The "it must be medically necessary or my insurance wouldn't cover it" argument

[DahliaRW]

Ever get this one:

"Well, if it there wasn't proven medical benefit my insurance wouldn't pay for it."

Here's a good comeback for you... My insurance (premera through Microsoft) helps pay for sexual reassignment surgery. Tell me that's medically necessary?

Just a thought...and a counter argument!

[trmpetplaya]

When I had Premera (also near the Cascades ), they didn't cover RIC... so one could also argue that not ALL insurance companies pay for it - and all of them would if it was medically necessary, right? - and many states' don't cover it through medicaid anymore either. I never looked into sex reassignment surgery when I had Premera... I know that a co-worker would have had to pay $500 out of pocket to have her ds circumcised at the pediatrician (the hospital she birthed at doesn't perform RIC ).

Insurance companies are starting to wise up about circumcision. I wish they'd hurry up about it though. I have a feeling that the rates plummet when insurance companies stop paying for it. If true that would partially help to explain why the rates are so low around here - no medicaid or private insurance that I know of covers it.

love and peace.

[Fi.]

My insurance (premera through Microsoft) helps pay for sexual reassignment surgery. Tell me that's medically necessary?

Considering Gender Identity Disorder is an actual medical disorder and reassignment surgery IS an actual recognised fix for it...yeah. Sorry. Not a great argument.

[minkajane]

Originally Posted by Fi.

Considering Gender Identity Disorder is an actual medical disorder and reassignment surgery IS an actual recognised fix for it...yeah. Sorry. Not a great argument.

And in certain cases, circumcision IS medically necessary and SHOULD be paid for, such as in cases of cancer, gangrene, or frostbite. The point is that RIC shouldn't be covered for all boys any more than sex reassignment should be covered for all people.

[DocsNemesis]

Um, this kinda bugs me. I personally, do view sexual reassignment surgery as medically necessary....though I suppose it is more classified as a psychologically necessary surgery. And as someone else pointed out, sometimes circumcision really is necessary. (and this kind of strikes close to home because my FIL is going through sexual reassignment surgery)
Maybe a better way would be to point out that MANY insurances do not cover it and more and more are stopping their coverage every day.
Also, my insurance (medicaid) is covering a non-medically necessary surgery on myself-I had a lump under my arm that is just excess breast tissue but because it hurts, they are going to remove it.

[moonbeem]

cosmetic surgery

is not covered by most insurance carriers and that seems to be what RIC is about - cosmetic alteration, there is no medical benefit. Lots of parents who choose to circ don't want their son to "look different."

I would venture that this comparision is more apt that gender reassignment.