Surgeons who accept medicare?

[traci_k]

Sorry Kate,

The link has expired, it had until mid July to get the requisite number of signatures to get it to go public.

It was   http://wh.gov/lHsnA but all you get now is that the petition has expired.

[Helpline1]

The National Center for Lesbian Rights along with the ACLU, Gay & Lesbian Advocates & Defenders (GLAD), and a New Mexico civil rights attorney filed the successful challenge to Medicare's ban. For more information on what is happening now and how to find a doctor, you can contact Amy Whelan at NCLR at 1-800-528-6257.

[Alexis2107]

My therapist told me in our last session she signed off on for surgery for someone that has found a surgeon in Indiana that accepted medicare.  I will check with her for clarification to make sure she not meant medicade but she said medicare.  I'll post an update when I get a response from her about the doctor.  So don't get high hopes yet, as I am some what in this boat too.

[LordKAT]

Medicaid does not yet cover SRS so I would guess she meant medicare. It does not mean this doctor will accept more medicare patients though.

[Jeneva]

I become eligible for Medicare on Jan 1 so I will be calling the above line for Amy Whelan at NCLR later today.

I know there was some talk earlier about Dr Rumner possibly accepting it, but I never saw either way.

[Alexis2107]

She said it was Dr. Matthew Mellon of Indianapolis that accepted medicare for SRS.  Let me know if you have any success.  It appears he is out of IU University Health.

[Jeneva]

As an update do not call Ms. Whelan directly.  They have to check for conflict of interest first so you need to go through the helpdesk.

[LadyStaci]

Can we please have a topic on insurance instead of these posts, everywhere. I am looking keep update with what is going on as well and I am having to hunt these posts down.  I hope more doctors will take medicare. Right now as I have read Washington state and Oregon will have medicaid provide services for HRT, and SRS. I do hope these states will take medicare.

[jennifer356]

Staci - there is a fundamental difference between Medicare and Medicaid - Medicare is federally provided insurance for seniors 65yo and over - guidelines and standards are enforced nationally - Medicaid is a combined state/federal program for low income families - quidelines and standards are determined by each state with the majority of funding being supplied by federal government - the few states that do provide Medicaid funds for transgender procedures is no indication of when/if the federal government will ever get around to fully endorsing them

be well
jenifer

[Jeneva]

Never heard back from NCLR.  Been busy with a move so haven't followed up on my end yet.


Just to clarify the above post, Medicare is NOT just for seniors.  It is a program administrated by the Social Security Administration.  Yes, it covers seniors, it also covers those of use with SSA approved disabilities receiving SSDI after a year.

[qwerty108109]

I tried calling the 1-800-528-6257 number on a previous post here. As anybody had any success with that number or any more resources?

[JennJenn]

2 years later, just wondering if anyone has a list of SRS/GRS (Vaginoplasty) surgeons who accept Medicare in the US?

[Laurie]

The trans Healthcare has a tool to search for this kind of information. Select the operation, select the state, and select the coverage ie insurance medicaid or medicare and submit. That is all there is to it. Surgeons that  meet the criteria are listed.

http://www.transhealthcare.org/find-surgeon/

Hope this helps,
   Laurie

[Gail20]

Medicare 101 for the Trans Community. . .

First, Medicare does not pay as much for surgical procedures. In some cases it pays quite a bit less. Surgical Practices that have long waiting lists have absolutely no incentive to take Medicare patients that they will make a lot less money on, for doing the exact same procedure.

Once a Practice accepts a single Medicare patient the Practice then has to accept ALL Medicare patients in the future. Again, successful practices would not want to be deluged with a lot of low profit Medicare patients so they wont take the first one. Also, its against the law for you to offer to pay the difference.

Medicare uses regional "Medicare Administrative Contractors" to work with local Healthcare providers.  These Contractors decide what procedures will get paid for in their areas. This is a very important bit of information.  It means that what is paid for by Medicare in one part of the country may not be readily paid for in another part of the country. These contractors work first with the Healthcare providers in their region. So you may live in a Region that is governed by one Contractor but could travel to a Region for a procedure that will be handled/governed by a different Contractor.

Soooo . . .what does all this mean to us. . .here's my thoughts and what I've done . .

Look to the Surgical practices and programs associated with University Hospitals.  They already take Medicare and theoretically have to take Medicare patients for our surgeries. Regional Medicare Administrative Contractors are going to be less likely to question or turn down a major university medical center looking for reimbursement.

For friendly Medicare Administrative Contractors look to the more gender friendly areas of the country. Look to the East and West coasts. . . .

All this info is what I discovered over the last 6 months as I sought to get Medicare to pay for my GCS next week which it appears they will . . . .

[JennJenn]

So if I lived in Central USA, and have Medicare, I could still fly out to either coast and get the surgery there and get Medicare to cover it?  Mind sharing which hospital / surgeon you are going with?

Thanks for the tips.

[DawnOday]

Can we please have a topic on insurance instead of these posts, everywhere. I am looking keep update with what is going on as well and I am having to hunt these posts down.  I hope more doctors will take medicare. Right now as I have read Washington state and Oregon will have medicaid provide services for HRT, and SRS. I do hope these states will take medicare.

Kaiser in WA, OR and CA does. I am on medicare and they have offered me counseling, voice and mentoring, orchi if I want it. and other surgeries if you medically qualify that usually takes a couple approvals. You are required to join their Transgender program before any solutions are administered. They also supplied a social worker to help with id's, finding support groups etc.  https://thrive.kaiserpermanente.org/care-near-you/southern-california/transgender/

[Lady Sarah]

2 years later, just wondering if anyone has a list of SRS/GRS (Vaginoplasty) surgeons who accept Medicare in the US?

After I did a fairly thorough search to no avail,I had my primary care doctor's office do a search. There are no doctors in the US willing to perform vaginoplasty for medicare patients, as Medicare will only pay about 20% of what they want. You might be able to get everything except the surgeon paid for through medicare, but you would still be responsible for paying your surgeon out of pocket.

[Dena]

Using the forum search feature, I found three threads of interest but there might be more. This isn't a recommendation as I am not studying surgery for myself and I don't know the detail of the surgeons.

https://www.susans.org/forums/index.php/topic,213990.msg1895130.html#msg1895130
https://www.susans.org/forums/index.php/topic,178561.msg1875978.html#msg1875978
https://www.susans.org/forums/index.php/topic,203419.msg1809693.html#msg1809693

[Gail20]

So if I lived in Central USA, and have Medicare, I could still fly out to either coast and get the surgery there and get Medicare to cover it?  Mind sharing which hospital / surgeon you are going with? Thanks for the tips.

I live in the Central USA and that's exactly what I'm doing . . .  I'm also logging in comments about my experience on the GCS Forum here   https://www.susans.org/forums/index.php/topic,226115.0.html

[jessiets]

There are 2 surgeons that I know of that do accept Medicare for GRS surgery here in Los Angeles, California. The first is Dr. Garcia at Cedar Sinai Hospital and Dr. Josef Hadeed at Plastic Surgery Center.