As I spiral down to a point of no return (doing much worse than now then when I posted before), I have begun the pursuit of having my surgery with my health insurance (Aetna), which resulted in a resounding no. It devastated me because initially it was approved. Yet it came back denied because, as the doctor said "Your employer has a specific exclusion for transgender surgery." I found this odd as they are paying for my hormones, and in many policies now they include gender identity/expression as a protected status within the company.
I spoke with my HR at length about this, who has been wonderful. I have started a process of having this given a second look, but I am not sure where else to look or what to say. I posted what happened on our internal company "Facebook", on a specific board for the LGBT community.
I fit Aetnas guidelines below (as many of us probably do), so I do not understand why it is this way. I imagine it comes from the ol' cosmetic argument. Part of me thinks if I can provide an honest, factual, valid business plan how my employer would benefit, I think that would go along way. I would think the reduced medication, therapy, and doctor visit costs over the next 2-5 years would make up a lot of the difference.
Even it was a meet halfway deal, like I pay the surgery and they pay the hospital/anesthesia less deductible. Trying to be realistic too. Even though I seem to be the only transsexual in the company, out of 220,000, I would guess there are at least five to ten others, so it is not like they would suddenly be paying millions of dollars more for these surgeries. I wouldnt mind either if I had to have a higher tier/expensive plan. We have two now as it is, a third with more coverage would not be a big deal. Not sure if that would make a difference, but my employer is a Fortune 100 company. Anyone have experience or advice in this situation?
