Hey Panther,
Good to see you. I feel for you. That must be awful not being able to bind.
Actually, I've heard a lot of guys say that they had a breast reduction prior to male chest reconstruction, so if you have the reduction and then have top surgery at a later date, it can be done. And I've heard that surgeons can work with the scars, so it may not be so bad. Of course, as you know, there's no guarantees with surgery. But I do know a lot of guys have had reductions and then top surgery later.
Unfortunately, I kind of doubt a doc would do the reduction and the reconstruction at the same time.
I don't know much about insurance, if you have to see a certain doc or what.
Maybe if you go to an FtM top surgery doc who also does reductions (many do), you could convince him to help you.
Good luck. I hope everything works out.