Author Topic: Self Funding my Surgery  (Read 268 times)

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Offline Borneheld

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Self Funding my Surgery
« on: August 18, 2020, 08:10:58 pm »
I am going to have to self fund my bottom surgery... after being told I was covered 3 years prior.

In 2017, I was informed and had not been told differently that I had coverage for my gender reassignment. Fla Blue told me and I repeated it several times back and they said yes, be happy, you are covered. i remember that distinctly.

I contacted my first therapist, cheering and excited made my appointment (out of pocket $100), made my second therapist appointment with a different one ($125) to complete my letters. DONE

Set up my consults with my surgeon Dr Salgado in Miami, ($175) had my OBGyn appointment for the exam and ultrasound (more $$) everything checked out. DONE

Made a consult appt for a hysterectomy in Miami with Dr. Fein - 1 Month later had surgery (more $$) - DONE

Started my Ideal Image treatments due to my hairy arms - I did not want a hairy penis. ($1600 and still paying for it)

Up to this point, July 2020 I had not been told by any Doctors office of my insurance lacking. Only when the I got the denied letter from FL Blue in July for the pre-approval from Dr. Salgado's office for the Phalloplasty and associated procedures did I find out I had no coverage.

So here I am...sad, hurt, broke, dazed, unsure, but still damned determined.

My Company policy carries the exclusion on our private plan for Gender Reassignment.  They meet for the 2021 policy plan 1st week in Sept. not enough time for me to set a plan in place to present my proposal/request, to plead my case for them to drop the exclusion.

I had my HR get me in touch with our Baily group Rep to get me some insurance quotes that did cover GRS but the monthly premium is outrageous and don't cover half the things I get now, so overall, my company's plan is a great one, other than no Gender Reassignment coverage.

With that said, I have decided i would be better served to finance it through a loan of some kind.

So this is what I would like to find out in order to put my budget together. I don't know of many Trans forums as active as Susan's Place, I don't post a lot, but  i do browse ever so often and can appreciate the wisdom and experience i can see many posters have.

Surgery type: Phalloplasty with Urethra Lengthening

I am a working man and dont want to break my Family's back with bills, so i am going to do all my research and fine tune as much as i can before heading to a loan shark officer... :)

  • Because I am going the self-funding should i use an Advocate of some kind? Any Recommendations?
  • Are there any guys that could share by what-means they used to pay for their surgery, if it wasn't family, insurance or good fortune? How did you do it?
  • When it comes to the cost of the surgery, I know the surgeon`s office will have surgical fees, but does that cover the hospital and anesthesiologist? Is that separate?
  • Does anyone know of any financial breakdown samples on the web (I have googled and came up empty) If I could look at that might help me determine what I might expect for the final costs of a typical procedures I want to under go (knowing that complications will arise), an approximate figure from previous likewise surgeries that other guys have undergone.
  • Is it possible somethings could get covered under my stay and services, in patient things that are not associated with the GRS procedure that is excluded in my insurance plan. Things i might could get claimed on my insurance.

Thanks in advanced for any insight, advice, suggestions you might be able to leave me.


Offline Dex

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Re: Self Funding my Surgery
« Reply #1 on: September 01, 2020, 01:52:24 pm »

I had a metoidioplasty (with vaginectomy, scrotoplasty and a second stage for testicular implants and a mons resection) so not exactly the same but similar situation. I had my surgeries in 2018 and 2019.

I also work for an organization that (at the time) explicitly excluded any GRS related surgeries. Fortunately with the metoidioplasty, the costs are a little bit more split up. It was about $20,000 for the first stage and $18,000 for the second stage. I had them 9 months apart. That was only the costs of the actual procedure, anesthesia, hospital fees, and professional fees. It did not include pre and post op medications that you would get at a pharmacy, nor does that include travel expense. For me, travel expense was pretty significant. I live in the upper Midwest and had surgery in Austin, Tx. My first surgery was a 3 week stay, my second was a 1 week stay. My doctors office did include the hospital and anesthesia fees (and then paid them on my behalf) but not all of them do. That will be important to ask so you know what to expect.

Mostly, my wife and I saved every little bit we could. I put together a tracking spreadsheet with the budget laid out (including travel expense) and the dates all the items would need to be paid so I knew how close I was to my projected total over time as it relates to savings. I also made payments on the surgery every other week so we weren’t tempted to “borrow” from the saved funds. Being diligent and starting at the end point and then working your way back will show you if you can realistically save for it or if you need to look at other options.

We did take out a small loan (a signature loan with no collateral) to pay for about $5,000 worth. Additionally, you can look into a healthcare credit card called CareCredit. We had that card for several years already (we keep it with a zero dollar balance mostly for unexpected veterinary care in an emergency). If your doctor accepts care credit, you can often get a 6 or 12 month zero financing option which would give you more time to pay off the debt without having to pay interest. We used $6000 on that card with 12 months no interest and then only had to make sure we had that paid off in 12 months (which we did). It is REALLY important to pay it off on time, though. If you hit that cap on the 0%, they will charge you ALL the interest that would have been due over that time.

There isn’t any magical formula, unfortunately. It comes down to evaluating your assets to see where you can realistically take out debt on equity without pinching yourself too much, looking at financing opportunities like care credit, saving, and (maybe) looking into any skills you have that might be profitable. I do woodworking and so I also sold some pieces to  make a bit of extra money. Every little bit helps.

I hope this has been somewhat helpful and let me know if you have any other questions.