Hello everyone, my name is Lance G. For the past two years, I've been on track to get my top surgery done before my insurance with my parents runs out when I turn 26 in July 2022. I've been working with two primary care doctors, my therapist, and my insurance, United Healthcare of California in order to get it taken care of.

 

Back in April 2021, when I was first trying to get this taken care of, my doctors and insurance told me there were no in-network plastic surgeons that would be able to go to for this, and that I should look out of network. In June, after my consultation with my surgeon's office, United Healthcare told me that they had received my letters of support from my therapist and my referral from my doctor to this out-of-network surgeon. I've called them multiple times between June and November, and each time they assured me that my case had been accepted and closed, and I was on track to get my top surgery completed on December 17th, 2021.

 

However, 31 days before my scheduled surgery date, United Healthcare dropped the bomb that because there were now in-network surgeons that offered this same procedure, they will not be covering my request for an out of network provider and that I need to receive a consultation from one of them instead. However, they do not seem to understand that this procedure takes anywhere from around 4-6 months to get a consultation and surgery date set up, and the closest in-network provider that now offers this service isn't seeing people for consultations until July 2022, and by then I will lose my insurance. This is too long to wait just for a consultation. I've tried to send an appeal, and because they deemed my top surgery "not medically necessary," they will not put my case under emergency review and told me I will have to wait 30 days for my appeal to be processed. However, they only decided to tell me this 31 days before my surgery, making this literally impossible.

 

After further research, it seems that United Healthcare has a history of telling transgender patients that they are cleared for gender-affirming surgery, only to tell them right before their procedures that they will not be covered anymore.

 

I cannot reschedule this date, or else I will not be able to receive top surgery until at least December 2022. I've already had to wait 5 years for this surgery. It is between my two semesters in college, and classes will be in person during Spring 2022. I was set to move into the dorms at my University in January, and I was excited to do this while presenting male and without needing to bind anymore. This date of December 17th was supposed to allow me to go into surgery immediately after my Fall 2021 semester and give me adequate time to recover before moving closer to my campus for my January 24th start date for the Spring semester.

Funds will be used first to cover the out-of-pocket expenses I will have to pay to cover the fees for my top surgery. I am fully expecting that if I will have to use most if not all of my own savings and school loans to pay for this, so any extra money will go towards paying back my student loans and rent after I move out. 

 

Because of what United Healthcare is doing, they are ruining the plan for my life I have been meticulously setting up for the past year and a half. Please help if you can.