Surgery(s) financing question

[mikaellucien]

As I live in the USA, this question primarily applies to US residents.

Given the astronomical cost for many of the transition procedures, etc, how do/did you fund them?  Do any health insurance plans cover any of it?  Personal loans, payment plans through the surgeon, massive nest egg savings account?  Some or all of the above?

I'm asking because I've begun to realize that between a mortgage, 2 small children & the ever increasing gap between salary & inflation, I can't imagine *ever* being able to pay for most of, let alone everything solely out of pocket. 

It certainly does not help that I currently lack health insurance.  The monthly premium spiked to $600+ & we had to opt out.  My children currently are covered by medicaid & my spouse has VA medical benefits, so I am the lone man out on that score.

Thanks in advance for any light you may be able to shed on my query.

[cindianna_jones]

Neither insurance or any other government program is available here in the US. You're on your own. Sucks doesn't it? That may change in the distant future.... maybe not. I sure wouldn't bet on it. Your best bet is to save for it. Sucks doesn't it?

Sorry I couldn't offer more help.

Cindi

[Arch]

Neither insurance or any other government program is available here in the US. Cindi

That's not true. I have a friend who funded most of his top surgery through a university health program--granted, it's not available to non-students--and a couple of friends (one male, one female) whose bottom surgeries were covered by health insurance. I know quite a few guys who had hysto covered, but most of them had major health issues with their innards. I've heard that some guys were getting stuff covered through Kaiser plans, but I didn't keep up with those folks and don't know how it all worked out. And one guy is on Medicare, I think--or is it Medi-Cal? He has to jump through a lot of hoops, but he gets stuff covered. These people are the ones off the top of my head--there may well be others.

I know a couple of guys who got surgery loans, but I don't know how all of that works.

There are a couple of scholarships and sponsorships out there, but they don't appear to cover the whole thing.

I paid for my own top surgery (that is, not through insurance), but my ex made pretty good money, I had stable work at the time, and we had a reasonable rent and no kids. Now that I'm single, I have no idea when I will be able to get bottom surgery because I am not consistently employed, and the price is astronomical. Maybe Obamacare...

[Zerro]

I have a job with no health benefits, but I'm paid way over minimum wage. If you choose to sacrifice certain benefits(such as company health insurance) and make yourself as flexible as possible, you can command a decent hourly wage. Before that, however, I was able to raise almost $2000 by selling gold jewelry and luxury items I didn't need. I opted for a basic cell phone, got rid of cable TV and a home phone, and chose to buy bulk foods like rice to live off of. Depending on where you live, some insurance companies can cover things like top surgery.

But, well, you have to jump through more hoops than if you were to go the private route.

There are good surgeons in France who will do the procedure for what basically amounts to $3000 USD, but I'm not counting the travel expenses.

Unfortunately, I'm not too sure how one would do all of this with children. I'm on my own and not responsible for another person, which can drastically affect how things work in your favor.

Some folks have had luck with CareCredit, but it's difficult to work with from what I've seen.

[Sindo]

I'm having a hysterectomy on Sept. 19th that will be covered by insurance. I've got a documented history of endometriosis, so gender issues don't figure into it anywhere and won't be mentioned. Top surgery we'll have to finance ourselves, as the surgeon I'm considering doesn't accept insurance for it. We'll probably do a mixture of saving up money and a loan. I *think* it's something that would probably be covered by my plan (my partner works for the state, so our health plan is pretty decent). The financial aspect does worry me. I work, but what i do doesn't pay particularly well and we have a mortgage and student loans and school tuition for our daughter so yeah, it's not going to be easy. Even with insurance covering my upcoming surgery, I'm probably still looking at a couple thousand in medical bills which does stress me out since I'm going to be out of work for at least 2 weeks, if not longer and our finances are a bit on the tight side.

[JCH84]

You may want to try applying for care credit, i think it is just carecredit.com although you still have pay the amount they offer financing options that are pretty reasonable. I'm not sure if ALL doctors accept it but I know that dr garramone does.

[aleon515]

Curious here re: Care Credit. I used this to pay for vet bills which were around $1500. (No, that's for the other cat.) Anyway, I actually paid it off before I owed much interest. What are the interest rates like anyway? This info might help someone else.

--Jay Jay

[Ayden]

That's not true. I have a friend who funded most of his top surgery through a university health program--granted, it's not available to non-students--and a couple of friends (one male, one female) whose bottom surgeries were covered by health insurance. I know quite a few guys who had hysto covered, but most of them had major health issues with their innards. I've heard that some guys were getting stuff covered through Kaiser plans, but I didn't keep up with those folks and don't know how it all worked out. And one guy is on Medicare, I think--or is it Medi-Cal? He has to jump through a lot of hoops, but he gets stuff covered. These people are the ones off the top of my head--there may well be others.

I know a couple of guys who got surgery loans, but I don't know how all of that works.

There are a couple of scholarships and sponsorships out there, but they don't appear to cover the whole thing.

I paid for my own top surgery (that is, not through insurance), but my ex made pretty good money, I had stable work at the time, and we had a reasonable rent and no kids. Now that I'm single, I have no idea when I will be able to get bottom surgery because I am not consistently employed, and the price is astronomical. Maybe Obamacare...

I've heard of a lot of guys getting it covered though insurance, but apparently you have to jump through hoops depending on what coverage you have. But, like Arch says, it is possible if you know where to look. I haven't bothered though, since I am living in a foreign country and will be having my surgery while I am here. I'm flying back to the states to do it, but I won't be employed in America and most likely will only have Japanese national healthcare. I've got my fund already saved up and waiting in my savings account. Granted, I was only able to save up because the husband and I have no kids and managed through living as if we were dirty poor to get through school with no debt.

Lower surgery is most likely out of the question for me too, like Arch. Even if I had stable work and he was making what he is now, the price is insanely high and for now I can live with it. We are pretty paranoid about our accounts falling below a certain point.

I know some folks have luck with medicaid, but I would advise you to do your research if you try that route. I was a pharmacy tech and my primary jobs were inventory control and insurance billing. Medicaid was a pretty big pain in the hinder and I can tell you a lot of clinics and doctors won't bill it if they have to jump through hoops. To give an idea, I had a patient who was an elderly woman and had her adult undergarments covered through medicaid - but it took me anywhere from two to three hours to get it covered every two weeks. This happened for three years consistently even though it was on her file that she receive them. It also depends on state guidelines, so check with your state and see. If that isn't an option, check with insurance companies and see if, with a diagnosis of GID/GDD they are willing to cover at least part of the surgery.

Another option I have heard is to just go in for a breast reduction. If you have a larger chest and can tell a doctor that it is physically painful, your insurance will probably cover it. It doesn't always work, but I know of a few people who have gone that route and I even know one woman (the mother of a high school friend) who went in for a reduction and just had the doctor remove everything.

[Jigsaw]

If you can avoid the loan companies with maybe the exception of care credit on Dr. Garramone's page I highly recommend it.  They will approve you no problem, but the amount of money you pay back is insane. I was able to avoid them luckily because of some good fortune that happened about that time.   

[mikaellucien]

I've already got a CareCredit card that I use for oral surgery expenses.  I've had 15 teeth removed in the last year & the remaining 17 will run $5500 (& that's with local anesthetic only).  Then comes the variable cost of replacement.  Damn, life is expensive.

The details on CareCredit:  The current interest rate for CareCredit is 26.99%.  When you use the card, they decide on either 6/12/24/36 months for repayment.  The interest & deferred interest penalty is calculated each month.  If you pay it off before the deadline, no back interest or deferred interest charge(s).  If not, the amount tacked on can be quite high, plus new interest charges.

My state's Medicaid only covers an adult within the poverty guidelines if they are 1) elderly, 2) disabled or 3) pregnant.

As for insurance, my spouse's employer offers a plan, for $600+ monthly ($656 I believe).  That was roughly the same as the prices quoted for plans purchased independently from his work.  To go that route, I think it would depend heavily upon what surgery(s) are being covered by it.  I say that because most of the plans had a 1 year wait before you could receive coverage for anything major & non-emergency.  Meaning they would rack up $7800 in premiums before paying for anything substantial.

I did find several *scholarship* programs that I will likely apply for, should I opt for bottom procedures.  At this point I am primarily focusing on weight reduction/management, top surgery (in whatever form that takes) & possibly T (as finances allow)

Thanks for the feedback all, it has been a huge help. 

[aleon515]

Thanks for info on Care Credit. High interest rates is all I have to say. It's ok if you pay within the time limit as I recall. I did 6 months or something. Really did save my cat's life. So I guess I was grateful at the time.

--Jay Jay

[insideontheoutside]

I think Sindo's situation could apply to a number of guys ... if you have documented issues with the reproductive system that might at least handle a hysto, which I think is a more expensive surgery than top surgery?

[Epi]

I've heard of a lot of guys getting it covered though insurance, but apparently you have to jump through hoops depending on what coverage you have. But, like Arch says, it is possible if you know where to look. I haven't bothered though, since I am living in a foreign country and will be having my surgery while I am here. I'm flying back to the states to do it, but I won't be employed in America and most likely will only have Japanese national healthcare. I've got my fund already saved up and waiting in my savings account. Granted, I was only able to save up because the husband and I have no kids and managed through living as if we were dirty poor to get through school with no debt.

Lower surgery is most likely out of the question for me too, like Arch. Even if I had stable work and he was making what he is now, the price is insanely high and for now I can live with it. We are pretty paranoid about our accounts falling below a certain point.

There are some schools that provide SRS and HRT for their staff.

American University - one health plan option includes coverage, another option does not
Harvard University
MIT ­ hormones only
Penn State University ­ hormones only
Syracuse University
University of California 10 campuses
University of Michigan
University of Pennsylvania
Yale University ­ faculty and exempt (non-union) staff; union negotiations continue

http://www.uclgbtia.org/transhealth.html


IMO I think it's more attainable for younger individuals who are at the beginning stages of their post-secondary education, but it is all dependent upon which school they attend and what plans are available to them.  Depending on when the student started SRS/HRT, the type of insurance coverage they had, if there were a cap or not and their own financial situation I do think it would be possible in the time frame it takes to complete an undergraduate degree for a student to obtain hormones and undergo top surgery while covered by their schools insurance before they graduate.  Bottom surgery may be possible if the student didn't reach the maximum cap or had an insurance plan that covered a certain percentage and was able to pay the remainder out of cost.  However, that might require the student start their first year of college or take 5 years to complete their undergraduate degree.  (You would have to also take into account the availability of surgeons and doctors in your area as well.)  It'd be great if it was offered at all public institutions, even better if it was covered 100%.


National List of Campuses Providing Hormones and SRS [for students]:
[updated October 2010 by the Consortium]

Emerson College
Emory University
Harvard University [top surgeries only - mastectomy and breast augmentation]
New York University
Portland State University
Stanford University
University of California, Berkeley
University of California, Davis
University of California, Irvine [undergrads only]
University of California, Los Angeles
University of California, Merced [graduates only]
University of California, Riverside
University of California, San Diego
University of California, San Francisco
University of California, Santa Barnara
University of California, Santa Cruz
University of Michigan
University of Washington
National List of Campuses Providing SRS only [for students]:
[updated August 2009 by the Consortium]

Washington University in St. Louis
National List of Campuses Providing Hormones only [for students]:
[updated March 2010 by the Consortium]

American University
Bridgewater State College
Cornell University
Emory University
Massachusetts Institution of Technology
Ohio State University
Pennsylvania State University
Princeton University
Suffolk University
University of Vermont
University of Wisconsin, Madison

[MrTesto]

A common challenge even when there is health coverage for surgeries is that most surgeons do not take insurance up front. So the patient has to lay out the money and after the surgery, get reimbursed.

OP - if you are under your partner's VA benefits, you may wish to check to see if the VA coverage of hormones (and blood work, which can be pricy) for vets is available to you as well.

[Jake P]

Re: Care Credit

Just a note about using Care Credit for Dr. Garramone. His office offers a lower interest option (14.90%) for either 24, 36 (and another one, maybe 48?) months. And there isn't a penalty fee for paying off early if you don't want to worry about having it for that set time period. So the interest is much lower than the 26.99%.

[Paul]

Neither insurance or any other government program is available here in the US. You're on your own. Sucks doesn't it? That may change in the distant future.... maybe not. I sure wouldn't bet on it. Your best bet is to save for it. Sucks doesn't it?

Sorry I couldn't offer more help.

Cindi

That's not true.  My Health Insurance through work covers everything.  Yes there are a couple of hoops to jump through, but if it means I only have $150 co-pay for top surgery and $1,000 for bottom (if I choose bottom) I'm willing to jump through those few hoops.  If you're around Albany, NY I would suggest CDPHP; they're amazing.

[Felix]

Quite a few people here in portland funded their transition with student loans and/or PSU aetna insurance. I'm on medicaid myself, and they technically cover transition expenses but only if the public funding is good in that fiscal term. They have a list, and they don't pay for anything below a certain number on that list. Transition costs consistently rank very low on that list.

My income is almost 1k a month, which is cool for paying for HRT out of pocket, but I don't even try to save for top surgery. I've tried the monk thing where i budgeted down to the dime, for years, and it was hell. All my extra money went to paying for (emergency and not trans related) surgeries that I or my daughter had years ago.

I count myself lucky to have a nice binder and no-cost buproprion. You might need to adjust your desires, or at least the timeframe they inhabit.