Insurance is crazy

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I ran into another snag with my insurance company.

In the Dallas/Fort Worth area. There are no longer any doctors that who prescribe HRT that are listed as specialists. At least none that I am willing to see. That leads into a problem that United Healthcare is not setup to handle. I am using my HRT doctor as a specialist. I don't mind paying the specialist fee to see him twice a year. Then I would keep a local doctor as my PCP. The reason I do not want to combine the two is to avoid an hour drive for my routine visits. Especially as often as I need to see my PCP.

Unfortunately, my insurance company has no way to do that. I can have one or the other doctor as my PCP. Then if I want to use the other, he is effectively out of network so I have to pay cash. Either way, I cannot afford to do that. One lab from either of them would eat my medical budget for the year.

It is sad that my local PCP will not prescribe my HRT meds. Though, because he does not have the interest or experience, I really do not want him to. That leaves me with not having a local doctor because of financial reasons.

I tried to explain the problem to the UHC agent on the phone and it was almost impossible to get her to understand. Somehow, we really need to change the system to take care of trans-people.

On a different note, today I receive my medicare card and found out that the agent at the SS office only forwarded my name change to Medicare. So my Medicare card reads Cassie Ellen - Male. Grrrrrrr. So now I am waiting another 2 weeks to 2 months for them to fix it. I so wish that it was just possible to count on the government to do the right thing because that is their job. Still, not having to be called that boy name by medical providers will be a big relief.

Comments

I'm confused..

Frank's picture

You can pick the doctor as your PCP, but can't see him in-network if you don't?

If you aren't going to the PCP monthly. You can (if your plan is like mine) change your PCP to take effect the following month, see the hormone doctor, and then put in to switch back to the regular PCP the following month. So the HRT doctor would be your PCP for one month, and the rest of the time you'd see the regular guy.

{{Hugs}}

Hugs

Frank

Thank goodness for the NHS

Angharad's picture

despite its foibles and failings it's still better than anything run by private and insurance interests. Though I did encounter a new phenomenon yesterday. One of the practices I work at had someone who had moved down from Scotland and their Scottish NHS number was not accepted by the NHS England data base, so she couldn't register as a patient. Probably some form of loophole that hasn't been envisioned or is England getting ready for a potential split from the UK by Scotland? What's absurd, if they'd come from Outer Mongolia we'd probably have been able to register them - duh!

Angharad

I can agree

There are no endocrinologist in Peoria Illinois who are in UHC list who will deal with hrt so I have to see a Dr in either Chicago or St. Louis. So I travel 4 hours one way to see him twice a year and I still have my PCP for my diabetes and other day to day medical. My PCP even found him for me when I came out. Found out that I'm covered for surgery if my doctors say it is a necessary surgery took me a few tries to find out now I need to save the money to take off work to pay bills and the everyday living expenses.

Randi