FTM's and Transitioning

DamonK · 01-11-2011, 11:55 PM

To answer the questions,

Yes, I have Aetna. However, no trans-friendly docs that I'm aware of. My psych doc is trans-friendly, but that's another story. He's hilarious.

In fact, when I changed jobs, I kept the docs at the Catholic hosp just so I could keep my psych doc. He means THAT much to me. I will "happily" struggle with the rest as to keep him on my medical team.

Seeing as my docs are based of Catholic hospital, it could potentially be difficult for me to just go straight to top surg. Since I do NEED the other surg, I don't want to cause issues to get it, such as asking about top surg.

If I can't win them all, I might as well win at least ONE.

Likely for T, I will end up in SL or KC.

raising2alone · 01-12-2011, 09:11 AM

Hi Damon,

If you live in KC there is a Trans friendly doctor in KCKS. Dr. Lee has a clinic off of SW Blvd and would probably be able to refer other doctors in the area if you didn't want to go there.

DapperButch · 01-12-2011, 01:05 PM

Quote:

Originally Posted by DamonK

To answer the questions,

Yes, I have Aetna. However, no trans-friendly docs that I'm aware of. My psych doc is trans-friendly, but that's another story. He's hilarious.

In fact, when I changed jobs, I kept the docs at the Catholic hosp just so I could keep my psych doc. He means THAT much to me. I will "happily" struggle with the rest as to keep him on my medical team.

Seeing as my docs are based of Catholic hospital, it could potentially be difficult for me to just go straight to top surg. Since I do NEED the other surg, I don't want to cause issues to get it, such as asking about top surg.

If I can't win them all, I might as well win at least ONE.

Likely for T, I will end up in SL or KC.

Oh, well, seriously Damon, if your insurance covers top surgery, then there is a physician in your network that will do the work. It shouldn't matter where your therapist or psychiatrist work in order for you to get a letter for surgery. If you are certain it is top surgery you want, you really should look into it instead of settling for a breast reduction. One less surgery! Lots would kill to have your insurance to cover their top surgery. You're lucky!

Glad you found a psych doc you like!

Good Luck with whatever route you take.

Just my thoughts, for what they're worth.

DamonK · 01-12-2011, 01:14 PM

Quote:

Originally Posted by DapperButch

Oh, well, seriously Damon, if your insurance covers top surgery, then there is a physician in your network that will do the work. It shouldn't matter where your therapist or psychiatrist work in order for you to get a letter for surgery. If you are certain it is top surgery you want, you really should look into it instead of settling for a breast reduction. One less surgery! Lots would kill to have your insurance to cover their top surgery. You're lucky!

Glad you found a psych doc you like!

Good Luck with whatever route you take.

Just my thoughts, for what they're worth.

That's the problem. The docs in my network are NOT trans-friendly. Therefore, the majority will NOT do top surgery.

Linus · 01-12-2011, 01:16 PM

Quote:

Originally Posted by DapperButch

Oh, well, seriously Damon, if your insurance covers top surgery, then there is a physician in your network that will do the work. It shouldn't matter where your therapist or psychiatrist work in order for you to get a letter for surgery. If you are certain it is top surgery you want, you really should look into it instead of settling for a breast reduction. One less surgery! Lots would kill to have your insurance to cover their top surgery. You're lucky!

Glad you found a psych doc you like!

Good Luck with whatever route you take.

Just my thoughts, for what they're worth.

Actually, DamonK is in the same boat as me. You have to get two doctors to write that it's a medical necessity. Although Aetna covers it, it doesn't explicitly say just go and do. There are some hoops to go through. My company recently switched to Aetna (thank you Anthem for trying to jack up rates 800%!) and the doctor I'm seeing (out of network) is good and very trans friendly but I may try to find a doctor that is in network and trans friendly (not always possible). At the least, this doctor I'm going to ask if she can recommend a surgeon or two since she's known to the transmen community here.

I'd like to go to the one that Theo recommended but I don't know if that would then be covered by insurance or not.

DamonK · 01-12-2011, 01:32 PM

Quote:

Originally Posted by Linus

Actually, DamonK is in the same boat as me. You have to get two doctors to write that it's a medical necessity. Although Aetna covers it, it doesn't explicitly say just go and do. There are some hoops to go through. My company recently switched to Aetna (thank you Anthem for trying to jack up rates 800%!) and the doctor I'm seeing (out of network) is good and very trans friendly but I may try to find a doctor that is in network and trans friendly (not always possible). At the least, this doctor I'm going to ask if she can recommend a surgeon or two since she's known to the transmen community here.

I'd like to go to the one that Theo recommended but I don't know if that would then be covered by insurance or not.

Exactly. And since the docs work at a catholic based place, it makes it even harder for me.

Linus · 01-12-2011, 02:00 PM

Quote:

Originally Posted by DamonK

Exactly. And since the docs work at a catholic based place, it makes it even harder for me.

Since the therapist is trans friendly would they perhaps know of a doctor that is also trans friendly that could help?

Greyson · 01-12-2011, 02:14 PM

To the guys who may be getting the "Run Around" from your insurance companies regarding Top Surgery. I experienced some of the same frustrations. I am not trying to be insensitive to your plight and here is how I got around it. I decided to save up the money and pay out of pocket. It took a few years to put the money together but in the end, for me, it was gratifying. I took back the control over my own body.

I know this may not be an immediate solution while you are negotiating your way through the maze of documentation, paperwork required by medical providers. It may seem impossible to save that kind of money, the cost is approximately $10,000 but just putting something aside may also offer you some sense of control over your own individual life and the direction your life moves forward. Good luck.

Thinker · 01-12-2011, 07:42 PM

Quote:

Originally Posted by Greyson

To the guys who may be getting the "Run Around" from your insurance companies regarding Top Surgery. I experienced some of the same frustrations. I am not trying to be insensitive to your plight and here is how I got around it. I decided to save up the money and pay out of pocket. It took a few years to put the money together but in the end, for me, it was gratifying. I took back the control over my own body.

I know this may not be an immediate solution while you are negotiating your way through the maze of documentation, paperwork required by medical providers. It may seem impossible to save that kind of money, the cost is approximately $10,000 but just putting something aside may also offer you some sense of control over your own individual life and the direction your life moves forward. Good luck.

Same here. Insurance coverage was not ever going to be an option for me.....not at that particular point in my life anyway. And like you, I totally get how daunting (and possibly impossible) it may be. I gave up everything but the basics for a while in order to save the money.

I also know of a guy who said 'screw it' and took out a loan. He got himself in a position with his budget where he could make the monthly payments and went for it.

In the meantime, I wish you all the very best with your efforts to make this happen.

T D · 01-12-2011, 11:22 PM

Same for me, I have no intentions of even trying to get my health care insurance to pay for top surgery. It's just not going to happen. Soooo, working on getting the money together to pay for it myself. Kaiser does have someone on board now in S.F. who can perform such surgeries, but it's like their cosmetic surgeries where the patient is responsible for the costs. Not covered by insurance.

Thinker · 01-14-2011, 08:50 AM

Quote:

Originally Posted by Thinker

Same here. Insurance coverage was not ever going to be an option for me.....not at that particular point in my life anyway. And like you, I totally get how daunting (and possibly impossible) it may be. I gave up everything but the basics for a while in order to save the money.

I also know of a guy who said 'screw it' and took out a loan. He got himself in a position with his budget where he could make the monthly payments and went for it.

In the meantime, I wish you all the very best with your efforts to make this happen.

This article reminded me of the conversations here about saving for something so meaningful.

A "spending fast"!!!! I love it!

http://money.cnn.com/2011/01/14/pf/a...x.htm?hpt=Sbin

DapperButch · 01-12-2011, 06:54 PM

Quote:

Originally Posted by Linus

Actually, DamonK is in the same boat as me. You have to get two doctors to write that it's a medical necessity. Although Aetna covers it, it doesn't explicitly say just go and do. There are some hoops to go through. My company recently switched to Aetna (thank you Anthem for trying to jack up rates 800%!) and the doctor I'm seeing (out of network) is good and very trans friendly but I may try to find a doctor that is in network and trans friendly (not always possible). At the least, this doctor I'm going to ask if she can recommend a surgeon or two since she's known to the transmen community here.

I'd like to go to the one that Theo recommended but I don't know if that would then be covered by insurance or not.

Yes, I am aware of that. I am also a member of WPATH.

This may be helpful, Damon, to find providers, including doc #2 for a letter/other resources for finding a provider.

http://www.wpath.org/ (formerly HBIGDA).

http://wpath.org/Documents2/Referral...rces-01-05.pdf

01-12-2011, 02:14 PM	#8
Greyson Infamous Member How Do You Identify?: Transmasculine/Non-Binary Preferred Pronoun?: Hy (Pronounced He) Relationship Status: Married Join Date: Nov 2009 Location: SF Bay Area Posts: 6,589 My Photo Gallery Thanks: 21,132 Thanked 8,146 Times in 2,005 Posts Rep Power: 21474858	To the guys who may be getting the "Run Around" from your insurance companies regarding Top Surgery. I experienced some of the same frustrations. I am not trying to be insensitive to your plight and here is how I got around it. I decided to save up the money and pay out of pocket. It took a few years to put the money together but in the end, for me, it was gratifying. I took back the control over my own body. I know this may not be an immediate solution while you are negotiating your way through the maze of documentation, paperwork required by medical providers. It may seem impossible to save that kind of money, the cost is approximately $10,000 but just putting something aside may also offer you some sense of control over your own individual life and the direction your life moves forward. Good luck. __________________ Sometimes you don't realize your own strength until you come face to face with your greatest weakness. - Susan Gale

01-12-2011, 11:22 PM	#10
T D Member How Do You Identify?: Person of the trans variety Preferred Pronoun?: He, Sir, Bro, TD, Stevin Relationship Status: On occasion Join Date: Nov 2009 Location: SF Bay Area Posts: 1,165 My Photo Gallery Thanks: 1,428 Thanked 1,125 Times in 311 Posts Rep Power: 3570339	Same for me, I have no intentions of even trying to get my health care insurance to pay for top surgery. It's just not going to happen. Soooo, working on getting the money together to pay for it myself. Kaiser does have someone on board now in S.F. who can perform such surgeries, but it's like their cosmetic surgeries where the patient is responsible for the costs. Not covered by insurance. __________________ “Don’t ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive.”

01-11-2011, 11:55 PM	#1
DamonK Senior Member How Do You Identify?: . Preferred Pronoun?: . Relationship Status: . Join Date: May 2010 Location: . Posts: 2,199 My Photo Gallery Thanks: 1,527 Thanked 7,762 Times in 1,881 Posts Rep Power: 21474854	To answer the questions, Yes, I have Aetna. However, no trans-friendly docs that I'm aware of. My psych doc is trans-friendly, but that's another story. He's hilarious. In fact, when I changed jobs, I kept the docs at the Catholic hosp just so I could keep my psych doc. He means THAT much to me. I will "happily" struggle with the rest as to keep him on my medical team. Seeing as my docs are based of Catholic hospital, it could potentially be difficult for me to just go straight to top surg. Since I do NEED the other surg, I don't want to cause issues to get it, such as asking about top surg. If I can't win them all, I might as well win at least ONE. Likely for T, I will end up in SL or KC.

01-12-2011, 09:11 AM	#2
raising2alone Junior Member How Do You Identify?: Trans Preferred Pronoun?: He Relationship Status: Name says it all Join Date: Mar 2010 Location: Kansas Posts: 28 My Photo Gallery Thanks: 5 Thanked 43 Times in 20 Posts Rep Power: 15142	KC doc Hi Damon, If you live in KC there is a Trans friendly doctor in KCKS. Dr. Lee has a clinic off of SW Blvd and would probably be able to refer other doctors in the area if you didn't want to go there.