Ask a trans person!

[theoddz]

Originally Posted by Blade

I have a question for those who have had top surgery. How did you pay for your surgery?

It has been suggested that I have a reduction for health reasons and my insurance would pay for it. As tempting as that sounds they wouldn't be gone they'd still be there just much smaller.

So how did you pay for your surgery?

I'm going to answer your question and also another common question that's asked, simply so others will know what this takes, moneywise, to do, since this procedure is seldom covered by insurance at all.

I paid entirely out of my own pocket. Dr. V's fee, about $7750, included everything (he has his own accredited surgical center) except the lab pathology, which ran about $450. Surprisingly, my health insurance (FEHB) paid for that, minus a $38 deductible, which I paid.

I had to travel to Newport Beach, California, from here in Las Vegas, so by the time I added up the travel expenses (for my girlfriend and me), hotel, meals, etc., the total cost was right under $10K.

~Theo~

[TCB]

Originally Posted by theoddz

I'm going to answer your question and also another common question that's asked, simply so others will know what this takes, moneywise, to do, since this procedure is seldom covered by insurance at all.

I paid entirely out of my own pocket. Dr. V's fee, about $7750, included everything (he has his own accredited surgical center) except the lab pathology, which ran about $450. Surprisingly, my health insurance (FEHB) paid for that, minus a $38 deductible, which I paid.

I had to travel to Newport Beach, California, from here in Las Vegas, so by the time I added up the travel expenses (for my girlfriend and me), hotel, meals, etc., the total cost was right under $10K.

~Theo~

Are you happy with the results from Dr. V? If he is in Newport beach, that would be ideal for me. I'm still trying to figure out how to raise funds for my surgery. It's getting to a point, where I don't care what I need to do to make this happen.
I have Kaiser insurance, but I'm pretty sure they won't cover squat. I've asked my Endo about it, and he pretty much confirmed that.

[The Oopster]

Originally Posted by TCB

Are you happy with the results from Dr. V? If he is in Newport beach, that would be ideal for me. I'm still trying to figure out how to raise funds for my surgery. It's getting to a point, where I don't care what I need to do to make this happen.
I have Kaiser insurance, but I'm pretty sure they won't cover squat. I've asked my Endo about it, and he pretty much confirmed that.

Hey cris did I ever show you my surgery? Dr V is who I went to. Yes he is in newport beach. He was more around 8k for me. Linus just had his with Dr. V so he would know the most current rates. Nice thing is you would cut down other costs with how close he is to you.

[Linus]

Originally Posted by The Oopster

Hey cris did I ever show you my surgery? Dr V is who I went to. Yes he is in newport beach. He was more around 8k for me. Linus just had his with Dr. V so he would know the most current rates. Nice thing is you would cut down other costs with how close he is to you.

The total cost for me was about $8400 (including labs). However, since I've had some prior back issues apparently the insurance has no problem covering some of it. That has meant my actual out of pocket was $4900 (not including Lazy Boy costs, although I am wondering if I can write that off as a medical expense ).

I'm just about a week past the surgery but thus far have been happy. The reality is that the rest will be up to me and how I take care of my chest going forward. In another week I go for stitch removal I believe and a check up. I like that I don't have to visit constantly in person and can just email photos to him so he can see how I'm recovering. Saves time (which for me is more of an issue than money).

[Camo Eagle]

Originally Posted by Corkey

I said to use peroxide on the adhesive, not the wound. Again Vitimen E oil should be used ONLY on closed wounds and AFTER stitches have been removed.

I did say that didn't I?

My comments were not directed to you. I posted what I did, bc some are new out of surg., and the incisions may not be closed. Many of the top surgeons are now not using sutures, they are closing up the entire line with steri strips or some such product. So for some the adhesive IS directly on the entire incision.
I had 192 strips I believe. Some came off clean, others left a mess. Dr. even told me not to use soap & water until it was closed bc he wanted it to stay dry. He said those "nastys" covering it, were actually protecting it.
It was a happy day indeed when I could wash & shower.

2 of the most often misused OTCs after surg. is the 2 I mentioned. It was my intention to educate on those items. I know after my surgery, literally everyone I spoke too, offered a remedy idea for some facet of my Tx. For many yrs (some still do) Drs would tell you to clean the wound area w/ peroxide, then apply antibiotic ointment. As of 3 yrs ago, this is no longer the accepted standard. Some old die hards still refuse to move forward.

The source of my info is the textbook, handbook for wound care, and info given during one of the 1st Wound Care Certification courses held in the nation.

[atomiczombie]

Originally Posted by Camo Eagle

My comments were not directed to you. I posted what I did, bc some are new out of surg., and the incisions may not be closed. Many of the top surgeons are now not using sutures, they are closing up the entire line with steri strips or some such product. So for some the adhesive IS directly on the entire incision.
I had 192 strips I believe. Some came off clean, others left a mess. Dr. even told me not to use soap & water until it was closed bc he wanted it to stay dry. He said those "nastys" covering it, were actually protecting it.
It was a happy day indeed when I could wash & shower.

2 of the most often misused OTCs after surg. is the 2 I mentioned. It was my intention to educate on those items. I know after my surgery, literally everyone I spoke too, offered a remedy idea for some facet of my Tx. For many yrs (some still do) Drs would tell you to clean the wound area w/ peroxide, then apply antibiotic ointment. As of 3 yrs ago, this is no longer the accepted standard. Some old die hards still refuse to move forward.

The source of my info is the textbook, handbook for wound care, and info given during one of the 1st Wound Care Certification courses held in the nation.

Yeah, my sutures were internal along my incisions. I had to have paper tape on them for 2 weeks. When I took the tape off they were pretty much closed except for some scabs. I left the scabs alone and let them come off by themselves. I could at that point shower but not let the water hit directly on my chest or rub it to dry off. I still can't do that yet. But its nice to be able to actually shower instead of having sponge baths. Anyhoo, my doc said no ointments or anything on my incisions once the tape came off. At this point the scabs are all gone and my wounds are closed.

[Turtle]

Itching could be:

healing, skin not 'breathing' so well because it is covered/wrapped, an allergic reaction - to tape, anesthesia, betadine, sumthin else...

hair growing back - nerves reconnecting - scar tissue forming....


Benedryl can help with itching for various reasons, you can try a dose or two and see if it makes a difference - it's good to have in the house anyway if someone has a bad reaction to something. Benedryl comes in pills, cream/gels, and spray - good for different things.

Mederma is really good for scar tissue, especially if your skin heals with keloids. I still put it on years after a burn when I feel deep tingles in that area. It is only for closed skin.

Cut nerves reconnect with anything from nothing to tingles to sharp zings to pain.

Linus, you are probably too soon for scar tissue and in the healing, hair growing, skin not breathing category - somewhere...just my opinion.

Good healing and blessings to all.

[Corkey]

Originally Posted by Camo Eagle

My comments were not directed to you. I posted what I did, bc some are new out of surg., and the incisions may not be closed. Many of the top surgeons are now not using sutures, they are closing up the entire line with steri strips or some such product. So for some the adhesive IS directly on the entire incision.
I had 192 strips I believe. Some came off clean, others left a mess. Dr. even told me not to use soap & water until it was closed bc he wanted it to stay dry. He said those "nastys" covering it, were actually protecting it.
It was a happy day indeed when I could wash & shower.

2 of the most often misused OTCs after surg. is the 2 I mentioned. It was my intention to educate on those items. I know after my surgery, literally everyone I spoke too, offered a remedy idea for some facet of my Tx. For many yrs (some still do) Drs would tell you to clean the wound area w/ peroxide, then apply antibiotic ointment. As of 3 yrs ago, this is no longer the accepted standard. Some old die hards still refuse to move forward.

The source of my info is the textbook, handbook for wound care, and info given during one of the 1st Wound Care Certification courses held in the nation.

Did i quote you? No I did not. Assume what you will.

[TCB]

Originally Posted by The Oopster

Hey cris did I ever show you my surgery? Dr V is who I went to. Yes he is in newport beach. He was more around 8k for me. Linus just had his with Dr. V so he would know the most current rates. Nice thing is you would cut down other costs with how close he is to you.

I figured I would probably need to prepare for 10k. But 10k is a lot of money.
Yes it is very convenient that Newport is nearby, and that would greatly save me some cash. I wish that Kaiser would cover something

[Linus]

Originally Posted by TCB

I figured I would probably need to prepare for 10k. But 10k is a lot of money.
Yes it is very convenient that Newport is nearby, and that would greatly save me some cash. I wish that Kaiser would cover something

TCB, do an initial consult with Dr. V as his office might be able to get it covered in some fashion. It doesn't hurt to ask them as I know they've dealt with different providers. I didn't get it all covered but basically got about half was. Still better than nothing.

[TCB]

Originally Posted by Linus

TCB, do an initial consult with Dr. V as his office might be able to get it covered in some fashion. It doesn't hurt to ask them as I know they've dealt with different providers. I didn't get it all covered but basically got about half was. Still better than nothing.

Thanks Linus. Do you know what he charges for a consultation?? What's his full name?

[The Oopster]

Originally Posted by TCB

Thanks Linus. Do you know what he charges for a consultation?? What's his full name?

consultation is free!

http://www.newportsurgery.com/

call though! Don't email!

[The Oopster]

Originally Posted by TCB

Thanks Linus. Do you know what he charges for a consultation?? What's his full name?

He supposeably does give some type of discount if someone referred you to him. So I would mention all three of our names. The more the merrier and maybe a better discount? Doesn't hurt!

[DapperButch]

Originally Posted by TCB

Are you happy with the results from Dr. V? If he is in Newport beach, that would be ideal for me. I'm still trying to figure out how to raise funds for my surgery. It's getting to a point, where I don't care what I need to do to make this happen.
I have Kaiser insurance, but I'm pretty sure they won't cover squat. I've asked my Endo about it, and he pretty much confirmed that.

I believe that Aetna continues to be the only insurance that will cover male reconstructive top surgery, however, you can call your insurance directly, and ask.

You may find a doctor who is willing to adjust the ICD-9 code (medical/billing code) to breast reduction, but you would have to meet the criteria for a medically needed breast reduction, which is based on a number of things, including measurements of indentations in your shoulders from bra straps, a documented history of back problems due to chest size, etc.

(In regards to the above, I have not heard of any surgeons that fudge the ICD-9 code, but it would not surprise me if there were some surgeons out there who would be willing to do this due their empathy around transpeople's issues).

[The Oopster]

One never knows what insurance will covers. If you can somehow show a medical necessity one never knows what will happen.

The doctor who handles my testosterone told me that he got an mtf's bottom surgery covered. Something was off with her prostrate and they contacted her insurance and asked rather then putting her on meds would they cover surgery to have the testicals removed and they did.

[TCB]

Originally Posted by DapperButch

I believe that Aetna continues to be the only insurance that will cover male reconstructive top surgery, however, you can call your insurance directly, and ask.

You may find a doctor who is willing to adjust the ICD-9 code (medical/billing code) to breast reduction, but you would have to meet the criteria for a medically needed breast reduction, which is based on a number of things, including measurements of indentations in your shoulders from bra straps, a documented history of back problems due to chest size, etc.

(In regards to the above, I have not heard of any surgeons that fudge the ICD-9 code, but it would not surprise me if there were some surgeons out there who would be willing to do this due their empathy around transpeople's issues).

Originally Posted by The Oopster

One never knows what insurance will covers. If you can somehow show a medical necessity one never knows what will happen.

The doctor who handles my testosterone told me that he got an mtf's bottom surgery covered. Something was off with her prostrate and they contacted her insurance and asked rather then putting her on meds would they cover surgery to have the testicals removed and they did.

This is all very true. I asked my endo though, and he was very quick to respond that Kaiser will not cover it. He didn't exactly suggest attempting to work around it either. He basically told me there are two companies you can go work for that will cover it (I can't remember now which ones).
To my knowledge, I don't believe I have medical reasons for him to try and slip it through the cracks.....unfortunately (as bad as that it to say). I'm grateful for my health.

[The Oopster]

Originally Posted by TCB

This is all very true. I asked my endo though, and he was very quick to respond that Kaiser will not cover it. He didn't exactly suggest attempting to work around it either. He basically told me there are two companies you can go work for that will cover it (I can't remember now which ones).
To my knowledge, I don't believe I have medical reasons for him to try and slip it through the cracks.....unfortunately (as bad as that it to say). I'm grateful for my health.

Look at this:

http://www.uclgbtia.org/transhealthupdate.html

[Corkey]

http://otrans.3cdn.net/fa908f9f867b4537a1_ihm6iipnp.pdf

Guys this is Medicare, this will apply to all of you sooner or later. We need to change how Medicare is effecting our community.

[DapperButch]

Originally Posted by The Oopster

Look at this:

http://www.uclgbtia.org/transhealthupdate.html

Thanks for posting!

[TCB]

Originally Posted by The Oopster

Look at this:

http://www.uclgbtia.org/transhealthupdate.html

Now that I think about it, I recall my Doc saying I would have to work for a UC to be eligible. I don't.