I have transitioned, MTF, to full time. I am almost 69 years old and on Medicare. My wife and I are still together and sexuall active though my function is nil. For her, I have deferred GRS, but she has said several times that she expects it to happen, eventually. I am beginning to contemplate doing it. I am feeling, how shall I say it?, unfinished, incomplete.
I'm beginning the process of looking at my options. GSR is covered by Medicare but I understand there are problems with finding surgeons who will deal with the reimbursement problems associated with Medicare. Can anyone help me find a surgeon that will accept Medicare? Firsthand information is preferable, but I will track down any leads I can stir up. I don't mind jumping through the hoops, but are there any possibilities so that it even makes sense to try?
Stevi
I have had several people (including doctors) try to find an SRS surgeon that would do mine on Medicare and Medicaid. Not even one could be found, ever since Obama made it possible. The best hope I found was one in Dallas that would do it if I could come up with 80% of the total.
That being said, I'll probably die with my penis still intact.
Sarah,
Thank you for the reply. Do you know if it was because the reimbursement from Medicare was only a small part of the surgeon's normal fee? Or the hassle of dealing with the system?
Do you have a name for the doctor you did find?
Thanks again,
Stevi
Dr. Dugi, who did my surgery, takes Medicare. They pay for almost all of it. I am extremely happy with my results, but he has a very long wait list now.
Quote from: Stevi on November 24, 2018, 02:15:28 PM
I have transitioned, MTF, to full time. I am almost 69 years old and on Medicare. My wife and I are still together and sexuall active though my function is nil. For her, I have deferred GRS, but she has said several times that she expects it to happen, eventually. I am beginning to contemplate doing it. I am feeling, how shall I say it?, unfinished, incomplete.
I'm beginning the process of looking at my options. GSR is covered by Medicare but I understand there are problems with finding surgeons who will deal with the reimbursement problems associated with Medicare. Can anyone help me find a surgeon that will accept Medicare? Firsthand information is preferable, but I will track down any leads I can stir up. I don't mind jumping through the hoops, but are there any possibilities so that it even makes sense to try?
Stevi
I am pretty much in the same situation, albeit a few years older and without a wife.
I really would like to find out, who and where Medicare is accepted. My psychologist believes that the surgeon at the U of Miami will accept Medicare, but his outcomes seem to be pretty lousy!
Quote from: AutumnLeaves on November 26, 2018, 11:51:15 AM
Dr. Dugi, who did my surgery, takes Medicare. They pay for almost all of it. I am extremely happy with my results, but he has a very long wait list now.
Where is he located? Can you give us some more info about him/contact info?
Dr Dugi is in Portland and his waitlist is up to 3 years already.
Dr Rachel Bluebond-Langer at NYU does take Medicare. Her wait list is about a year and a half to two years, but less if you ask to be put on the cancelation list.
Thanks you all. The wait list would easily allow the mostly required year on HRT to be done. I better get going to get in line, too!
Thanks, Autumn, Dietlind and Sydney,
I am just beginning my thought process about having GRS. As a first step, I needed to know if the possibility even exists. If it were just me. I would have pursued GRS a long time ago. But, I have been trying my best to accommodate my wife's needs as much as possible. As things have progressed, we have learned to provide for one another's needs in new ways. From some of her comments, I see that it is possible, maybe even expected, for me to go the next step of GRS. Before I open up the subject for serious discussion, I need to know it is reasonable to expect to be able to succeed. No sense in broaching the subject when the destination is unobtainable.
I'll have to see about the details with my Medicare Insurance provider and begin to look into the techniques and outcomes of the potential surgeons.
Thanks again, You've been a big help. I don't have a lot of options but I know the door is not completely closed.
Stevi
@ Stevi
I am in a similar situation like you. I do, however, not to coordinate my surgery with a partner, I am a little more Independent in that area.
However, I am retired an live on a fixed income, and I can afford any surgery only, if Medicare and my supplement insurance will pay for it.
I cannot afford to travel to Thailand, or any other exotic place, and pay out of pocket for the surgery. If any surgery under is not possible under Medicare, I will live with my plumbing for the rest of my life.
It seems to me that my insurance would pay for surgery in Florida, but not out state. The only SRS done in Florida, however, is done in Miami, and they seem not to have a great outcome there.
I will meet with my insurance broker later this week and see if he can find a supplemental for a reasonable price that would pay for out of state elective surgeries.
Why not just take out a personal bank loan to pay up front until you receive your reimbursement, then pay it off?
Quote from: ForeverLacey on November 27, 2018, 08:51:01 AM
Why not just take out a personal bank loan to pay up front until you receive your reimbursement, then pay it off?
Have you ever dealt with Medicare? I may be dead before I see the money back!
Dr Bluebond-Langner did my surgery and originally was taking medicare but NYU was having trouble getting paid. They may have stopped taking it. Its my understanding that only one patient has ever successfully had Medicare pay for their surgery and she had to file suit. It was also before Trump started doing whatever Pence and Evangelicals wanted him to do . . .
Here is the newest position of Medicare on Gender Reasignment Surgery
https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=282
Quote from: Dietlind on November 27, 2018, 07:40:24 AM
It seems to me that my insurance would pay for surgery in Florida, but not out state. The only SRS done in Florida, however, is done in Miami, and they seem not to have a great outcome there.
Dietlind, there is Dr Daniel Greenwald in Tampa and he does the full suite of plastic and transgender surgeries. I don't know if he takes Medicare, but it would be worth a call.
Quote from: JudiBlueEyes on December 12, 2018, 10:36:18 PM
Dietlind, there is Dr Daniel Greenwald in Tampa and he does the full suite of plastic and transgender surgeries. I don't know if he takes Medicare, but it would be worth a call.
Judi - or anyone else here - do you know anything specific about Doctor Greenwald? I live just 60 miles from Tampa, yet I rarely hear about him and I've talked to only one person who'd gone to him. He isn't well-known, but he is in-network for some insurance. It would be nice to get references from his patients.
Stephanie
Quote from: Steph2.0 on December 12, 2018, 11:59:44 PM
Judi - or anyone else here - do you know anything specific about Doctor Greenwald? I live just 60 miles from Tampa, yet I rarely hear about him and I've talked to only one person who'd gone to him. He isn't well-known, but he is in-network for some insurance. It would be nice to get references from his patients.
Stephanie
He is a plastic surgeon, I don't know if that is the discipline doing bottom surgeries. I always thought urologists would do this. Nothing on his site or Google comments show that he does SRS.
Th only group I found that is accepted by Medicare are the ones in Miami (University) who seem to have a pretty poor outcome.
I looked into him since I have family nearby where I could stay inexpensively to recover. He doesn't actively advertise so he's not known much for GRS. I had read a couple reviews that were positive. Check out his website. http://bayshoreplasticsurgery.com/transgender-surgery.php
As far as being specifically a plastic surgeon, I wasn't concerned about that as many doctors offering transgender services offer a wide range of possibilities.
Quote from: JudiBlueEyes on December 13, 2018, 09:05:13 AM
I looked into him since I have family nearby where I could stay inexpensively to recover. He doesn't actively advertise so he's not known much for GRS. I had read a couple reviews that were positive. Check out his website. http://bayshoreplasticsurgery.com/transgender-surgery.php
As far as being specifically a plastic surgeon, I wasn't concerned about that as many doctors offering transgender services offer a wide range of possibilities.
I would be good for me, because I have to drive only 2 to 3 hours to be there. I might be able to recover at home?
Try the University of Michigan Gender Services.
I don't know how Medicare works (yet, but soon!) but might you get surgery and file to be reimbursed by Medicare?
Quote from: JudiBlueEyes on December 14, 2018, 11:24:23 AM
I don't know how Medicare works (yet, but soon!) but might you get surgery and file to be reimbursed by Medicare?
I on't know either. If Medicare deems the surgery not be medically required, they will not reimburse anything. And looking through the new position paper, it seems to be up to the local offices to decide it.
It thus would be nice to find a surgeon who works with medicare and knows the appropriate case coding already!