Susan's Place Transgender Resources

I have been in transition since May 14, 2012.  that's the day I went full time. 

I am finally in the homestretch!  I had my phone consult with Dr. Kathy Rumer last week.  I did a lot of research on surgeons, and between Bowers, McGinn, Meltzer and Rumer, I felt Rumer afforded me the best options of what I was looking for.  I spoke to all 4, and I felt a comfort from talking with Rumer that I didn't get from the other 3.  I spoke to a couple of patients from each as well.  Some that I knew, some that were sought out online.  I was also very impressed with the reviews that a few on here had left about Dr. Rumer.

I have an office consult scheduled for December of this year.  Since I live in Colorado, I have the option of purchasing health insurance that will cover my procedures (lower surgery and breast implants only.  FFS is unfortunately not covered yet, hopefully that will change soon).  Will be picking up my insurance in Dec 2015 following my office consult.

Today my therapist faxed over my surgery letter to Dr. Rumer's office.

Only a few steps left! 

1.)  Office consult
2.)  Book my surgery date
3.)  Submit itemized billing to the insurance company.
4.)  pay my deductible
5.)  Show up for surgery. 

Looking like February to March of 2016 will be when surgery happens.

my initial goals were to be done by the end of 2016.  With exception to facial corrections, that will hold true.  I'll have to pay for those out of pocket.  Dr. Rumer will be doing my lower surgery and breast augmentation at the same time. Gonna be painful, but I will live. 


I am so excited.  I wish this year would just fly by.  Ready to be complete and to feel whole.  :)

Congrats Audrey! I'm sure the year will go fast enough, make sure you have lots of fun in the meantime! :D

congrats and good luck

Congrats!  Time flies; I've been looking forward to having lipo with hip and butt augmentation since last June, and my surgery date is less than two weeks away now  :)

thanks ladies!  :)

I wish you well on getting everything in order.

Time seems far away but will be here and gone before you know it.

Hugs

Congrats!   I'm almost there myself, still weighing my options and figuring out when I can actually take the required down time.

One thing you should probably ask yourself now is "What next?".  A common problem is finding something other than transitioning to occupy yourself once you're done. 

my consult is Dec 7th.  I'm moving right along.  trying to save up the last of the money necessary.  Hoping for some time in late spring early summer! 

Quote from: Jill F on January 26, 2015, 08:04:25 PM
Congrats!   I'm almost there myself, still weighing my options and figuring out when I can actually take the required down time.

One thing you should probably ask yourself now is "What next?".  A common problem is finding something other than transitioning to occupy yourself once you're done.

I wont have that problem.  I'm so active with hiking, climbing, photography and exploring Colorado.  I have no shortage of activities every weekend.  Usually I can't get everything done I need and want to every weekend lol. 

Congratulations... home stretch indeed!

Yeah, Dr. Rumer is my top choice when the time comes too.  Post update plz!

I am so excited for my surgery it should be next year some time.

well...after 4 1/2 years of fighting and battling, Cigna has approved my gender reassignment surgery.

I was notified on Monday by the Customer Care Manager that has been working with me and my surgery coordinator that it was approved.  A letter should be arriving in the mail any day now.

I was in total shock and disbelief that they actually said yes.

Yesterday while on a phone session with my therapist, the dam broke loose and I just started bawling my eyes out and all these emotions that had been pent up so long finally were purged. It was such a good cry too.  Really been needing that.

I fly to Philly on Feb 20th.  My surgery is Feb 22, 2017.

I'm beyond ecstatic and overjoyed.

Still waiting on a review of the breast implant surgery though.  They denied it due to cosmetic, but I found their own language and used it against them cause it says if you have been on hormones for at least 12 months and have no significant breast development then they will cover the breast implants, so fingers crossed and I'm optimistic that it will come through.


In hindsight, I did have my consult with Dr. Rumer on Dec 7, 2015 and she and her staff were completely wonderful!  They explained everything, walked me through it all, did a breast size fitment.  She and her staff were very professional and courteous.

Wonderful news Audrey!!  I am so happy for you, this month will fly by

-Sarah

Quote from: Inarasarah on January 25, 2017, 09:57:09 PM
Wonderful news Audrey!!  I am so happy for you, this month will fly by

-Sarah

thanks Sarah!  I'm very happy too. [emoji3]

Wow that's awesome that they approved it!

I have a feeling I will have all kinds of troubles getting anything from my insurance. I was on the phone with them a few weeks ago just trying to straighten out their not covering a regular office visit when the lady on the phone stopped, said " wait this code can't be right, hold on a minute". When she came back she couldn't wait to get me off the phone. I know what the code was. That was the visit my GP put gender dysphoria on my medical chart. This is a southern state BCBS group.

Quote from: josie76 on January 26, 2017, 09:52:17 PM
Wow that's awesome that they approved it!

I have a feeling I will have all kinds of troubles getting anything from my insurance. I was on the phone with them a few weeks ago just trying to straighten out their not covering a regular office visit when the lady on the phone stopped, said " wait this code can't be right, hold on a minute". When she came back she couldn't wait to get me off the phone. I know what the code was. That was the visit my GP put gender dysphoria on my medical chart. This is a southern state BCBS group.

as I understand it a Federal Mandate went into effect on 01/01/2017 eliminating all exclusions regarding transgender surgeries and closing all the loopholes that insurance companies were using to deny surgery.

These things strengthen your case

your letters from your therapist must state "
that GRS is "Medically Necessary".


For breast augmentation, your therapist must state you have been on hormones for the number of months and that you didnt have any significant breast development.  (I've been on them for 4 1/2 years and very little development.  Not even an "A cup". It also must state that it affects your identity as woman and detracts from your daily life and causes loss lf confidence.

If I can help please let me know, feel free to send me a pm.

Quote from: audreytn on January 27, 2017, 07:09:34 AM
as I understand it a Federal Mandate went into effect on 01/01/2017 eliminating all exclusions regarding transgender surgeries and closing all the loopholes that insurance companies were using to deny surgery.

These things strengthen your case

your letters from your therapist must state "
that GRS is "Medically Necessary".


For breast augmentation, your therapist must state you have been on hormones for the number of months and that you didnt have any significant breast development.  (I've been on them for 4 1/2 years and very little development.  Not even an "A cup". It also must state that it affects your identity as woman and detracts from your daily life and causes loss lf confidence.

If I can help please let me know, feel free to send me a pm.

Unless your insurance plan is self-funded, with no federal subsidies.  Then they can skip any federal mandates.  That is what my Cigna rep told me about my policy.  Self-funded means they can offer what they want...

Gratz on getting approved.

Besides, this.....

http://www.washingtontimes.com/news/2017/jan/1/judge-blocks-obama-mandate-forcing-doctors-to-perf/

Hi Audrey,

First off, congratulations!  You must be ecstatic.

I was very intrigued by your post, since you consulted with Bowers, McGinn, Meltzer and Rumer.  The surgeons I chose to schedule a consultation with are McGinn, Meltzer and Rumer. I actually had Bowers on my list as well, but a three-year waiting list was not acceptable.  In fact Meltzer has a 1-2 year waiting list, so he may not really be an option, either, but I may still see him.

My consultations are scheduled for April 3rd (McGinn and Rumer) and April 26th (Meltzer).

Aetna has pre-certified McGinn as in-network, so that may in fact be who I end up with, but I was really interested to know if you did in-person consultations as well. Did all three have the same clinical approach, follow-up care, etc.? I was also interested in the fact that Rumer does SRS and BA at the same time, but I have heard McGinn does not recommend that. It's not a big deal; I'm not sure I could afford a BA at this time.  I'm still paying off my FFS.

If you like, I can PM you.

Thanks,

Terri

Quote from: NikkiB51 on January 27, 2017, 01:47:32 PM
Unless your insurance plan is self-funded, with no federal subsidies.  Then they can skip any federal mandates.  That is what my Cigna rep told me about my policy.  Self-funded means they can offer what they want...

Gratz on getting approved.

that is correct unfortunately. That's the reason I declined my employer's insurance and bought my own plan on the Colorado Exchange, so that they couldn't deny.

Quote from: NikkiB51 on January 27, 2017, 02:35:12 PM
Besides, this.....

http://www.washingtontimes.com/news/2017/jan/1/judge-blocks-obama-mandate-forcing-doctors-to-perf/

thankfully, that doesn't apply here.  This only allows doctor's that DON'T want to perform the surgeries the right not to do so.  However, if you think about it, all of the doctors currently doing them, WANT to do them.

Quote from: Maybebaby56 on January 27, 2017, 05:04:29 PM
Hi Audrey,

First off, congratulations!  You must be ecstatic.

I was very intrigued by your post, since you consulted with Bowers, McGinn, Meltzer and Rumer.  The surgeons I chose to schedule a consultation with are McGinn, Meltzer and Rumer. I actually had Bowers on my list as well, but a three-year waiting list was not acceptable.  In fact Meltzer has a 1-2 year waiting list, so he may not really be an option, either, but I may still see him.

My consultations are scheduled for April 3rd (McGinn and Rumer) and April 26th (Meltzer).

Aetna has pre-certified McGinn as in-network, so that may in fact be who I end up with, but I was really interested to know if you did in-person consultations as well. Did all three have the same clinical approach, follow-up care, etc.? I was also interested in the fact that Rumer does SRS and BA at the same time, but I have heard McGinn does not recommend that. It's not a big deal; I'm not sure I could afford a BA at this time.  I'm still paying off my FFS.

If you like, I can PM you.

Thanks,

Terri

I'm beyond ecstatic.  I've been in a good happy mood, on cloud 9 for 3 weeks!  Surgery is only 6 days away!  OMG! woot! 

I did an in-person with Rumer.  After the way the others came off on the phone, I wasn't even about to waste my time or money on them.  I didn't get that far with Meltzer, Bower or McGinn as to their approach or follow up care.  Once it became apparent to me that I didn't matter to them, I was turned off to the idea of them operating on me.  Maybe I caught them on a bad day, or off day, or whatever, but I just didn't feel like I mattered to them.  They wanted to know when I wanted surgery and how I intended to pay and when. Dr. Rumer wasnt that way with me. 

Different surgeons do and recommend different things.  I know several transwomen that had both done at the same time, and no issues.  More pain, but they have pain meds for that.  For me, I'd rather get both done in one visit and be done with surgeries.  I'm not fond of Operating Room's and anesthesia. I get nervous and anxious.  My brain starts working overtime and I fear the worst.