Lucent's Coverage of TS Medical Needs

It's official: Lucent's policy is that the medical needs of transsexuals are covered, just like any other medical issue.. Sharon got her reimbursement check in October of 2000.

It's never simple, of course. It took quite a bit of persistence. Lucent's HR organization has beeen wonderful, but the insurance companies are not terribly cooperative. Here's my understanding of how it's handled.

What is covered and how?

How did Sharon do it?

Sharon had her surgery in November of 1999. Two months later, we had informal assurance from Lucent HR that SRS was already covered, and she should file for reimbursal. She did, and had to re-file many times when United Health Care kept losing her paperwork or denying it without giving a reason. With persistance, and with an appeal, she was approved. However, she paid a 10% penalty for not having pre-certified, and a 20% deductable for having gone off-network with a referral. With advance planning and appropriate paperwork, both of these fees might have been avoided. She eventually received her reimbursement check in October of 2000, nearly a year after her surgery.

Here are some letters she wrote with details:

  • Sharon's e-mail announcing success.
  • Sharon's letter with advice for the next time,

    There were two attachments to Sharon's advice letter:

  • Doctor's Letter
  • Therapists's Letter

    Other Resources used in Planning

    Proposed language for policy inclusion (not used).

    Position paper why it should be covered.

    Discussion of various procedures that are sometimes involved in SRS, and reasons why such procedures would be covered for other diagnoses.

    Links to resources useful for background.

    Math showing the cost for Lucent to be 18 cents per year per employee.