Debtception

Even in my darkest moments, I never give up hope. But I’m in my darkest moments now. Maybe this is the very stuff that keeps me alive. I can’t explain it really. Some folks call me a negative pessimist, but I’m not. I complain, yes. But I’m actually an optimist. I fight. And I am hopeful.

I spent half the day putting together paperwork that would hopefully appeal to my insurance company regarding the differences in transgender body types: FTM. MTF, and FTN. I thought I was pretty clear and polite. I added notes from Dr. Mosser (world-renowned top surgeon in San Francisco) with illustrations on where nonbinary people prefer their incision scars–and why it relieves their dysphoria. Curved lines seem to be reminders of what was previously there. Wouldn’t that make sense to anyone with empathy for nonbinary people?

Well, maybe it wouldn’t if your insurance company has a bogus trans team on your medical board. My doctor’s office (my PCP) submitted this referral yesterday, with my excellent letter, Dr. Mosser’s notes and illustrations, with a page and a half on nonbinary’s equal rights. It was submitted at 11:00 am and denied by 3:30 pm. WTF?!

There is also nothing for me to download off the portal to see WHY it was denied. No explaination.

A lot of the times in the past, they have re-routed these “denials” to other plastic surgeons in the netowrk (surgeons that have never heard of top surgery or trans people)–just so I couldn’t appeal the denial if I wanted to. By the time I try to come back to appeal it, the original referral is stale-dated. Meanwhile these other surgeons treat me like a freak and discriminate my kind. I’m telling you, IEHP (my insurance company) does this on purpose!

After crying for 20 minutes, I wrote to the Ombudsman, but I won’t hear back from them for three business days. My impatience doesn’t last that long. I suppose I can start a Civil Rights complaint though.

I can call my insurance company again to talk to my social worker on the “Trans Team” (I’ve spoken to her a few times. Her name is Irene), but yesterday they said I never had a social worker. Can you believe all this shit?

Is this all worth $15,000? Let it be known, I’m on a fixed income. I’m fucking disabled and have been for many years. By law, the state is supposed to help me, so it’s the injustice that enrages me, not being in debt the rest of my life, and I will be.

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4 thoughts on “Debtception

  1. lindacbugg January 22, 2021 / 11:10 am

    Does the quality of care change depending on which county you’re in? I also get IEHP (or health care thru the state of CA) & recently got a referral for neurology–only to find the Dr’s closest office was in Redlands which is 1hr from our home. The rule is 15 miles & hence got a letter saying I’d filled a grievance & they’d look into it & yada yada.
    NO–I nicely requested a new referral because potentially traveling 2hrs for botox for my migraines (a 10 minute procedure) shouldn’t require a 2hr drive! Especially since your own rule is 15 miles of travel (give or take) & my driver is 75yrs old!

  2. lindacbugg January 22, 2021 / 11:15 am

    I am aware the 15 miles of travel is depending on where the heck you live & since I live in a much more populated area of the IE in the “IEHP” (Inland Empire health plan) my results of course vary from yours in bum fuck JT–to clarify for whomever else may read the comment section.

  3. Carol Es January 22, 2021 / 11:26 am

    IEHP is some major bullshit if you ask me! I wonder if we can change it to Molina or something like that? Have you ever called DHS to find out? Maybe I’ll call today, but now I’m in the middle of the appeal and do have authorization for at least one other surgeon. I don’t want to start all over from scratch. 🙁

  4. Carol Es January 22, 2021 / 11:27 am

    Most of my docs are either in Yucca Valley (6 minutes) or Palm Springs (40 mins). I don’t mind Palm Springs because there are better doctors there.

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