Author Topic: Surgeons who accept medicare?  (Read 6743 times)

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Offline JennyH

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Surgeons who accept medicare?
« on: October 14, 2014, 06:17:53 pm »
Does anybody know of any surgeons who will accept medicare?

Jill F

Re: Surgeons who accept medicare?
« Reply #1 on: October 14, 2014, 06:21:11 pm »
Rarer than unicorns, I'm afraid.

Offline Randi

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Re: Surgeons who accept medicare?
« Reply #2 on: October 14, 2014, 06:27:31 pm »
Marci Bowers filed a claim with medicare in August 2014.  I haven't heard how that worked out.


http://marcibowers.com/ftm/victory-medicare-to-cover-transgender-services/


Offline Jessica Merriman

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Re: Surgeons who accept medicare?
« Reply #3 on: October 14, 2014, 06:28:05 pm »
Not a single one. I have E-mailed and called all in the United States. I am stuck with this myself. If anyone says they do, um, they don't. No one is more interested or concerned of this than me I guarantee!  :)

Offline Jessica Merriman

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Re: Surgeons who accept medicare?
« Reply #4 on: October 14, 2014, 06:28:59 pm »
Marci Bowers filed a claim with medicare in August 2014.  I haven't heard how that worked out.


http://marcibowers.com/ftm/victory-medicare-to-cover-transgender-services/
Her reimbursement was not enough from Medicare, so it will probably never be a reality.  :(

Offline Randi

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Re: Surgeons who accept medicare?
« Reply #5 on: October 14, 2014, 06:56:06 pm »
I assume that a surgeon has to agree to accept what Medicare offers as payment in full.

There's no way to make up the difference?

Her reimbursement was not enough from Medicare, so it will probably never be a reality.  :(

Offline Jessica Merriman

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Re: Surgeons who accept medicare?
« Reply #6 on: October 14, 2014, 08:16:48 pm »
There's no way to make up the difference?
Not legally. They just have to accept what they give. The thing that bothers me is she takes Medicare in her OB/Gyn practice. Why discriminate or choose one type of patient over the other for coverage? That is my question to Medicare. I have not gotten an answer yet. ???

Offline peky

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Re: Surgeons who accept medicare?
« Reply #7 on: October 14, 2014, 08:36:44 pm »
Her reimbursement was not enough from Medicare, so it will probably never be a reality.  :(

Do you know how much is medicare willing to pay?

Offline traci_k

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Re: Surgeons who accept medicare?
« Reply #8 on: October 15, 2014, 06:58:55 am »
How much will Medicare pay? From what I see on Addendum B for (If I'm reading this right) HCPCS Codes 57291 Construction of Vagina or 57292 Construct Vagina with Graft both pay $2,522.58 - with a minimum unadjusted co-payment of $504.52. This is the Physician Fee only. This does not include the hospitalization which would be covered under Part A Medicare.

Also, quoted reimbursement does not include Orchi or any other procedure removal of testis 54520 is $2,599.64 - minimum co-pay $519.93.
Traci Melissa Knight

Offline peky

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Re: Surgeons who accept medicare?
« Reply #9 on: October 15, 2014, 04:56:37 pm »
How much will Medicare pay? From what I see on Addendum B for (If I'm reading this right) HCPCS Codes 57291 Construction of Vagina or 57292 Construct Vagina with Graft both pay $2,522.58 - with a minimum unadjusted co-payment of $504.52. This is the Physician Fee only. This does not include the hospitalization which would be covered under Part A Medicare.

Also, quoted reimbursement does not include Orchi or any other procedure removal of testis 54520 is $2,599.64 - minimum co-pay $519.93.

Thank you Traci !

So that is why they do not accept it...

Offline Jessica Merriman

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Re: Surgeons who accept medicare?
« Reply #10 on: October 15, 2014, 06:43:21 pm »
The lifting of the trans care exclusions is just  pre election strategy to get trans supporters who do not know the details to vote for the incumbent party, that's all. Nothing has changed at all. People are so easily distracted. I figure after the general elections Medicare will reverse because of lack of people using the provisions even though there are none or "public" outcry over funding it will succeed in also getting a reversal. I would not expect it to stand. :(

The only trans related care I have had covered is HRT under the drug plan. 90 days of Spiro, "E", "P" and syringes/needles is only $13.00  a refill.

Jill F

Re: Surgeons who accept medicare?
« Reply #11 on: October 15, 2014, 06:54:05 pm »
The lifting of the trans care exclusions is just  pre election strategy to get trans supporters who do not know the details to vote for the incumbent party, that's all. Nothing has changed at all. People are so easily distracted. I figure after the general elections Medicare will reverse because of lack of people using the provisions even though there are none or "public" outcry over funding it will succeed in also getting a reversal. I would not expect it to stand. :(

The only trans related care I have had covered is HRT under the drug plan. 90 days of Spiro, "E", "P" and syringes/needles is only $13.00  a refill.

Yup.  Lip service.  That's all we get.  I guess it's better than outright hatred, but at the end of the day we're still the same turds stuck to the bottom of society's shoes no matter who is running the show.  Politicians are there to serve their corporate masters' shareholders interests, not justice... and clearly not us.

/bitterness

Offline Jessica Merriman

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Re: Surgeons who accept medicare?
« Reply #12 on: October 15, 2014, 07:11:13 pm »
I share your bitterness Jill!  >:(

Offline traci_k

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Re: Surgeons who accept medicare?
« Reply #13 on: October 16, 2014, 06:49:32 am »
I have to respectfully disagree about coverage being reversed. The coverage came about on an appeal for coverage, I believe in Arizona. The government lost on the appeal by board that recognized that SRS and other related care is not experimental, has proven effective and does meet a real need. Reimbursement amounts are another issue we in the hospital industry face. The fact is that there is a limited number of physicians who do provide these services and therefore can charge what the market will bear. I would love to find a physician who does quality SRS and introduce them to our hospital management. As we see greater acceptance of transsexual individuals by society, we are also seeing greater numbers coming out of the closet in the older years and we are seeing many more younger people, with the support of their parents seeking trans-related care. I think we are going to see a greater need for physicians providing these surgeries. I believe there are now 5 states that mandate insurance coverage and I'm going to guess that as with the growing number of states with Same Sex Marriage, more states, as the recognize the need for trans-gender health services, will mandate expansion of coverage. Again, this will fuel the need for more physicians.

What can we do? The chances of getting Medicare to increase rates is unlikely as quite a bit of Medicare money was moved to fund expansion of Obamacare. We can gather the facts much as we do here about the numbers of suicide attempts, 41% as we seen reported here, explain the pain and suffering that those who suffer from GD endure and lobby the state governors and insurance boards to expand coverage. Yes many would like to transition and go stealth, there are others like Kate Bornstein and others who are activists for transgender rights. We also need to educate the public that transgender health services, SRS and FFS, while seemingly cosmetic surgeries, can be needed life saving interventions.

I'll get off my soapbox now but hopefully there a few ideas that might inspire some people to action. The only reason I found out about the Medicare change was that I was trying to get a petition going on the We the People White House website and unfortunately I couldn't get more than a few people to sign on, even from the other forum I used to frequent. I had put it out in May and found that Medicare had just lost the appeal and the Trans-woman in Arizona, I believe, was going to have her surgery covered. Now, who did the surgery, or was there a doctor who accepted the Medicare reimbursement? I don't know.
Traci Melissa Knight

Offline JennyH

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Re: Surgeons who accept medicare?
« Reply #14 on: October 17, 2014, 05:41:53 am »
Well it's disheartening to hear that no surgeons accept medicare, but i don't give up easily. I am going to whine and fight and put up the biggest stink that I can until they do. Even if I have to camp out on a surgeon's front lawn, someone's taking my medicare!!!

Offline White Rabbit

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Re: Surgeons who accept medicare?
« Reply #15 on: October 17, 2014, 09:18:08 am »
File a petition on the White House web page and get the word out, I think it is 50 k signatures then the President's office has to officially comment on it. It might not result in any changes but at least they can't hide behind an intern sending responses.

Blue Senpai

Re: Surgeons who accept medicare?
« Reply #16 on: October 17, 2014, 09:46:46 am »
Ehhh just something to think about:

Let's assume a surgeon will accept Medicare.
Appointment is set.
You get everything in order.
You come in.
The procedure is done.
You wake up.
The results are not as good as you have thought. You've seen pictures and the results were MUCH better than what you seen in a consultation.
You can sue, make a news story of it and raise hell to get a settlement but the damage has been done.

I don't know, I feel like if they accept it that won't stop them from doing a less than desirable job on you.

Online stephaniec

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Re: Surgeons who accept medicare?
« Reply #17 on: October 17, 2014, 10:11:54 am »
Ehhh just something to think about:

Let's assume a surgeon will accept Medicare.
Appointment is set.
You get everything in order.
You come in.
The procedure is done.
You wake up.
The results are not as good as you have thought. You've seen pictures and the results were MUCH better than what you seen in a consultation.
You can sue, make a news story of it and raise hell to get a settlement but the damage has been done.

I don't know, I feel like if they accept it that won't stop them from doing a less than desirable job on you.
I just noticed your ticker , congrats

Offline traci_k

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Re: Surgeons who accept medicare?
« Reply #18 on: October 17, 2014, 10:49:09 am »
White Rabbit,

That's what I did. I forget how many signatures were needed to get it open to the public, something like 50 to 100 or so. Unfortunately could only get about 20. Not to mention the thousands to get a response from the WH. If anybody else is up for starting another one asking for Medicare Reimbursement to be enough to induce surgeons to start accepting Medicare for SRS, let me know, I'll sign and re-publicize. That's what we need to do, keep networking and gather some momentum.

Hugs,
Traci Melissa Knight

ImagineKate

Re: Surgeons who accept medicare?
« Reply #19 on: October 18, 2014, 08:32:53 am »
 Put the link up. I haven't seen it.

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