle SidheElf Amaianna
Insurance
Complaining to your doctor or insurance company will not work. They will not pay for transition stuff because they are not required to by law. They are in the business of making money, not paying money out, therefore they only pay for what they have to. US law, in this issue, won't be changed until an anti-discrimitory law is on the books.
On the other hand, if the tax courts, say it is not optional, then you can recover a percentage of your costs back at tax time by claiming them on your taxes.
Indeed...
Simply complaining will not help. Taking them to court will. And I'm not sure if it's already a law, or if it won't be until next year, but when certain aspects of "ObamaCare" go into effect you would DEFINITELY win. Even now you stand a very strong chance of winning, especially with good lawyers. Talk to Lambda, IIRC they LOVE taking these cases.
Me, I've gotta wait till next year to even get insurance at all, when the ObamaCare aspects that control state medical assistance will require them to give me insurance if I can not afford my own.
Abigail Drew.
$7000
I spent $7000 on hair removal and it has been wonderful, got it all, including ... The only caveat is that it will NOT do grey hair. My facial beard was a lot of grey and I still have to shave every day. It may have caused some attendant skin issues, as I have to be extremely careful about rashes, bites, bumps, and rubbing. My skin is now as or more delicate than a woman's.
I used Kaiser Permanente. Be very careful of the shopping center folk. Lots of people go to the burn clinic after a session with them.
Interesting...
The bit that most intruiges me is the clause "when used to improve the gender specific appearance of an individual who has undergone or is planning to undergo gender reassignment surgery" - which seems to imply that some / all of those may not be considered cosmetic if requested by the general (cis-gendered) population. It won't change things for you, but it might be interesting poking through the insurance documentation (easier if they've provided an electronic copy) to see if there's any mention of those procedures outside that specific context.
However, if your current insurer covers the GRS itself, it's probably best to stick with them until after the op and try to make do with temporary hair removal products in the meantime. Once you've undergone reconfiguration, you can then try hunting for an insurer with reasonable premiums who does cover the additional steps you require.
As the right side of the brain controls the left side of the body, then only left-handers are in their right mind!
Hair removal.
I seem to remember that hair removal is deemed medically essential from the male genitalia, particularly the scrotum which is sometimes used to create labia majora and labia minora during the vaginoplasty and reconstructive surgery.
The appearance of the reconstructed female genitalia is deemed vitally important and essential to the satisfactory medical and psychiatric outcome of the SRS. Yet the addition of labia is functionally as much a cosmetic issue as a clinical one. So if hair removal from the pre-op genitalia is deemed a medical necessity as well as a cosmetic one, then might not other hair removal be accorded the same degree of necessity, especially the beard area which is a major issue for many transsexuals who arrive late to SRS.
It might be worth trying to argue this in court.
Bev.
Thin ground
Problem is, there are genetic women who need electrolysis who I believe don't get insurance coverage. It is purely a secondary coverage which I have yet seen available.
Similarly stuff like hair implants and stuff are not covered for non-trans men or women for that matter.
You can try to slip it in under the aegis of transition but I don't think it will wash. I can understand that as essential transition is really just SRS. You can argue all sorts of stuff should be covered due to transition: clothes, cosmetics (at least initially), pre and post psychological counseling, voice therapy, voice surgery, FFS, Adams apple removal, hair implants, hair removal, hair line revision, comportment school, job retraining, and, if available one day, pelvis revisioning, height reduction, hand size reduction, foot resizing/contouring, synthetic womb implant, ovary transplant etc. Basically what may be necessary to rehab a male body into a simulacrum of a female one as well has a social transition of same.
What are the boundaries? What should be reasonable to draw from the common insurance pool where more life threatening costs should be covered? Who should pay more into that pool? Fat and obese and addicted people? Trans people? Recently a coworker had a wife who got gastric bypass. Not essential surgery necessarily but she is obese and apparently could not lose weight any other way.
I paid for my entire transition (electrolysis, SRS) with the small exception of the minor cost of meds and endo so I understand how expensive it is. That said, it took over 10 years from hormones to final surgery, partially due to lack of money and work and secondly due to when I finally felt I was ready and I knew I was ready because afterwards the sense of freedom was so nice and I have not regretted it, except for having been born trans in the first place.
Kim