About a year and a half ago I unexpectedly lost my health insurance coverage.

As you may have read in my posts about transitioning on the job, the client I was working with when I transitioned initially told me they could accept the revelation that I was a transitioning Transsexual.   Then after two months they found an excuse to cancel our contract.

Obviously, I was concerned about the sudden loss of income, but I was more concerned about having lost my health insurance.   (As part of the contract, my client covered my health insurance and in return I gave them a steep discount on my fee.)

As we all know, healthcare in this country is insanely expensive if you aren’t insured.   (It can even be expensive if you have health insurance, as anyone out there who pays for their own will tell you.)

I had, of course read of the difficulty we Transgendered have in obtaining health insurance.   I had most certainly heard the stories first-hand in various support groups I attended.

All of a sudden I was uninsurable, simply by virtue of being a transitioning Transsexual.

And I refused, and still refuse, to lie about the fact that I am a Transsexual to obtain health insurance or anything else for that matter.   This journey has been too long and too hard and too painful for that.   I will never again hide, lie or deny the truth of my existence.

So, knowing that I was uninsurable, I began to wonder just what would happen if I applied for insurance without trying to hide the fact that I am Trans.

So I did it.

Here’s what happened.

It was one of the big, well-known ones.   You would probably recognize the name.

I went to their website one afternoon and spent quite a while filling out the detailed (very detailed) application form.   Now, I did not explicitly say I was a Transsexual.   I said I was a female named Ashley Alexandra Wilson (my legal name).   But I listed all the drugs I took at the time, including the hormones and both my most recent family doctor (yes, the one who discriminated against me) and my endocrinologist.

When I was finished I pressed ‘œenter.’

And then the fun began.

The first letter arrived maybe ten days later.   In very clipped language it instructed me to send all my medical records for the last five years to their medical underwriters.   The letter concluded with ‘œYou will be receiving separate notification of the status of your pending application.’

So I swallowed my pride, contacted my former physician’s office, obtained a copy of my medical records and mailed them off.

Another ten days or so went by and I received another letter.   It read in part: ‘œwe have received the medical records you submitted.   However, our letter of September 24 requested all medical records for the last 5 years.   Please arrange to have copies of your medical records from Dr. _____ (my endocrinologist) sent to us.’   (OK that one was my oversight.)

It was the next part that really got to me: ‘œPlease also complete the enclosed questionnaire and return it to us in the enclosed business reply envelope.’

It was a very long and detailed questionnaire about my drug and alcohol usage.   And I found some of the question unnecessarily intrusive, even insulting.

Now, if that questionnaire had been part of the original application and, thus something every applicant was required to complete, I probably wouldn’t have thought much of it.   However, coming, as it did, at this point in the process it was clear they were actively looking for reasons to deny me coverage.

Curious to see where this would all end, I filled out the questionnaire, mailed it off and arranged to obtain copies of my endocrinologist’s records.

A few days later, I received another letter from the insurance company, this one dated October 29th:   It read in part: ‘œthank you for promptly completing and returning the questionnaire mailed to you on October 18 ‘¦ At this time we await your medical records from Dr. _____ and hope to have them no later than November 15 ‘¦’

Deadlines.   Now we’re setting deadlines.   (And pretty tight ones at that.)   Not to mention there’s something in the tone of it that strikes me as condescending.

I missed that deadline through no fault of my.   (My endocrinologist had just joined a new practice and they were still in the process of moving all the medical records.   If I remember correctly, I missed the deadline by about a week.

And, of course, I promptly received a letter denying my application.

I responded with a letter of my own, explaining the situation, informing them that I had just mailed the records and asking them to reserve judgment until they received the records.

A few days went by and I got another letter from the insurance company, the last one I would receive.   It was oh so carefully worded.   I could just tell it was the work of several lawyers and doctors.

It was quite dismissive of my endocrinologist’s records, saying they ‘œprimarily consist of injection dates and no lab work since 2006.’   (This whole incident occurred in the fall of 2007.)

I think they were hoping to find lab work that indicated that the Hormone Replacement Therapy had damaged my liver or kidneys.

Since they didn’t have that, they denied my coverage based on the fact I take hypertension medicine. (Of course they also have five years of detailed medical records that indicate the medicine controls my hypertension and that I am very healthy for my age.   Everybody agrees on that, including the surgeon who performed my GRS.)

The letter also said that if I were to reapply at a later date I would need to provide ‘œinformation regarding any surgery planned with respect to your transgender status.’

Although I could never prove it of course, it seems to me that this was clearly a case of gender discrimination.

I’m sure one of the first things they do with these applications is to run a credit check on the applicants.   If they did, they found out that I could have paid for the coverage.   (Maybe not easily given the current state of my finances, but I could have swung it.)

The other thing I find ironic is just how much time and effort the insurance company put into this.   We were going back and forth for four months.   This must have cost them more than a little in salaries and time.

There seems to be a perception in the insurance industry that the transgendered are uncoverable, that they would lose too much money on us.

If that is what they’re thinking, it seems ridiculous to me.   There are so few of us.   How much more could we cost them in the grand scheme of things?

I took care of both of my parents in their final years.   As they got increasingly frail, I assumed more and more of the financial responsibilities, including handling their health insurance.   My father’s final illness put him in the hospital for two solid months.   The final bill was something on the order of $750,000.   Of that we only had to pay somewhere between $3,000 and $4,000.   Dad’s health insurance paid the rest.

Paying costs like this for the tens of millions of policy holders in this country must be routine for the health insurance companies.   Obviously, they can do it and still make a profit.

So I ask the question: is this really about money or something much uglier?

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