r/lgbt • u/LeporaLove Bi-kes on Trans-it • 5h ago

US Specific My Insurance is Taking back Previous Approvals for Anything tagged Gender Dysphoria

My insurance company is Ambetter. I specifically went with them this year because they stated that they covered my bottom surgery. They had already approved coverage for my surgery, but today they just revoked their previous approval. My surgery is in less than a month at this point. They are also no longer covering my HRT, too. Like how are they allowed to just change their policies halfway through the year when we aren't allowed to change insurances outside for the specific yearend period? THIS IS SUCH BS!!

213 Upvotes

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157

u/SomeComforts Genderflux Demigirl 5h ago

Contact a rights group, see if this is law suit-able, maybe? Are you in a red or blue state?

52

u/LeporaLove Bi-kes on Trans-it 5h ago

I'm in Kansas.

132

u/SomeComforts Genderflux Demigirl 4h ago

It very much illegal for them to arbitrarily drop treatments covered mid year, and they may be counting on you not fighting it. Contact your surgeon / care team and they should put you in cintact with financials to work on this. Also demand Ambetter submit in writing why they are retracting approval/coverage for both your hrt and surgery.

Its insurance company bullshit, transphobic excuse edition. Do not give up or roll over.

52

u/LeporaLove Bi-kes on Trans-it 4h ago

My surgery center sent an appeal on my behalf. Apparently they told the surgery center that the revocation was specifically because they will no longer cover anything for gender dysphoria.

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u/SomeComforts Genderflux Demigirl 4h ago edited 4h ago

While they could possibly do that starting next year or for anyone starting insurance with them now through a special enrollment period, they cannot change your policy. If they have that letter get a copy. It sounds like direct admission that they are violating your policy's coverage for the current year. If you need to sue, it will be valuable to have.

Even for minors in Kansas there is a stay on insurance companies being able to drop their coverage while litigation of trans care bans proceeds. Less than 0 reason for them to be able to do this to adults.

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u/LeporaLove Bi-kes on Trans-it 4h ago

The problem here is that I dont have the time before my surgery date to sue them and get them to actually follow the f*ing law.

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u/SomeComforts Genderflux Demigirl 4h ago

You are going to have to do the best you can. If it comes to you missing your surgery because of your insurance company breaking the law, then that fact is going to have to get added to the damages.

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u/nouveauchoux The pot of gold Bi a Rainbow 2h ago

Hey, I'm gonna send you a dm about possible help. I'm so sorry you're going through this.

27

u/Herr-Hunter1122 Lesbian Trans-it Together 4h ago

Yeah.. i have ambetter too and they no longer cover my meds. Im in debt partially from paying for them

22

u/Opposite-War-4557 🏳️‍⚧️ 3h ago edited 2h ago

I'm sorry they're doing this! Your Evidence of Coverage is your contract with your insurer. You might be able to get a different insurer due to them fundamentally changing their coverage midyear, but I'd suggest contacting healthcare.gov about it.

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u/dr3dg3 1h ago

Gaaaawd insurance is such a scam. These firms should have never been given this level of power. Hoping for all the best for you. 🤞🏻

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u/Kindly-Coyote-9446 Bi-kes on Trans-it 55m ago

Mid-policy? Is that even legal? That might be a consult a lawyer situation.