How do I know if I'm covered?
April 3, 2014 7:20 AM Subscribe
I am a trans woman. Recently, I received a job offer from a private higher education institution in New York City. I would really like to accept the job, but repeated conversations with the individual who recruited me—who has been asking questions on my behalf to the institution's Human Resources department—have left me unsure whether or not their health insurance will cover trans-related care. How do I get this information? Can
I get this information?
In my experience, many health insurance plans have restrictions and coverage exceptions when it comes to trans-related care. Not just for "surgery" (which isn't relevant to me at the moment) but for hormone replacement therapy, doctor's visits related to HRT, and mental health care related to transition, etc.—all of which would be very expensive for me to pay for out-of-pocket. I don't feel comfortable accepting the job until I know whether or not there are such restrictions with this employer's plan. For other recent job offers, I've had success in simply asking HR representatives for a copy of the organization's certificate of coverage, which generally has enough information for me to make an informed decision.
With the institution in question, however, things have been more difficult. I asked the individual who recruited me for the certificate of coverage, and they asked HR on my behalf, and HR flatly refused. Since then, my request has been escalated several levels up the hierarchy, with the director of the department who wants to hire me talking to the director of HR—but I still haven't been allowed to see the document. They've now put me directly in contact with someone from HR, who I'm scheduled to have a phone conversation with soon—but given HR's unwillingness to help anyone else, I'm not optimistic that they'll want to help me when I ask on my own.
The individual who recruited me for this job knows I'm trans, but hasn't disclosed that to any of the other parties involved. They did ask the HR department questions about the institution's trans-related care, at my request—questions which HR apparently refused to answer—but without ever making specific reference to me.
I understand that it would be irresponsible for HR to "promise" that their insurance would cover whatever medical treatment. Still, it's difficult for me to accept a job not knowing whether I might be on the hook for hundreds of dollars worth of medical treatment each month for HRT and related visits to the doctor. (I am privileged in that I'm confident I could find a way to pay for this treatment on my own if I needed to, but that extra cost definitely weighs into whether or not I want to take the job.)
So my questions are: Do I have any recourse? Is there some magical sequence of words I can say that will make someone in HR want to give me any kind of useful information about trans-related care under their health coverage? Would this be something worth contacting an advocacy organization about? Is it paranoid to assume that health coverage at such an institution might have specific exclusions for trans-related care? Am I even approaching this situation the right way? At this point, I just feel awful—I am bewildered and frustrated by the whole thing and don't really know where to turn or what to do.
Other context, in case it's relevant: I live in New York City. I'm still at the beginning of my transition, and right now I'm only "out" to a few friends and family. I am seeing a therapist and I am under a doctor's care for hormone replacement therapy.
Here's a throwaway e-mail, if you'd like to contact me privately: email@example.com