Susan's Place Transgender Resources

Community Conversation => Transitioning => Gender Correction Surgery => Topic started by: Linde on April 05, 2019, 12:33:15 PM

Title: I am starting to get nuts!
Post by: Linde on April 05, 2019, 12:33:15 PM
My genital dysphoria is growing by the minute.  If anything, the orchi really brought it out!  I am in need of SRS very urgently, and my therapist is in full agreement with this and is willing to write as many letters as required!
My problem is to find a surgeon who will accept my insurance!
The insurance company is no help whatsoever, they give me all kinds of names of plastic surgeons because they have no listing of surgeons who do SRS.
would any of you know a surgeon who will except Humana PPO?  I don't care where in the US, I just can hopp into my motorhome and take my hotel with me.  I just need to find a surgeon who is doing the bottom stuff, and will take my insurance!
I am retired and have no means to pay that out of my pocket!
Title: Re: I am starting to get nuts!
Post by: Dena on April 05, 2019, 02:32:41 PM
Probably as they don't have a surgeon in the system (something I would expect from a PPO), you need to go back to them and find out what their out of the system procedure is and how much will be covered. Most surgeons will accept any insurance if they know the coverage is sufficient. The problem with PPOs is that unless special arrangements are made, a PPO probably isn't going to pay out of the system so you need to nail down the exception.
Title: Re: I am starting to get nuts!
Post by: KathyLauren on April 05, 2019, 02:57:16 PM
Please tell me that the ironic pun in the title was intentional!  :D

I wish you success in finding a surgeon.
Title: Re: I am starting to get nuts!
Post by: Linde on April 05, 2019, 03:43:46 PM
Quote from: KathyLauren on April 05, 2019, 02:57:16 PM
Please tell me that the ironic pun in the title was intentional!  :D

I wish you success in finding a surgeon.
To be honest, originally it was not, but as I opened it a little while ago, I realized this, too.  I am good as a micro sized satiric, aren't I?

Thank you for your wishes!
Title: Re: I am starting to get nuts!
Post by: Linde on April 05, 2019, 03:48:40 PM
Quote from: Dena on April 05, 2019, 02:32:41 PM
Probably as they don't have a surgeon in the system (something I would expect from a PPO), you need to go back to them and find out what their out of the system procedure is and how much will be covered. Most surgeons will accept any insurance if they know the coverage is sufficient. The problem with PPOs is that unless special arrangements are made, a PPO probably isn't going to pay out of the system so you need to nail down the exception.
Thanks, I found out that a doc could contact their Clinical Intakes Team and ask for becoming an in system provider.
Now I have to contact every surgeon who does bottom surgery and ask them this! 
This is another clear sign that the US health insurance system sucks to the nth degree!
Title: Re: I am starting to get nuts!
Post by: Dena on April 05, 2019, 04:14:38 PM
The medical system isn't that bad but the problem is PPOs. They are low cost but they do it at the expense of selection of medical care. My job had one of those and I found it useless for any of my trans medical care so I continued to pay it out of pocket. It's great for a family that stays at home and just needs routine care but not for much else.

You will have to explore out of system care because the doctors aren't likely to join a PPO for your surgical care. It doesn't pay enough and they need to accept everybody that comes along. If it was a good deal for them, they would have joined a long time ago. I know there was no way I could get my doctors to join one and I suspect you will have the same problem.
Title: Re: I am starting to get nuts!
Post by: CynthiaAnn on April 05, 2019, 04:34:58 PM
Hi ya,

  I will share a little of my experiences with PPO - Dr Bowers was "in plan" for my PPO at work, that part was good, her fee, the labs, the anesthesiologists fee all were taken care of, but where the system failed (I've heard others have this issue), was the negotiations for the ambulatory care (3 days in the hospital). The hospital billed outrageous numbers, only to have PPO reject the claim. Sticking me the patient in between this mess. Long story short it took months to get my PPO to negotiate with the hospital and finally come to a "reasonable" payment of less than half the original billed amount. Just a heads up, even if you get the Dr's to accept your insurance, the hospital billing can be "gotcha" waiting to happen.

Hope you find the care you need at a reasonable price....

Take care

C -
Title: Re: I am starting to get nuts!
Post by: Linde on April 05, 2019, 04:42:08 PM
Quote from: Dena on April 05, 2019, 04:14:38 PM
The medical system isn't that bad but the problem is PPOs. They are low cost but they do it at the expense of selection of medical care. My job had one of those and I found it useless for any of my trans medical care so I continued to pay it out of pocket. It's great for a family that stays at home and just needs routine care but not for much else.

You will have to explore out of system care because the doctors aren't likely to join a PPO for your surgical care. It doesn't pay enough and they need to accept everybody that comes along. If it was a good deal for them, they would have joined a long time ago. I know there was no way I could get my doctors to join one and I suspect you will have the same problem.
Well, the problem is being on Medicare and living in Florida.  I had a nice Advantage Plan up north, and every facility there was excited to take it.  But they don't do business in Florida, and my insurance broker got me into this thing!

I really don't want to wait until next year with the selection of a new insurance to get this SRS started, because dysphoria wise I need it tomorrow!

I am writing to all of those docs I know, it they would accept me as a special case.
Title: Re: I am starting to get nuts!
Post by: Linde on April 05, 2019, 04:44:49 PM
Quote from: CynthiaAnn on April 05, 2019, 04:34:58 PM
Hi ya,

  I will share a little of my experiences with PPO - Dr Bowers was "in plan" for my PPO at work, that part was good, her fee, the labs, the anesthesiologists fee all were taken care of, but where the system failed (I've heard others have this issue), was the negotiations for the ambulatory care (3 days in the hospital). The hospital billed outrageous numbers, only to have PPO reject the claim. Sticking me the patient in between this mess. Long story short it took months to get my PPO to negotiate with the hospital and finally come to a "reasonable" payment of less than half the original billed amount. Just a heads up, even if you get the Dr's to accept your insurance, the hospital billing can be "gotcha" waiting to happen.

Hope you find the care you need at a reasonable price....

Take care

C -
Tanks, I am willing to fight (I am actually a pretty mean fighter in those things). Can you provide me with the contact information of Dr. Bowers?  He/she might be in plan, with Humana, too, or might be willing to join them.
Title: Re: I am starting to get nuts!
Post by: CynthiaAnn on April 05, 2019, 04:49:48 PM
Quote from: Dietlind on April 05, 2019, 04:44:49 PM
Tanks, I am willing to fight (I am actually a pretty mean fighter in those things). Can you provide me with the contact information of Dr. Bowers?  He/she might be in plan, with Humana, too, or might be willing to join them.

Oh sure Dr Marci Bowers is a great surgeon, I am one of her happy patients, just she has a long waiting list is the only downside. I waited 18 months myself.

Here is her contact web page....

http://marcibowers.com/contact-us/

Cynthia -
Title: Re: I am starting to get nuts!
Post by: Linde on April 05, 2019, 05:01:37 PM
Quote from: CynthiaAnn on April 05, 2019, 04:49:48 PM
Oh sure Dr Marci Bowers is a great surgeon, I am one of her happy patients, just she has a long waiting list is the only downside. I waited 18 months myself.

Here is her contact web page....

http://marcibowers.com/contact-us/

Cynthia -
Thanks a million!  She may take me in fast once she sees my friendly face, who knows?

Just did shoot a message off to her!
Title: Re: I am starting to get nuts!
Post by: Rachel on April 06, 2019, 01:39:55 PM
Hi, you can get a spot with Dr. Bowers and ask to be on a first open spot from a cancellation.

You should start genital electrolysis ASAP.

Dr. Bowers is a fantastic surgeon and you can cut the wait time substantially by being on a cancellation list. Since you are retired this can work in your favor.

Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 06, 2019, 02:11:04 PM
Best of luck on getting this taken care of.
Title: Re: I am starting to get nuts!
Post by: Linde on April 06, 2019, 06:57:47 PM
Quote from: Rachel on April 06, 2019, 01:39:55 PM
Hi, you can get a spot with Dr. Bowers and ask to be on a first open spot from a cancellation.

You should start genital electrolysis ASAP.

Dr. Bowers is a fantastic surgeon and you can cut the wait time substantially by being on a cancellation list. Since you are retired this can work in your favor.
I have an email in to her already!  I do not need much, I never had more hair down there than between Tanner II and Tanner III (Probably more towards II), and because I want limited depth only, I might not need any electrolysis at all.
I was this mostly hairless person all of my life, only the hair on my head is growing very well!
Title: Re: I am starting to get nuts!
Post by: Linde on April 06, 2019, 06:59:25 PM
Quote from: NatalieRene on April 06, 2019, 02:11:04 PM
Best of luck on getting this taken care of.
Thank you.  At our meeting today I got an address for a surgeon in Miami.  That would be tops, because that is only 2.5 hours to drive.
Title: Re: I am starting to get nuts!
Post by: Gail20 on April 07, 2019, 01:38:03 PM
Look up Dr Bluebond-Langner at NYU.  NYU is a phenomenal Hospital and she is a top GCS surgeon. They take virtually every insurance. . .
Title: Re: I am starting to get nuts!
Post by: Linde on April 07, 2019, 09:30:05 PM
Quote from: Gail20 on April 07, 2019, 01:38:03 PM
Look up Dr Bluebond-Langner at NYU.  NYU is a phenomenal Hospital and she is a top GCS surgeon. They take virtually every insurance. . .
Thanks! She seems to take my insurance!  I need to double check that with them!
Thanks a million!
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 08, 2019, 11:42:09 AM
Quote from: Dietlind on April 06, 2019, 06:57:47 PM
I have an email in to her already!  I do not need much, I never had more hair down there than between Tanner II and Tanner III (Probably more towards II), and because I want limited depth only, I might not need any electrolysis at all.
I was this mostly hairless person all of my life, only the hair on my head is growing very well!

Why not go for full depth? Even if you're not interested in guys I can say that the toys are amazing.
Title: Re: I am starting to get nuts!
Post by: Linde on April 08, 2019, 11:58:24 AM
Quote from: NatalieRene on April 08, 2019, 11:42:09 AM
Why not go for full depth? Even if you're not interested in guys I can say that the toys are amazing.
I don't have any libido left, and am not interested in toys.  I thought I would be after the orchi, and no spiro, so I invested some money for a toy.  It was wasted money, and is just catching dust now!
The minimal depth is a less invasive surgery, and the complication rate is to be expected less and also less dramatic (I don't need to get a hole created in my abdomen).  All work is more or less surface/skin work, and the healing should also be faster and easier.  And I would not have to mess with the dilation for nothing but to keep an artificial hole in my abdomen open for nor real purpose.
If I would be younger and sexually active, I would go for the full show, but for me the return I would get out from it is if anything, extremely limited, and my risk analysis tells me, don't do it!

I just want this done to eliminate this stupid genital dysphoria which is troubling me pretty badly!
Title: Re: I am starting to get nuts!
Post by: DawnOday on April 08, 2019, 12:59:17 PM
I am in the same boat. Sexual interest has been on the wane for a good part of twenty years. Health problems keep me from the surgery table. Mom used to dress me in sisters clothes. I wonder if time were different maybe she would have sought advice on getting me a sex change. I know she was concerned about my testicles not dropping until senior year. To me this is another DES clue.
Title: Re: I am starting to get nuts!
Post by: Linde on April 09, 2019, 06:32:17 PM
Quote from: Gail20 on April 07, 2019, 01:38:03 PM
Look up Dr Bluebond-Langner at NYU.  NYU is a phenomenal Hospital and she is a top GCS surgeon. They take virtually every insurance. . .
Thank you so much for this tip.  They confirmed that they take my insurance, and my insurance confirmed that they are in network (one cannot ask enough questions with the insurance stuff).

I now have to contact the surgeon, and see if she wants to take me on.  I will try to fit that in tomorrow!

Thanks again!
Linde
Title: Re: I am starting to get nuts!
Post by: Linde on April 10, 2019, 03:15:38 PM
And here I thought it would be easy!  Dr Bluebond-Langner does not take telephone calls from non patients, nor can one connect with her via email.  The only direct way to communicate with her is through an appointment in a face o face session.  They are booking October currently,  That would man, I would need to fly from Florida to New York to me the doctor for an hour or two, to probably find out that she does not want to take me on due to whatever reason, and I threw thus hundreds of dollars away for nothing!
After some long discussion I could to get the person on the other side to agree that I could send a fax with my questions and the doc would take a look at them, and let me know.

Now I have to think about what to write!
Title: Re: I am starting to get nuts!
Post by: Dorit on April 14, 2019, 08:23:04 AM
Many surgeons do Skype consultations.   I was certainly not going to fly from Israel to the US for a one hour appointment!   I had two Skype consultations with my surgeon that lasted over one hour each, there was a charge, but it was deductable from the bill because I decided to use him.
Title: Re: I am starting to get nuts!
Post by: Linde on April 14, 2019, 09:06:47 AM
Quote from: Dorit on April 14, 2019, 08:23:04 AM
Many surgeons do Skype consultations.   I was certainly not going to fly from Israel to the US for a one hour appointment!   I had two Skype consultations with my surgeon that lasted over one hour each, there was a charge, but it was deductable from the bill because I decided to use him.
I hope to get something similar.  The people in NYC expect me to fly  up for this consultation, I am not that hot about it.

I have to see if your surgeon will take my insurance. It is way closer to where I live, and i can even drive it with one over night stay!
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 12:21:21 AM
Quote from: Dietlind on April 14, 2019, 09:06:47 AM
I hope to get something similar.  The people in NYC expect me to fly  up for this consultation, I am not that hot about it.

I have to see if your surgeon will take my insurance. It is way closer to where I live, and i can even drive it with one over night stay!

I know that my surgeon required a face to face consultation so I had to drive from Virginia to Pennsylvania for it. I don't have any experience with Skype consultations. My suggestion is to do lots of research, see if you can get a Skype consultation but be prepared to travel in your motor home. Maybe you can make a trip out of it and see sights while your out there to get the most out of the fuel spent. ;D
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 01:14:24 AM
Quote from: NatalieRene on April 16, 2019, 12:21:21 AM
I know that my surgeon required a face to face consultation so I had to drive from Virginia to Pennsylvania for it. I don't have any experience with Skype consultations. My suggestion is to do lots of research, see if you can get a Skype consultation but be prepared to travel in your motor home. Maybe you can make a trip out of it and see sights while your out there to get the most out of the fuel spent. ;D
I am still in searching for surgeon mode.  Interesting, my dysphoria calmed down now that I am actively doing something about the situation!
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 06:45:09 AM
Quote from: Dietlind on April 16, 2019, 01:14:24 AM
I am still in searching for surgeon mode.  Interesting, my dysphoria calmed down now that I am actively doing something about the situation!

Hope is a wonderfully powerful anesthesia. Don't get discouraged things will work out. It's just a matter of being persistent and having fortitude.
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 09:09:52 AM
Quote from: NatalieRene on April 16, 2019, 06:45:09 AM
Hope is a wonderfully powerful anesthesia. Don't get discouraged things will work out. It's just a matter of being persistent and having fortitude.
The day that I give up has yet to be created! (unless the food tastes really good  ;D)
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 04:42:57 PM
Quote from: Dietlind on April 16, 2019, 09:09:52 AM
The day that I give up has yet to be created! (unless the food tastes really good  ;D)

That's why you are a strong individual. No and can't don't exist in your vocabulary.
Title: Re: I am starting to get nuts!
Post by: ChrissyRyan on April 16, 2019, 04:57:46 PM
Quote from: Dietlind on April 05, 2019, 12:33:15 PM
My genital dysphoria is growing by the minute.  If anything, the orchi really brought it out!  I am in need of SRS very urgently, and my therapist is in full agreement with this and is willing to write as many letters as required!
My problem is to find a surgeon who will accept my insurance!
The insurance company is no help whatsoever, they give me all kinds of names of plastic surgeons because they have no listing of surgeons who do SRS.
would any of you know a surgeon who will except Humana PPO?  I don't care where in the US, I just can hopp into my motorhome and take my hotel with me.  I just need to find a surgeon who is doing the bottom stuff, and will take my insurance!
I am retired and have no means to pay that out of my pocket!

Maybe you can apply for a grant, and get one, at www.jimcollinsfoundation.org

Chrissy

Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 05:10:30 PM
Quote from: ChrissyRyan on April 16, 2019, 04:57:46 PM
Maybe you can apply for a grant, and get one, at www.jimcollinsfoundation.org

Chrissy

That is an interesting idea.

The problem with PPO plans is it is difficult to get coverage on some things because of the number of people that need the procedure are small so the collective bargaining isn't as effective and since they are so specialized it's unlikely that other business can be drummed up if they do SRS.

I don't know if you have the ability to change providers for your insurance but I found this online. https://www.hrc.org/resources/finding-insurance-for-transgender-related-healthcare
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 05:54:00 PM
Quote from: ChrissyRyan on April 16, 2019, 04:57:46 PM
Maybe you can apply for a grant, and get one, at www.jimcollinsfoundation.org

Chrissy
Thanks, but nothing happens when I try to apply!
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 06:03:59 PM
Quote from: NatalieRene on April 16, 2019, 05:10:30 PM
That is an interesting idea.

The problem with PPO plans is it is difficult to get coverage on some things because of the number of people that need the procedure are small so the collective bargaining isn't as effective and since they are so specialized it's unlikely that other business can be drummed up if they do SRS.

I don't know if you have the ability to change providers for your insurance but I found this online. https://www.hrc.org/resources/finding-insurance-for-transgender-related-healthcare
One can change only at the end of the year.  I have a broker who is finding the best insurance for me, and I have that, for Florida.  But I did not realize that most surgeons are not taking it.  I now have to wait until October to be able to change for 2020
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 06:52:38 PM
Quote from: Dietlind on April 16, 2019, 06:03:59 PM
One can change only at the end of the year.  I have a broker who is finding the best insurance for me, and I have that, for Florida.  But I did not realize that most surgeons are not taking it.  I now have to wait until October to be able to change for 2020

Wow that stinks. I didn't realize that they do that for everyone. What are your plans? Are you going to try and pay your own way or find a plan that will cover it and wait until then?

If you wait it will provide time to find a surgeon that you prefer.
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 07:02:00 PM
Quote from: NatalieRene on April 16, 2019, 06:52:38 PM
Wow that stinks. I didn't realize that they do that for everyone. What are your plans? Are you going to try and pay your own way or find a plan that will cover it and wait until then?

If you wait it will provide time to find a surgeon that you prefer.
I can't do this on my own.  I am on a fixed income, and don't want to deplete my emergency money!  If I can't find anything, i have to continue to live in misery, like many of us did before it was possible to have this surgery!  At some point I will be to old for this surgery.
I was simply born a few years to early and decided to live in the wrong country!
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 07:09:59 PM
Quote from: Dietlind on April 16, 2019, 07:02:00 PM
I can't do this on my own.  I am on a fixed income, and don't want to deplete my emergency money!  If I can't find anything, i have to continue to live in misery, like many of us did before it was possible to have this surgery!  At some point I will be to old for this surgery.
I was simply born a few years to early and decided to live in the wrong country!

I have my fingers crossed you can find a way.
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 08:10:38 PM
Quote from: NatalieRene on April 16, 2019, 07:09:59 PM
I have my fingers crossed you can find a way.
Thank you.
if I see you young women here, I always think, I could have been one of you, if I just would have been born a few years later, and i could have enjoyed the life of a young woman.  But I was not born later (my mother would not have been happy to have a child when she was in her 60's), and the only thing is to make the best of the situation.  I hope that older trans women like I can be a good example for other older trans women, who are still closettet, that one can have a successful transition as an older person, and can live as a happy woman!
I enjoy my current life way better than I enjoyed my life for many years prior!
Title: Re: I am starting to get nuts!
Post by: NatalieRene on April 16, 2019, 09:47:42 PM
Quote from: Dietlind on April 16, 2019, 08:10:38 PM
Thank you.
if I see you young women here, I always think, I could have been one of you, if I just would have been born a few years later, and i could have enjoyed the life of a young woman.  But I was not born later (my mother would not have been happy to have a child when she was in her 60's), and the only thing is to make the best of the situation.  I hope that older trans women like I can be a good example for other older trans women, who are still closettet, that one can have a successful transition as an older person, and can live as a happy woman!
I enjoy my current life way better than I enjoyed my life for many years prior!

I have an idea of what you mean. I was pushing 30 years old before I was complete with my transition and it was only by a miracle that I managed to get the money to pay for SRS.

Hopefully you don't have to live without it if you desire to have it. Hopefully things will work out.
Title: Re: I am starting to get nuts!
Post by: Linde on April 16, 2019, 11:15:58 PM
Quote from: NatalieRene on April 16, 2019, 09:47:42 PM
I have an idea of what you mean. I was pushing 30 years old before I was complete with my transition and it was only by a miracle that I managed to get the money to pay for SRS.

Hopefully you don't have to live without it if you desire to have it. Hopefully things will work out.
Thank you for your wishes!  I just have to take the wohle thing one step at a time.  The entire surgery is for myself only, because hormone wise I am there where you and others are.  I am as much woman as I ever can be, just that little cosmetic change is required, and I would not dislike my looks anymore!
It will not stop me to live as a happy woman!
Title: Re: I am starting to get nuts!
Post by: ChrissyRyan on April 17, 2019, 04:18:10 PM
Quote from: Dietlind on April 16, 2019, 05:54:00 PM
Thanks, but nothing happens when I try to apply!


Wait about a month for the new grant cycle starts, as mentioned on the APPLY page.

Chrissy