Surgeon recommendations & insurance for Pennsylvania.

[Freya_Dee_Raven]

I have read several different posts and I really haven't got any closer to having my questions answered so I figured I would post.

I'm looking 3 different surgeons in Pa, Dr's McGinn, Rumor & Leis. I am waiting for a reply from McGinn, and I received a vague response to my questions from Leis basicly saying we would need to get pre authorization from my insurance. Rumor is the only Dr that came up on a google search for Dr's that accept my insurance.  I am currently receiving all of my transitioning treatment thru the DoVA/VA, they however do not perform SRS and it is a grey area as to whether they would cover the procedure otherwise. I currently have Aetna's Medicaid plan thru my states medical assistance which requires them to cover "all medically necessary procedures".

Does anyone have any experience with any of these Dr's, this insurance ,or the VA in regards to SRS?

[Jessica]

Hi Freya 🙋‍♀️ Welcome to Susan's Place!  I'm Jessica, a transgender woman.  I am out in CA, so I have no firsthand experience with VA, though I'm sure there are women on the east coast that can help you.  Glad you made it here! Enjoy and learn!
I see your new here, so I'll post some links that may help you get better acquainted with the site.

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[Freya_Dee_Raven]

Thank you for the welcome Jessica. I will do the introduction at some point her soon.  First I guess I should specify that I meant VA as in the Dept. of Veterans Affairs (VA).

[Mountain Warfare Girl]

I'm using the VA also for my HRT  at this time the VA covers no surgeries but my DR says they are trying to change that, the only surgeries that some times cover is Orki if you can convince them that it is safer for you to have it done then to stay on Spiro

[Rachel]

Hello, Dr. McGinn is fee up front and assist for you getting reimbursement by your insurance company.

I had GCS and a BA with her 1.25. and 7 months ago respectively. I am having additional vaginal work April 4th and she took my insurance without my paying up front. I have fantastic health insurance. I am pre-approved for all the procedures. I suspect the operation will cost approximately what my gcs cost. GCS ($22,000)and BA ($8,000).

I am intersexed and Dr. McGinn has been absolutely wonderful. My vaginal work is based on my intersexed condition. Soooo, Dr. McGinn promised to take care of me and see me through GCS. She reminded me of that when the 2nd operation was scheduled.

Dr. McGinn was a Navel Flight Surgeon and takes care of business.

Good luck.

[Freya_Dee_Raven]

I'm using the VA also for my HRT  at this time the VA covers no surgeries but my DR says they are trying to change that, the only surgeries that some times cover is Orki if you can convince them that it is safer for you to have it done then to stay on Spiro

Thank you for the info Mountain Warfare Girl. That's what my team at the VA told me too. But they also said about the possibility of some of the cost for an outside procedure being covered if it was medically necessary and the VA didn't offer it. I was unsure if anyone had any dealings  or info about that. I'm not sure if they meant parts of the surgery or after care stay etc. 

[Jessica]

Thank you for the welcome Jessica. I will do the introduction at some point her soon.  First I guess I should specify that I meant VA as in the Dept. of Veterans Affairs (VA).

Oh, silly me!

[Freya_Dee_Raven]

Hello, Dr. McGinn is fee up front and assist for you getting reimbursement by your insurance company.

I had GCS and a BA with her 1.25. and 7 months ago respectively. I am having additional vaginal work April 4th and she took my insurance without my paying up front. I have fantastic health insurance. I am pre-approved for all the procedures. I suspect the operation will cost approximately what my gcs cost. GCS ($22,000)and BA ($8,000).

I am intersexed and Dr. McGinn has been absolutely wonderful. My vaginal work is based on my intersexed condition. Soooo, Dr. McGinn promised to take care of me and see me through GCS. She reminded me of that when the 2nd operation was scheduled.

Dr. McGinn was a Navel Flight Surgeon and takes care of business.

Good luck.

Thank you for the info. I love the fact she is prior service. May I ask what type of insurance you have? Everyone I've seen that talks about there insurance is using a private policy & not medical assistance (Medicaid) which is what I have.

[Rachel]

We are self insured with Aetna as the administrator and we have trans additional rider coverage.

[HappyMoni]

Having very good experience with McGinn. No experience with Leis. Bad experience with Rumer. Moni

[Freya_Dee_Raven]

We are self insured with Aetna as the administrator and we have trans additional rider coverage.

Ok. Thank you!

[Freya_Dee_Raven]

Having very good experience with McGinn. No experience with Leis. Bad experience with Rumer. Moni

Thank you for the info.  May I ask what the issue with Rumer was about?

[Freya_Dee_Raven]

Having very good experience with McGinn. No experience with Leis. Bad experience with Rumer. Moni

I understand. Ok, I will keep that in mind. Thank you

[Mountain Warfare Girl]

Thank you for the info Mountain Warfare Girl. That's what my team at the VA told me too. But they also said about the possibility of some of the cost for an outside procedure being covered if it was medically necessary and the VA didn't offer it. I was unsure if anyone had any dealings  or info about that. I'm not sure if they meant parts of the surgery or after care stay etc.

From what I have been told is they they will not cover SRS at all do to at this time the VA doesn't consider it medically necessary and say HRT and counseling is all that is needed. They are trying to change that but no luck yet. There are several trans veterans groups out there fighting for us out there they are just having a hard time.


I'm not only a patient at the VA I also am a VA employ so I have been working on the problem for all of us also 

[Freya_Dee_Raven]

From what I have been told is they they will not cover SRS at all do to at this time the VA doesn't consider it medically necessary and say HRT and counseling is all that is needed. They are trying to change that but no luck yet. There are several trans veterans groups out there fighting for us out there they are just having a hard time.


I'm not only a patient at the VA I also am a VA employ so I have been working on the problem for all of us also

Ok. Thank you. And thank you again for the info.

[TinaVane]

Thank you for the info. I love the fact she is prior service. May I ask what type of insurance you have? Everyone I've seen that talks about there insurance is using a private policy & not medical assistance (Medicaid) which is what I have.

From what 411 i got from my girlfriend in PA she stated that with medicaid your option is just Rumer .... McGin,Leis does not take the state insurance

[Freya_Dee_Raven]

From what 411 i got from my girlfriend in PA she stated that with medicaid your option is just Rumer .... McGin,Leis does not take the state insurance

Ok, Thank you.