Insurance That Covers Srs, Hormones, Labs

[Guest joe0117]

I had a follow up with my doctor for my injuries. She is really nice and was genuinely trying to see how I was doing and if I felt safe after being attacked. It is going to trial and as of now it is going to be considered a hate crime. The police said that I don't get to decide if it is a hate crime or not just like I don't get to decide what the charges are, that is up to the DA. The two were arrested but are out on bail. They said I can either be a cooperative victim or a hostile one.

I am going to have to have multiple surgeries from this but we were talking about some of the tests I need for the surgeon I have to see on Monday. I am hoping that she will ok a full hysterectomy so it will be covered by my insurance. I guess I could look at this as the silver lining to what happened. Anyways, we were talking about how expensive surgeries for transgendered were and how TG deserved better medical care and she told me about Aetna health insurance. They cover all SRS surgeries, procedures, follow-up, hormones, testing, labs, and supplies. They have very strict guidelines and timelines for procedures but they cover all costs. She has a patient that has this insurance and they are paying for her surgery. She said she is telling all her transgendered patients about it. I don't know what employers offer this insurance or how to get your employer to offer it but it will cover everything. I hope this information was helpful.

Joe

[Guest StrandedOutThere]

Hi Joe, I'm glad you are healing up and getting some kind, sympathetic medical care! Hopefully you'll get that hysto covered. It's good to try and keep a positive outlook. I wish you the best!

That's interesting about the DA deciding about whether something is a hate crime and what charges will be brought. I think there are like two levels at which assault can be prosecuted. The part that is voluntary for you is probably as a civil suit. You get to decide if you want to sue for personal injury. I guess the criminal charges are determined by whatever court is dealing with the case (county, state, federal, etc...). I guess it make sense to do things that way.

Since this is already going to court, are you going to sue for any kind of damages? Are you paying for all your medical care out of pocket?

That's great that there is an insurance company that covers GRS. However, I just want to mention that it's not just that Aetna covers or doesn't cover GRS procedures. I have insurance through Aetna, purchased through my school, and it specifically does NOT cover those procedures. Anyway, what determines whether GRS is covered depends not only on the company, but on your individual policy, as in what state you live in and whether your insurance is purchased individually, or if it is through school or work. I've heard rumors that Blue Cross Blue Shield of Michigan (I think) covers GRS. Blue Cross Blue Shield in South Carolina doesn't cover it. I've also heard of companies in New York, Oregon, and California that will cover it. Sometimes there are ridiculous rules and hoops to jump through. One of my friends was trying to get his top surgery covered by insurance (because they said they covered it). He ended up paying out of pocket because the company required that you be on hormones for 2 years before they'd pay.

Insurance is complicated. Remember, they don't cover things to be nice. They do it either because they have no choice (laws), or because the numbers come out in their favor (pays off for them in the long run). The best way to get GRS procedures covered is to talk to your employer or to vote for elected officials who will work toward getting legislation in place that requires companies to cover GRS.

*steps down from soapbox*

[Guest joe0117]

My apologies. My doctor was telling me about her patient and how she has this insurance and it has covered all her procedures and hormones. She had female top enhancement surgery(I apologize again, I don't know the correct terminology for females. I probably don't for males either.) Everything was covered by her insurance and she is having bottom surgery and they are covering that. I don't know what company or school it is through. She showed me the insurance booklet that her patient brought her and it said that the company believes in diversity and equality. I never ever meant to give misleading information. I was really hoping that the information would be helpful but I see now that it was not. I try but I never seem to succeed in being helpful. I think I should stick to what I'm good at - getting the tar beat out of me.

Below Average

Joe

[Guest StrandedOutThere]

My apologies. My doctor was telling me about her patient and how she has this insurance and it has covered all her procedures and hormones. She had female top enhancement surgery(I apologize again, I don't know the correct terminology for females. I probably don't for males either.) Everything was covered by her insurance and she is having bottom surgery and they are covering that. I don't know what company or school it is through. She showed me the insurance booklet that her patient brought her and it said that the company believes in diversity and equality. I never ever meant to give misleading information. I was really hoping that the information would be helpful but I see now that it was not. I try but I never seem to succeed in being helpful. I think I should stick to what I'm good at - getting the tar beat out of me.

Below Average

Joe

Hey now, don't take it wrong. I was just pointing out that there are lots of factors that determine what gets covered under insurance. It's great that whatever branch of Aetna that is is covering GRS. That's awesome!

You obviously weren't trying to be misleading. All I'm saying is that the story is more complicated. I just wanted to make sure people remember to read the fine print.

Don't freak out!

[Guest Pól_Eire]

Hormones are covered by the insurance I get through school, which I think is also Aetna. I guess it depends on where you are, like Ainsley said.

Good luck with the hysto and the trial and everything

-Pól

[Guest joe0117]

Hey Stranded,

My break down was not anything related to what you said. It was kind of a last straw/deal breaker kind of day. I met with the DA this morning and found out that it is going to trial and I do have to testify. I got notification that they were released on bail which has ade me very edgy and has me on high alert. I have already had two surgeries to repair damage from this attack and that is not counting the surgery to wire my jaw shut. I haven't had solid food in a month. I have at least three more scheduled surgeries. Everything is ten times more difficult because I can't use my dominant hand. I feel like my entire life has been getting beat up in some capacity or another and recovering from it so I can be beaten again. I have been having a lot of trouble with one detective. He gave me a lot of grief about not wanting it to be a hate crime. He tried to educate me on why I am a "woman" and need protecting as well as, my mental "instability" and "illness". The only bright spot was my conversation with my doctor and thinking that maybe this insurance company was as good as it sounded. Learning that it also had conditions just pushed me over the edge. I wish sometimes that they had just killed me that night. I get so tired dealing with all of the aftermath of all this. I really just want to live my life peacefully. I didn't mean to come across as it being from your response. It was the snowball effect and has been growing for a while. I appreciate how supportive you have been of my situation. I apologize for not looking into the insurance qualifications and coverage before posting. I also apologize for my subsequent meltdown. I didn't mean to be misleading or suggest false hope. I think my wishful thinking and excitement got the better of me. I am not looking forward to a trial and constantly looking over my shoulder.

Joe

[Guest Ryles_D]

He tried to educate me on why I am a "woman" and need protecting as well as, my mental "instability" and "illness".

I don't know what I'd do if someone tried to do that in your situation, besides try to educate him right back. *sighs* I hate people who act like they know what you are better than you do. At least with family and friends they know you ad have an excuse- they honestly think they know you and it kind of hurts to find out they don't as well as they thought. But complete strangers? *pulls what little hair they hasn't shaved off out*

I'm really sorry you have to deal with all of this.

[Guest Jackson]

Joe, you've been under an amazing amount of stress. Do not apologize or even feel like you should apologize for a meltdown or not realizing that insurance companies are a lot more wily and profit-hungry. You just take it easy while going through this whole procedure.

If you need anything, we're here for you.

[Sally]

OMG, Joe!

After all that you have been through and are still going through don't think for one moment that you aren't entitled to a melt down.

We understand and you will not offend any of us, we are here to support you.

Let some of that anger out and you will feel better.

Love ya,

Sally

[Guest DanM]

Hey Joe,

I totally understand how you feel, Just hold your head up and carry a big stick, LOL. I do. Good Luck with trial.

[Guest StrandedOutThere]

Hey Stranded,

My break down was not anything related to what you said. It was kind of a last straw/deal breaker kind of day. I met with the DA this morning and found out that it is going to trial and I do have to testify. I got notification that they were released on bail which has ade me very edgy and has me on high alert. I have already had two surgeries to repair damage from this attack and that is not counting the surgery to wire my jaw shut. I haven't had solid food in a month. I have at least three more scheduled surgeries. Everything is ten times more difficult because I can't use my dominant hand. I feel like my entire life has been getting beat up in some capacity or another and recovering from it so I can be beaten again. I have been having a lot of trouble with one detective. He gave me a lot of grief about not wanting it to be a hate crime. He tried to educate me on why I am a "woman" and need protecting as well as, my mental "instability" and "illness". The only bright spot was my conversation with my doctor and thinking that maybe this insurance company was as good as it sounded. Learning that it also had conditions just pushed me over the edge. I wish sometimes that they had just killed me that night. I get so tired dealing with all of the aftermath of all this. I really just want to live my life peacefully. I didn't mean to come across as it being from your response. It was the snowball effect and has been growing for a while. I appreciate how supportive you have been of my situation. I apologize for not looking into the insurance qualifications and coverage before posting. I also apologize for my subsequent meltdown. I didn't mean to be misleading or suggest false hope. I think my wishful thinking and excitement got the better of me. I am not looking forward to a trial and constantly looking over my shoulder.

Joe

I'm sorry you are having such a terrible time. I can only imagine how it must feel to know that those guys are out on bail. Hopefully you are in a safe place. That's really unacceptable what that detective was saying. Needing protection from goons like that has nothing to do with gender. If a person is outnumbered, there isn't much anyone can do. Not to say anything negative about police officers, but the profession does seem to attract some of the more "traditional" types. I remember this one time when we had off duty police officers doing security for my job. This one guy kept going on to my friend about "the libs" (that'd be liberal democrats) and "the gays". Poor cop didn't realize that our lab is populated by two transmen and a gay dude. Anyway, I digress.

Don't ever wish they had killed you! Life is precious. Things WILL get better. All of this will eventually be behind you. That detective was definitely out of line. Lots of people that you've been in contact lately have been out of line. Once you get out of the surroundings you are in, it will be easier to heal.

Man, I feel bad about being all "matter of fact" with the insurance company stuff. I'm not known for my sensitivity. My emotional reasoning is just not at all good. I'm really, really sorry. This is one of those times I should have kept my mouth shut. The fact that there is an insurance company that covers GRS stuff is great. Nothing I say detracts from that. It's not false hope. Some policies under Aetna definitely do cover GRS. So do some policies under other companies, like Blue Cross Blue Shield. I have such anger toward the insurance industry in general that I didn't see that this maybe wasn't the time to say something.

Dude, is there any way you can NOT go to the trial? Are you seeing a therapist? You sound like you are have plenty of emotional injury too. I hope you're talking to someone to help you work through this. I used to work in an office that saw a lot of people who had been in car accidents or work accidents. Those things are difficult to deal with when they are only accidents. I can't imagine what you must be going through, but I hope you have some support. PM me if you ever need to talk. I know I probably come across as kind of a jerk, but I'm really not. I'm just not the most socially competent person.

[Guest joe0117]

Thanks everyone for your kind thoughts. I've had a couple days to try to regroup. I spent most of today in bed just trying to expedite the recovery process. I just get majorly overwhelmed some days. I really am trying to stay positive. I am working on tring to be able to move. I am currently in a "safe house" by the police and DA for the case against my family. Obviously, they know where I live so I am trying to get the ok to move and then find a place. It's complicated beacuse there are police being investigated and charged so the state police are involved and everything has to go through them until that caseis over. These two are going to overlap so I don't know what will happen. They may just move me again which would save me having to find a place but then I get no say in where I live. Pros and cons. I am seeing a therapist. She is great. She came and saw me in the hospital a couple of times while I was there. She has been threatened by my family too so I am thankful she has stayed with me. I do have to go to trial. I am a witness for the state. I can only hope now for some sort of plea.

Stranded-in no way do I think you are a jerk. I just had poor timing on reading the response and I was already neck deep in my negative thinking. You are very knowledgable and I am thankful that you corrected me. In some ways, I am spoiled living in MA because it is so liberal and overall more accepting of diversity than other states. I have more protection, resources, and such available to me. It seems odd with everything I am going through right now and being nearly killed for being trans. There are ignorant, hateful people everywhere. Thinking with a clearer head, at least for the moment, maybe people can take it as just information. Hopefully some people can benifit from learning about this and seeing what coverage is offered where they live. If it was at all helpful to anyone then I can feel good with that. I know insurance companies suck and that not having that coverage/financial assistance is a huge barrier/restraint for a lot of us. I can only hope it helps somebody. If nothing else it is information.

I hope everyone is doing well. I really enjoy getting to know everyone here through your posts. I hope you are all safe and happy!

Joe

[Guest Benzrathe]

joe, sorry to hear about the recent crap-fest you've had to endure of late, man. As a former DA victim's advocate in MA, I just wanna make certain you've met and/or have been assigned one. In MA we have what's called the "Victim's Bill of Rights", make sure you get a copy of it. In it is detailed what the State can and can NOT compel you to do. And NOT revictimizing the victim is paramount! There's more to Victim's Rights than just the opportunity to complete and submit an "Impact Statement"...

I know they (the State) would like to grandstand on this case. Its a good one, in that they have a surviving witness; the matter was heinous and egregious; and its a hot button issue (and thus potentially a political coupe). But the bottom line is Do no harm. True, when they (The State) get right down to it, the public's interest is a concern. But ask the ADA handling the case - if s/he thinks that having the law behind them makes what they're doin' to you feel any better than what the assailant(s) did in THEIR quest for "justice"?

Be well man, and above all be safe.

Ummmm... Not necessarily advocating that you do this buuuut.... head trauma's often result in memory loss........ Check with your healthcare providers. =]

Benz

[Guest StrandedOutThere]

I didn't think about the head trauma stuff. Joe, have you been checked out by a neurologist?

[Guest joe0117]

Hey,

I do have a victim's advocate but I can't say that she is very helpful. The advocates through Fenway are much more helpful and supportive. I have seen a neurologist. I've had two appointments since the attack. I have long term problems from years of head trauma so this event didn't help any. I figure I'm lucky though. It could be worse. I should probably be brain dead so being able to form complete sentences and process thoughts is a big deal for me. I appreciate everyone's concern. All of your support has meant a great deal to me.

Joe

[Sally]

Joe,

We are so glad that our support is helping you, that's why we are here (unless we are needing support).

You are far from brain dead, I love reading your posts - you have been there through such terrible things and yet here you are on the forums helping others - you are a wonderful person.

Your attackers see you only as trans and therefore different and must be distroyed - if they only knew what a great person you really are.

Love ya,

Sally

[Guest joe0117]

Thank you Sally,

I love it here. I sign in a lot through out the day. I like to see how everyone is doing. I spend a lot of time during the night. I have a terrible time sleeping so I log in and read everyone's posts. It can be a little lonely on the Playground at night/early morning but it gives me a chance to go back and read older posts. I like to help when I can. I'd really like to make some friends. Your comments to me have made me smile and feel good about myself. That feels really nice. Thanks again.

Joe