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Best Ways of Coming up with the Cash

Started by GnomeKid, April 09, 2014, 10:09:20 AM

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GnomeKid

Hello there friends! 

So I'm in the early stages of looking into phallo. (Well...hopefully maybe intermediate stages of looking into it.  My hope is to schedule in the next 1-2 years.)  Currently I'm just about to get out of grad school, and have very little money to my name. 

I know some guys are lucky enough to get it through their country, but I am in the US. 

I know one guy (at least) was able to get his covered via insurance. It would be awesome to know how you finagled this. Though I'm loosing my parents insurance in October, so its doubtful whatever insurance I get on after that will cover it.

Other than that the only option I can think of is attempting to set-up a payment plan with my parents (.... I'd say I have like a 30-50% chance of making that successful...)  and hoping there are no complications that are going to run either of us into the poor house.  After 3 degrees and 8 years of higher education I don't have any student loans, so I kind of feel like taking on this debt is comparable to what my fellow students are having to deal with.  Hopefully I'll be able to find decent enough work. 

I've read that surgeries and hormones are actually tax deductible, but you would need the money first.... aaand I don't make nearly enough to have it be able to be deducted from my taxes (unless you can spread it out over years... Maybe I'll get surgery and not have to pay taxes for 10 or 15 years =p).

So.... I was just wondering.  Are there any hidden options I haven't considered?  Any tips or tricks anyone has to getting up the cash?  And while I'm at it any tips or tricks for convincing parents? 
I solemnly swear I am up to no good.

"Oh what a cute little girl, or boy if you grow up and feel thats whats inside you" - Liz Lemon

Happy to be queer!    ;)
  •  

Bimmer Guy

Hey, Gnomekid!

Have you looked into whether or not your parents insurance would cover it?  Some employers have it a part of their plans and some do not.  Your friend was able to get it covered simply because it is written in to his benefits contract (so I am not sure about the finagling part).  Cigna and Aetna plans are the ones who seem to cover it the most (but it depends on what the employer buys).

Although it is a long shot, it is possible that your parents insurance does cover surgery.  Call the benefits phone number on your insurance card and they can tell you.

Also, there is no reason to think that there is a better chance that your parents insurance will cover it while any that you may get does not.
Top Surgery: 10/10/13 (Garramone)
Testosterone: 9/9/14
Hysto: 10/1/15
Stage 1 Meta: 3/2/16 (including UL, Vaginectomy, Scrotoplasty), (Crane, CA)
Stage 2 Meta: 11/11/16 Testicular implants, phallus and scrotum repositioning, v-nectomy revision.  Additional: Lipo on sides of chest. (Crane, TX)
Fistula Repair 12/21/17 (UPenn Hospital,unsuccessful)
Fistula Repair 6/7/18 (Nikolavsky, successful)
Revision: 1/11/19 Replacement of eroded testicle,  mons resection, cosmetic work on scrotum (Crane, TX)



  •  

GnomeKid

Quote from: Brett on April 09, 2014, 05:17:39 PM
Hey, Gnomekid!

Have you looked into whether or not your parents insurance would cover it?  Some employers have it a part of their plans and some do not.  Your friend was able to get it covered simply because it is written in to his benefits contract (so I am not sure about the finagling part).  Cigna and Aetna plans are the ones who seem to cover it the most (but it depends on what the employer buys).

Although it is a long shot, it is possible that your parents insurance does cover surgery.  Call the benefits phone number on your insurance card and they can tell you.

Also, there is no reason to think that there is a better chance that your parents insurance will cover it while any that you may get does not.

eh my dad has a pretty ridiculously stellar job in the medical industry, so thats why I'm betting their insurance would probably beat out whatever I get.  I guess  I know I'm not getting surgery before that runs out, so not much point checking into that.  Unless I can convince my parents to cover me monthly for a year or so....(or more).... I highly doubt that'll happen.  You're right though... I shouldn't assume so much about whatever I may get.  Better financial means of obtaining insurance doesn't necessarily mean that that will cover SRS over a different one which might.  I guess I'll have to call up the doctors I'm looking into and see what insurance they've worked with before, and then try to get on one of those. 


anywho thanks for the reply! 
I solemnly swear I am up to no good.

"Oh what a cute little girl, or boy if you grow up and feel thats whats inside you" - Liz Lemon

Happy to be queer!    ;)
  •  

Alexthecat

Quote from: GnomeKid on April 11, 2014, 06:57:39 AM
eh my dad has a pretty ridiculously stellar job in the medical industry, so thats why I'm betting their insurance would probably beat out whatever I get.  I guess  I know I'm not getting surgery before that runs out, so not much point checking into that.  Unless I can convince my parents to cover me monthly for a year or so....(or more).... I highly doubt that'll happen.  You're right though... I shouldn't assume so much about whatever I may get.  Better financial means of obtaining insurance doesn't necessarily mean that that will cover SRS over a different one which might.  I guess I'll have to call up the doctors I'm looking into and see what insurance they've worked with before, and then try to get on one of those. 


anywho thanks for the reply! 
If you pay them to cover it why wouldn't they?

  •  

SX0877

Maybe look into your school's insurance plan for student. Many schools' plans cover the cost.
  •  

GnomeKid

#5
Quote from: SX0877 on April 11, 2014, 11:02:56 AM
Maybe look into your school's insurance plan for student. Many schools' plans cover the cost.

Unfortunately (and fortunately) I'll be done school by then.  As for me paying in for my parents insurance(from alex's response) I'm not even sure that their insurance would cover it, so may as well do the research there as to what companies do.  If theirs does on the plan we're on it may be easier to get traction on that.  That, and I still need to work out finding a job out of school, and paying for rent in an expensive city (moving to NYC after graduation... I'm in theatre and know the most people up there out of anywhere).  I have a feeling that I, personally, could not afford my part of their insurance on a monthly basis.  My mom has this whole insurance discussion (trans regardless) ear marked for sometime over the summer.  I've attempted to broach the topic once or twice in the past few months (with emphasis on my surgical aspirations) and my mom has told me that thats a topic for later on.  She is also still warming up to the whole surgery thing.  Regardless, I imagine I'd be getting the same answer of figuring it out in the summer.

I guess I have a lot more financial/insurance research to do, but I suppose thats why I made this thread... in many was I'm very life-ignorant when it comes to theses kind of logistics.  I'm good at budgeting, paying my rent, and food ect., but as someone who has been a full time student since age 4.. besides those basics I'm pretty oblivious - especially when it comes to health insurance.  I know the big picture and some basics on types of plans, but the details are new to me. 

Edit:  I think in the end I'm just going to type up an email to the Doc's office I'm looking into (Dr. Crane in SF...  My sister lives in the area, so it would be convenient.  I also have heard good things about him/like his results.), and ask them what insurances they have dealt with in the past/see if they can recommend specific plans that allow for SRS.  Hopefully I'll get something to work with.  I've been looking at different companies.  Most of the time it seems to say that only specific plans cover it, yet it gives no direction as to which.
I solemnly swear I am up to no good.

"Oh what a cute little girl, or boy if you grow up and feel thats whats inside you" - Liz Lemon

Happy to be queer!    ;)
  •  

Bimmer Guy

Hey, Gnomekid, let me see if I can be of some help.

You made a comment about looking to see what insurance company offers this benefit.  I don't believe that any of the insurance companies through the Obama Exchange offers gender surgeries (or at least they don't HAVE to by law...worth looking into I think).  Medicaid (all states) do not cover gender surgeries.  If you aren't getting your insurance through the exchange, or through the State, you will have whatever insurance your employer offers.

I wouldn't suggest picking a job based on what insurance they offer their employees.  You most likely won't be able to find out if their insurance package covers gender surgeries before taking the job.  Additionally, employers jump from one insurance company to the next, so even if you knew for sure their plan covered the surgery when you were hired, you may not even be able to get the surgery before they change their insurance plan yet again (companies renew plans once per year).

Like I said in an earlier post, Aetna and Cigna seem to be the only two insurance companies to my knowledge that will cover gender surgeries.  However, your specific company has to choose to have that as a part of their package.  You and your friend could both have Aetna, but his company's insurance policy will pay for gender surgeries, while yours doesn't.

My experience is that there are two types of companies who will pay for this "benefit" for their employee.

Companies who want to "look good" and non-profits who actually give a ->-bleeped-<-.

It is very possible your father's high end company won't pay, while one's theater company will.

It is the luck of the draw, my friend.

Your best bet would be after you get your first job and the company doesn't have the benefit, start fighting to get it written into the next year's policy.   ;)
Top Surgery: 10/10/13 (Garramone)
Testosterone: 9/9/14
Hysto: 10/1/15
Stage 1 Meta: 3/2/16 (including UL, Vaginectomy, Scrotoplasty), (Crane, CA)
Stage 2 Meta: 11/11/16 Testicular implants, phallus and scrotum repositioning, v-nectomy revision.  Additional: Lipo on sides of chest. (Crane, TX)
Fistula Repair 12/21/17 (UPenn Hospital,unsuccessful)
Fistula Repair 6/7/18 (Nikolavsky, successful)
Revision: 1/11/19 Replacement of eroded testicle,  mons resection, cosmetic work on scrotum (Crane, TX)



  •  

GnomeKid

Quote from: Brett on April 12, 2014, 08:21:14 PM
Hey, Gnomekid, let me see if I can be of some help.

You made a comment about looking to see what insurance company offers this benefit.  I don't believe that any of the insurance companies through the Obama Exchange offers gender surgeries (or at least they don't HAVE to by law...worth looking into I think).  Medicaid (all states) do not cover gender surgeries.  If you aren't getting your insurance through the exchange, or through the State, you will have whatever insurance your employer offers.

I wouldn't suggest picking a job based on what insurance they offer their employees.  You most likely won't be able to find out if their insurance package covers gender surgeries before taking the job.  Additionally, employers jump from one insurance company to the next, so even if you knew for sure their plan covered the surgery when you were hired, you may not even be able to get the surgery before they change their insurance plan yet again (companies renew plans once per year).

Like I said in an earlier post, Aetna and Cigna seem to be the only two insurance companies to my knowledge that will cover gender surgeries.  However, your specific company has to choose to have that as a part of their package.  You and your friend could both have Aetna, but his company's insurance policy will pay for gender surgeries, while yours doesn't.

My experience is that there are two types of companies who will pay for this "benefit" for their employee.

Companies who want to "look good" and non-profits who actually give a ->-bleeped-<-.

It is very possible your father's high end company won't pay, while one's theater company will.

It is the luck of the draw, my friend.

Your best bet would be after you get your first job and the company doesn't have the benefit, start fighting to get it written into the next year's policy.   ;)

Damn.  As someone who is going to most likely be working in freelance-type work I doubt I'll have any overlying company to get insurance through.  Maybe I'll get lucky though, or have a good job with benefits on the side of my show-by-show work. 

Thanks for explaining that though.  It all tends to get kind of muddled in my head without an explanation of how anything works in the first place.
I solemnly swear I am up to no good.

"Oh what a cute little girl, or boy if you grow up and feel thats whats inside you" - Liz Lemon

Happy to be queer!    ;)
  •  

Bimmer Guy

Quote from: GnomeKid on April 13, 2014, 03:44:27 PM
Damn.  As someone who is going to most likely be working in freelance-type work I doubt I'll have any overlying company to get insurance through.  Maybe I'll get lucky though, or have a good job with benefits on the side of my show-by-show work. 

Thanks for explaining that though.  It all tends to get kind of muddled in my head without an explanation of how anything works in the first place.

I understand that it is complicated.  Insurance is like another language and if you don't have the basics, then everything is confusing.

Looks like this is in your future:  https://www.healthcare.gov/

And you should be WAY happy Obamacare is out there.  You will spend a great deal less than you would have a year ago on the open market.
Top Surgery: 10/10/13 (Garramone)
Testosterone: 9/9/14
Hysto: 10/1/15
Stage 1 Meta: 3/2/16 (including UL, Vaginectomy, Scrotoplasty), (Crane, CA)
Stage 2 Meta: 11/11/16 Testicular implants, phallus and scrotum repositioning, v-nectomy revision.  Additional: Lipo on sides of chest. (Crane, TX)
Fistula Repair 12/21/17 (UPenn Hospital,unsuccessful)
Fistula Repair 6/7/18 (Nikolavsky, successful)
Revision: 1/11/19 Replacement of eroded testicle,  mons resection, cosmetic work on scrotum (Crane, TX)



  •  

aleon515

Quote from: Brett on April 13, 2014, 04:26:04 PM
I understand that it is complicated.  Insurance is like another language and if you don't have the basics, then everything is confusing.

Looks like this is in your future:  https://www.healthcare.gov/

And you should be WAY happy Obamacare is out there.  You will spend a great deal less than you would have a year ago on the open market.

It's possible it's coming, Medicare has been sued and has lost (although the status of what's going on now is not so clear). If Medicare funds them I don't see how Medicaid refuses them. And if Medicaid funds them, then it's kind of hard to see how the private insurance cannot. The reasons for not funding are basically old out-moded ones (it's cosmetic, it's experimental, it doesn't really solve the problems anyway). They aren't actually based on research and the research is pretty clear.



--Jay
  •  

Bimmer Guy

Quote from: aleon515 on April 13, 2014, 07:55:25 PM
It's possible it's coming, Medicare has been sued and has lost (although the status of what's going on now is not so clear). If Medicare funds them I don't see how Medicaid refuses them. And if Medicaid funds them, then it's kind of hard to see how the private insurance cannot. The reasons for not funding are basically old out-moded ones (it's cosmetic, it's experimental, it doesn't really solve the problems anyway). They aren't actually based on research and the research is pretty clear.



--Jay

I agree.  Since transgender people tend to be on the low end of socio-economic class (due to discrimination in workplace, housing, etc), many are on Medicaid.  Medicaid will probably get it before the bulk of private insurance.

EDIT: In case anyone doesn't know, top surgery started being tax deductible in 2011.  Tax deductible for those who are transitioning from female to male (I assume this means legally transitioning).
Top Surgery: 10/10/13 (Garramone)
Testosterone: 9/9/14
Hysto: 10/1/15
Stage 1 Meta: 3/2/16 (including UL, Vaginectomy, Scrotoplasty), (Crane, CA)
Stage 2 Meta: 11/11/16 Testicular implants, phallus and scrotum repositioning, v-nectomy revision.  Additional: Lipo on sides of chest. (Crane, TX)
Fistula Repair 12/21/17 (UPenn Hospital,unsuccessful)
Fistula Repair 6/7/18 (Nikolavsky, successful)
Revision: 1/11/19 Replacement of eroded testicle,  mons resection, cosmetic work on scrotum (Crane, TX)



  •  

Alexthecat

Quote from: Brett on April 14, 2014, 07:48:06 PM
EDIT: In case anyone doesn't know, top surgery started being tax deductible in 2011.  Tax deductible for those who are transitioning from female to male (I assume this means legally transitioning).

How would one file that?

  •  

kenton_07

It would only be tax deductible if you elected to itemize deductions on your individual income tax return. If your itemized deduction is lower than the standard deduction, then you wouldn't be deducting the surgery expenses unless you don't want to take the benefits of the standard deduction. Also the medical expense is subject to a limit of your AGI. The tax system is pretty complex and there are a lot of misconceptions about these things being tax deductible since many of them are subject to limitations.

Edit: also, I believe these deductions would be on a case by case basis and if you were to be audited, there would have to be certain documentation and you would need to argue your case.
  •  

Bimmer Guy

Quote from: Alexthecat on April 15, 2014, 04:19:42 AM
How would one file that?

Quote from: kenton_07 on April 15, 2014, 04:57:59 PM
It would only be tax deductible if you elected to itemize deductions on your individual income tax return. If your itemized deduction is lower than the standard deduction, then you wouldn't be deducting the surgery expenses unless you don't want to take the benefits of the standard deduction. Also the medical expense is subject to a limit of your AGI. The tax system is pretty complex and there are a lot of misconceptions about these things being tax deductible since many of them are subject to limitations.

Edit: also, I believe these deductions would be on a case by case basis and if you were to be audited, there would have to be certain documentation and you would need to argue your case.

The National Center for Transgender Equality  http://transequality.org/ had it listed on their frequently asked question from January 2012.  I have a hardycopy in front of me, but cannot find it on their website (I think I got this paper at a conference or something).

What I can tell you is at the top it says "Federal Taxes and Transgender People", Frequently Asked Questions January 2012.  Email the contact address and ask them to find the page for you.

On November 21, 2011, the IRS affirmed that transgender people can deduct the cost of hormones and surgery as medical expenses.

The expenses (meaning the cost of your surgery, Alex), must be more than 7.5% of your adjusted gross income.

It might be worth you looking into, Alex (I can't remember if your surgery was in 2013 or 2014).

As Kenton said, you would have to have all your ducks in a row in case you get audited.  It doesn't look complicated, however.
Top Surgery: 10/10/13 (Garramone)
Testosterone: 9/9/14
Hysto: 10/1/15
Stage 1 Meta: 3/2/16 (including UL, Vaginectomy, Scrotoplasty), (Crane, CA)
Stage 2 Meta: 11/11/16 Testicular implants, phallus and scrotum repositioning, v-nectomy revision.  Additional: Lipo on sides of chest. (Crane, TX)
Fistula Repair 12/21/17 (UPenn Hospital,unsuccessful)
Fistula Repair 6/7/18 (Nikolavsky, successful)
Revision: 1/11/19 Replacement of eroded testicle,  mons resection, cosmetic work on scrotum (Crane, TX)



  •  

GnomeKid

Quote from: Brett on April 15, 2014, 08:04:19 PM
The National Center for Transgender Equality  http://transequality.org/ had it listed on their frequently asked question from January 2012.  I have a hardycopy in front of me, but cannot find it on their website (I think I got this paper at a conference or something).

What I can tell you is at the top it says "Federal Taxes and Transgender People", Frequently Asked Questions January 2012.  Email the contact address and ask them to find the page for you.

On November 21, 2011, the IRS affirmed that transgender people can deduct the cost of hormones and surgery as medical expenses.

The expenses (meaning the cost of your surgery, Alex), must be more than 7.5% of your adjusted gross income.

It might be worth you looking into, Alex (I can't remember if your surgery was in 2013 or 2014).

As Kenton said, you would have to have all your ducks in a row in case you get audited.  It doesn't look complicated, however.

Yea I noticed that too.  I found a listing on another website about the Tax Deductible.

Here is the fact sheet you were referring to: http://transequality.org/Resources/IRS_Factsheet_2012.pdf (just googled IRS transgender surgery)

I found an official IRS document detailing it all, but the link I used to get there previously (off of http://www.ryansallans.com/transition/resources/) is now just taking me to a huffington post article about it.  Really odd.  I also know I sent other URL to my mom, and can't seem to find it in my sent emails. 

I'll try to keep an eye out for it.

The issue with this route is that you still have to have the money up-front.  I'm also a little iffy on Taxes (I'm just only becoming a real person... so trying, but kind of oblivious), but wouldn't you not be able to deduct 50,000 or whatever dollars from your taxes unless you owed/paid 50,000 or whatever dollars into taxes?

Essentially with a job where one may be paying say just randomly 5,000 dollars into taxes how would one hope to deduct 50,000? 

would you be able to deduct it over 10 years and just essentially not pay taxes because you paid for your surgery? 


I also just found this, which may be of assistance.  I've got a list of school work as long as my arm, so reading a 28 page paper on the subject isn't really something I've got time for at the moment I'll pass it on to you guys though. 

"Deducting the Cost of Sex Reassignment Surgery:
How O'Donnabhain v. Commissioner Can Help Us Make Sense of the Medical Expense Deduction"
http://www.columbiataxjournal.org/wp-content/uploads/2012/01/lusztig3-11.pdf

I solemnly swear I am up to no good.

"Oh what a cute little girl, or boy if you grow up and feel thats whats inside you" - Liz Lemon

Happy to be queer!    ;)
  •  

Alexthecat

Oh so the expense of $6500 isn't enough for my 16k gross I think it was last year?

  •