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Old 03-06-2011, 05:12 PM   #361
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Default Linus

Hey, Linus, is the issue that you want to go with someone "in network", or do you not have out of network benefits with your insruance?

If you don't find this woman to have enough experience and you do have out of network benefits, maybe it would be worth the percent you will have to pay for the surgery (and deductible, if that is how your insurance works).

Even if this Dr. V won't bill the insurance for you, I don't see why he wouldn't give you a paper saying what work you got done. he should provide you with a receipt and this should include diagnosis and ICD-9 code. Then you could just sumbit it to your insurance, yourself.

I have an out of network physician that I pay up front and then he give me a receipt that I send to my insurance company. They have a form specifically for it. I have to make sure I have the doc's Tax ID number on it and license number. I send in the form and receipts and get back a percentage that I paid.

If you do not have out of network benefits and your company does offer them (usually a more expensive health care plan than the regular HMO one/EPO one), if your years renewal isn't too far way, maybe you want to wait until then and make sure you sign up for a plan that has the out of network benefits (that of course will still pay for SRS).

Anyway, just a thought!
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Old 03-06-2011, 08:51 PM   #362
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Hey, Linus, is the issue that you want to go with someone "in network", or do you not have out of network benefits with your insruance?

If you don't find this woman to have enough experience and you do have out of network benefits, maybe it would be worth the percent you will have to pay for the surgery (and deductible, if that is how your insurance works).

Even if this Dr. V won't bill the insurance for you, I don't see why he wouldn't give you a paper saying what work you got done. he should provide you with a receipt and this should include diagnosis and ICD-9 code. Then you could just sumbit it to your insurance, yourself.

I have an out of network physician that I pay up front and then he give me a receipt that I send to my insurance company. They have a form specifically for it. I have to make sure I have the doc's Tax ID number on it and license number. I send in the form and receipts and get back a percentage that I paid.

If you do not have out of network benefits and your company does offer them (usually a more expensive health care plan than the regular HMO one/EPO one), if your years renewal isn't too far way, maybe you want to wait until then and make sure you sign up for a plan that has the out of network benefits (that of course will still pay for SRS).

Anyway, just a thought!
It's the paying up-front part that is the challenge. I can cover out of network but it's the initial amount: 10K. I can cash in some stocks to do it or some of my 401K but I want to avoid that. I've been trying to pay down some debt (from my move and other things) but it's been a bit of a hard slog. I'm waiting until after taxes to see if I get anything back from last year (thanks to the move). I might be able to figure something out.
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Old 03-06-2011, 09:13 PM   #363
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It's the paying up-front part that is the challenge. I can cover out of network but it's the initial amount: 10K. I can cash in some stocks to do it or some of my 401K but I want to avoid that. I've been trying to pay down some debt (from my move and other things) but it's been a bit of a hard slog. I'm waiting until after taxes to see if I get anything back from last year (thanks to the move). I might be able to figure something out.
Wow 10k dollars, that's a lot of dough. My surgery will cost 8k. Wonder why the difference.
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Old 03-06-2011, 09:23 PM   #364
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Wow 10k dollars, that's a lot of dough. My surgery will cost 8k. Wonder why the difference.
I always assume a higher cost. Either way, whether 8 or 10 thousand, it's still a lot of money.
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Old 03-07-2011, 11:30 AM   #365
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I always assume a higher cost. Either way, whether 8 or 10 thousand, it's still a lot of money.

You know, when I had my surgery, Dr. V quoted me $7750 for everything. That was HIS charge (including surgery, anesthesia, meds and followups), which I thought was very reasonable and I still do. But, by the time I figured up the travel expenses from here (Las Vegas) to Newport Beach, CA, plus lodging in a nice facility (I'm a bit of a hotel snob, but for this I was also willing to pay more for the comfort and convenience to Dr. V's office), meals and various other comfort expenses, it came out pretty close to $10K. Plus, L was with me, thank Jeebuz, and she's a trained and experienced paramedic/EMT.

Oh, and I was able to totally deduct ALL of these expenses, including the surgery, off on my taxes at the end of the year, so I got a lot of that $10K back. I would heartily recommend figuring *high* on your budget, just to be on the safe side. This is something that you must plan for, even if you have to save a little longer for, because you can't put a "price" on a job done well and/or being in a comfortable environment, post op.

The hotel where L and I stayed (The Ayres Hotel www.ayreshotels.com/costamesa/) was definitely one of the most comfortable hotels I have ever stayed in, and L and I had one of the suites. We stayed 4 nights there, until Dr. V cleared me to return to Vegas. It was a very pleasant and comfortable experience, and I guess this is why I so highly recommend Dr. Voloshin for top surgery. His office and staff is second to none!! And no, I'm not getting any kind of "bonus" for referring other guys to him. He may give YOU a bit of a break for mentioning my name, tho. One of my buddies here in Vegas (Caidyn) referred me to him and he gave me the same price as he did for Caidyn, so that helped. I think there is power in our referrals, both service and sometimes, pricewise. We should use the strength of our friendships and referrals to help each other, whenever possible, I think. We're all in this together and every bit helps!!!!

~Theo~
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Old 03-07-2011, 12:53 PM   #366
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Oh, I agree Theo. But I also believe in checking out what's around and what might be coverable by network. If this surgeon proves to be capable and supportive, then it may be to my benefit as well as a benefit to the community as a whole (more surgeons who can do this and do it well so we do not limit ourselves to a select few).

I won't make my final decision until I've checked everything out, which is why I asking for advice for more questions (to be thorough). I would be just as thorough with Dr. V or even Dr. Brownstein. I haven't excluded Dr. V yet; just haven't heard back from my first email query so I'll have to book a consult later in the month (my back being screwed up limits travel for me a bit)
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Old 03-07-2011, 04:09 PM   #367
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It's the paying up-front part that is the challenge. I can cover out of network but it's the initial amount: 10K. I can cash in some stocks to do it or some of my 401K but I want to avoid that. I've been trying to pay down some debt (from my move and other things) but it's been a bit of a hard slog. I'm waiting until after taxes to see if I get anything back from last year (thanks to the move). I might be able to figure something out.
Yes, I understand this Linus, I didn't even think about the up front cost..duh!

And yes, try to stay away from taking from that 401K! In the long run it will actually cost you a heck of a lot due to penalties, but ALSO of course the money that you would be making it if was still in there. If you have to go that route so, I would look to see if your work would let you qualify to get a loan from the 401K, not a "withdrawal" (that may be a long shot, though)

Sounds like you are indicating that you have a separate stocks in some account. I personally would take from that and then when you get money back from the insurance, buy back into the market.

Ok, so I am probably telling you things you already know!

With that said, I think sometimes it comes down emotional and psychological level. Sometimes what we need emotionally and psychologically outweighs what we would like our financial situation to look like (not taking money from 401k, for example).

Good luck with your decision making.
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Old 03-08-2011, 08:21 AM   #368
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Has anyone on here heard of Dr. Charles Garramone in Florida.

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Old 03-08-2011, 08:37 AM   #369
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Has anyone on here heard of Dr. Charles Garramone in Florida.

Rufus
I've heard of him quite a bit, Rufus. I have only ever heard stellar reports too!

http://www.youtube.com/user/drgarramone
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Old 03-08-2011, 08:44 AM   #370
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Has anyone on here heard of Dr. Charles Garramone in Florida.

Rufus
I'll second what Thinker said. He's cheaper than most (when talking just surgery costs -- not including things like flight, hotel, etc.) On a lot of the transsexual/gender boards I've noticed he's extremely popular with FTMs along the East Coast and I don't think I've seen a complaint yet about his work.
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Old 03-08-2011, 08:49 AM   #371
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Oh, I agree Theo. But I also believe in checking out what's around and what might be coverable by network. If this surgeon proves to be capable and supportive, then it may be to my benefit as well as a benefit to the community as a whole (more surgeons who can do this and do it well so we do not limit ourselves to a select few).

I won't make my final decision until I've checked everything out, which is why I asking for advice for more questions (to be thorough). I would be just as thorough with Dr. V or even Dr. Brownstein. I haven't excluded Dr. V yet; just haven't heard back from my first email query so I'll have to book a consult later in the month (my back being screwed up limits travel for me a bit)
Best to phone their office ... for some reason the email address they have on their website hasn't been fixed yet. Thought they fixed it but apparently not. If you want to continute to inquire with them by email atleast call to make sure you have the correct email address and inform them what email address you used ... they've had problems with this before.
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Old 03-08-2011, 09:03 AM   #372
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Best to phone their office ... for some reason the email address they have on their website hasn't been fixed yet. Thought they fixed it but apparently not. If you want to continute to inquire with them by email atleast call to make sure you have the correct email address and inform them what email address you used ... they've had problems with this before.
Ah.. that would probably explain why they didn't reply to me. LOL I'll call them later this week or early next.
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Old 03-08-2011, 09:11 PM   #373
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Ah.. that would probably explain why they didn't reply to me. LOL I'll call them later this week or early next.
They are really good with phone calls. I had a friend that had used the email on the website and they had no idea who it went to ... they think it's the same address that all their junk mail goes to.
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Old 03-08-2011, 09:16 PM   #374
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Oh, I agree Theo. But I also believe in checking out what's around and what might be coverable by network. If this surgeon proves to be capable and supportive, then it may be to my benefit as well as a benefit to the community as a whole (more surgeons who can do this and do it well so we do not limit ourselves to a select few).

I won't make my final decision until I've checked everything out, which is why I asking for advice for more questions (to be thorough). I would be just as thorough with Dr. V or even Dr. Brownstein. I haven't excluded Dr. V yet; just haven't heard back from my first email query so I'll have to book a consult later in the month (my back being screwed up limits travel for me a bit)
I think it's great that you are checking out a variety of drs. I would have like to have given someone not as known in the community a chance but the way my situation worked out that just didn't happen.

Where is Dr. Jewel... I believe that is who you intitially talked about? I know there is someone in Laughlin or somewhere like that. I can ask a friend if he knows who that is.
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Old 03-08-2011, 10:29 PM   #375
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I think it's great that you are checking out a variety of drs. I would have like to have given someone not as known in the community a chance but the way my situation worked out that just didn't happen.

Where is Dr. Jewel... I believe that is who you intitially talked about? I know there is someone in Laughlin or somewhere like that. I can ask a friend if he knows who that is.
Torrance. I'm in the South Beach Cities area (I think that's what it's called). Dr. Jewell is a 30 min bike ride from my house.
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Old 03-11-2011, 07:32 PM   #376
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I had my appointment. Very nice doctor. She answered every question and had answered some before I had even asked (e.g., drains, nipple reconstruction, etc.) She was very professional and admitted she hadn't done this surgery before, at least not for FTM. She has done gynecomastia and has done female breast surgery. She has said that breast surgery and reconstruction is her specialty. She also said whatever revisions that would need to be done she'd do. She talked about recovery time as well as post-care (vis-a-vis reducing scarring and such).

I was surprised that she said it was out patient surgery and that it would be 4 hours (not the 4 hours but the out patient part of it). She did say there would be no need for overnight unless there are complications. Does that sound right?

Anyways, I did mention that I would be seeking other doctors to get an idea of what fits best for me and what I'm most comfortable with. They did say that they would help with insurance filing and such if I decided to go with them and if the insurance approved or if I paid out of pocket I'd be looking at a date somewhere between 4-6 weeks from doing the "security deposit".

On Monday I'm going to try to book an app't with Dr. V to get a different look at things. The one somewhat huge downside is the cost to get there. I don't have a license (and even if I did, we only have one car which car uses to get to and from work). I'll be plunking down about $200-240 just in cab ride fare to and from. UGH

I so wish this city had a decent train system.
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Old 03-11-2011, 09:39 PM   #377
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Hey Linus...

Yes, outpatient sounds right and is, from all the stories I've heard, the norm.

Another thing to mention... I don't know how your system handles anesthesia, but it makes me nauseous. Most of the time I spent in recovery was because of the throwing up. If you are sensitive to it too, mention that to the anesthesiologist so he/she puts something in the drip to combat that. I learned that trick for my hysto and fared MUCH better.

Anyway... I do believe my surgery was right at 4 hours...maybe about 3 now that I think about it, and I spent about 2 hours in recovery.

I was still a groggy mess when I left there, but most of that was because of my stomach.

I'm sure you've researched the transportation piece but thought I'd ask about shuttle vans or buses???
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Old 03-11-2011, 09:44 PM   #378
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I'm going to ask K's brother (with payment being gas money and lunch) if he can take me there and back.

And I've had day surgery before (when I had all 4 impacted wisdom teeth out). I was ok and had minor nausea but that was because of swallowed blood from the former teeth locations.
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Old 03-11-2011, 11:14 PM   #379
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I had my appointment. Very nice doctor. She answered every question and had answered some before I had even asked (e.g., drains, nipple reconstruction, etc.) She was very professional and admitted she hadn't done this surgery before, at least not for FTM. She has done gynecomastia and has done female breast surgery. She has said that breast surgery and reconstruction is her specialty. She also said whatever revisions that would need to be done she'd do. She talked about recovery time as well as post-care (vis-a-vis reducing scarring and such).

I was surprised that she said it was out patient surgery and that it would be 4 hours (not the 4 hours but the out patient part of it). She did say there would be no need for overnight unless there are complications. Does that sound right?

Anyways, I did mention that I would be seeking other doctors to get an idea of what fits best for me and what I'm most comfortable with. They did say that they would help with insurance filing and such if I decided to go with them and if the insurance approved or if I paid out of pocket I'd be looking at a date somewhere between 4-6 weeks from doing the "security deposit".

On Monday I'm going to try to book an app't with Dr. V to get a different look at things. The one somewhat huge downside is the cost to get there. I don't have a license (and even if I did, we only have one car which car uses to get to and from work). I'll be plunking down about $200-240 just in cab ride fare to and from. UGH

I so wish this city had a decent train system.
Mine was a day surgery and 3 to 4 hours sounds right I honestly can't remember. Most surgeries and procedures these days are done outside of hospitals in days surgery facilities I think to help prevent spread of infection. Sick people are in hospitals so they try to keep you away from the sick people. Even with my back surgeries they generally have you out in 24 hours and honestly if I wanted to my dr. would have had me out the same day.

If K's brother can't take you Linus .. send me a message and if You pay for gas and lunch I'll take you! My schedule is fairly open this month. I can tell you i don't work the 16, 17, 18, 24, 25, 29, 31. Some of the other days are part days so they might work also .... can't remember what days dr. V sees people.
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Old 03-15-2011, 06:30 PM   #380
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So Tues (March 22) I have a consult with Dr. V. I'm still trying to get my original doctor from Callen-Lorde to send me a letter. On a plus side, the former leader of a support group I was part of in NYC has agreed to write a therapist's letter for me and has even offered to help me navigate Aetna's hoops and such. He actually does this as part of his job and has done it around the US for those in need.

Hopefully I'll be able to decide by end of the week and then get a date set. It would be nice to have this hurdle out of the way and allow me to move forward.
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