The run around

So not a very big update on things, more so this is a rant about health care. Something we all have to have in order to live. 

Now let me preface this really quick. I live in the united states in the state of Missouri, near Kansas City. 

On Thursday I called my insurance company which is run by the state. I am on medicaid right now under the name Home State. It’s the only insurance type I could go under in order to keep seeing my primary doctor. (The state has like 4-5 name plans, each networking to different physicians and so on. All plans have the same basic coverage though as far as medications and so on.((as far as I know.))

So I get in touch with a lady at the insurance company and I ask her about hormone therapy being done for transgender people. I ask if it’s covered or not. Literally every answer she gave me was one she kept reading off the screen. “Ma’am, we won’t know if it’s covered or not until the doctor sends in their code for the order on medication. Then the system can determine if it will be covered or not.” Do you KNOW how vague that is? I couldn’t get her to transfer me to speak with someone who would know, nor did their site say anything either. I have tried asking other people, and no one seems to have an answer for me. 

So Friday I happened to catch my doctor while getting my blood work done and I tell her what they said and the look of confusion confirmed it. What is this healthcare system really doing? Ok here’s a good clinical example. So you’ve been diagnosed with Gender Identity Disorder. As far as I know, this is a psychological diagnosis. So as any behavior health would go on basic things, your psychologist would recommend a medication to alleviate and help with your condition, correct? The order would be run by the insurance company and they’d say yay or neh on the matter, suggest a generic and move on right? 

From what I’m reading from various sites, some insurance companies thought it would be better to deny it all together and claim it under experimental. What? How do you even fight this? Then you have to factor in the new Obama Care. Well, shouldn’t under that, they have to approve me? 

I’m left with 100 more questions to my one and it’s aggravating. I can’t find anything on the subject and all I want to know is if I’m going to have to pay out of pocket or not. 

I’m going to state this now, I’m all for Obama Care. JUST because of that pre-existing clause that exists. My husband greatly needed that because of an accident that happened back when he was 15 and up until 09 he wasn’t covered for it. But the confusion it’s causing is overwhelming. It feels like stepping into the bitter cold of a snow storm, with papers lashing about in the wind and among all that confusion and snow, you’re trying to find the right paper. Grasping at toothpicks.

Well, on Tuesday I’ll be getting my letter for T, and the 13th I’ll be meeting back up with my doctor to speak about my blood lab results and figure things out from there. I only really feel comfortable spending $60 a month on my T so let’s hope I can find some sort of deal out there that meets my needs. Crossing fingers if I don’t hit any road bumps and hick-ups along the way, by mid February I’ll be starting my T.

Also… still no binder. Remind me next time I order something from another country, to save up for faster shipping lol.

Well that’s really it for now. I’ve got a few more things I could rant about but now’s not the time I suppose. Everyone have a great day and thanks for reading.


7 thoughts on “The run around

  1. oddly enough, most meds are covered though. There should be a website where you can check and see what your insurance covers. Also, most docs are smart enough to code it as a “hormone imbalance” and not transgender.

    1. See I thought I could check lists of medications and I checked both Mo health net and Home states sites and nothing. I found one article in 2010 where it stated T was meant only for men. But that was going on four years ago so I literally have no clue now. Sure it be nice if the doctor could say it was a hormone imbalance but without the test results to back that up it would be lying and she could face some serious ramifications for that and I don’t want her suffering because of me.
      Especially seeing the amount of T a transgender ftm needs compared to “normal doses” would be a red flag too ya know?
      So I’m kind of stuck until I either find someone who has medicaid in my state who’s got T and it’s covered and or find out the 13th.

  2. this is why I love California…Transgender protections are great here…but thats besides the point…I would advise you if your insurance company is dicking around with you…and they end up not covering it…look up the phone number for “Stroheckers” pharmacy in Oregon…I know it sounds weird but order from them…its usually about $60 (with no insurance) for about a 3 month supply of both T and draw needles, syringes and injection needles…oh and also the little alcohol swab guys…lol this is seriously WAAAAAAY cheaper than anywhere else…they ship to just about anywhere in the US and take prescriptions from all over. They are the only reason I can afford my T currently…definitely check them out!

      1. no prob…and I totally feel you on the prices…the cheapest I can find locally is about $90 for 1 month…so Stroheckers is a total life saver… 🙂

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