Intersex

Intersex Insurance Coverage


People with intersex condition have been failed by the medical community. 

We at MoZaic Care really are sorry for the harm caused by the latency of the medical world to catch up with appropriate care. We know it is unfair for the burden of educating providers/insurance to fall on our patients.

 

Unfortunately, we have had insurance coverage issues in the past when trying to use intersex codes in order to get insurance coverage. (For instance, Q.56.3 Intersex-Male condition. Purpose: rule out/confirm internal organs due to intersex condition, such as potential Q.55.8 congenital malformations of internal organs i.e. Persistent Mullerian Duct Syndrome (PMDS).) This puts us in an awkward position of using inappropriate codes in order to protect our patients pocket books and obtain optimal coverage.

 

Similarly, issues have come up in the past when the three letters have not been submitted.  It is disappointing that the insurance companies are sometimes unable or unwilling to separate intersex conditions from transgender identities.

We believe that the conditions we treat, including intersex are not mental disorders; therefore, our patients should not need mental health diagnosis nor mental health providers. Again, we run into the obstacle of insurance coverage for our patients.

 

Our goal is for our patients to always be treated with respect and validation but it is clear that as part of the system, trying to work within the system, we are part of the problem.  If you have been made to feel disregarded and unseen and that your intersex condition is not being taken seriously, we are truly sorry. 

Going forward, if you still trust us with your care, we are absolutely willing to submit the paperwork with the codes appropriately aligned with your condition upon your request.  The risk is care may not be covered by insurance. If there are issues with insurance coverage, we would be more than happy to provide you with any supporting documentation you may need to appeal their decision. Let us know how you would like to proceed.

 

We see you, we hear you and we aim to try to help you navigate the system that is alignment with you.

 

Sincerely,

MoZaic Care