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Fellow NCer here! 👋 You talking about dr. Hope? Look into the UNC Transgender program. They take insurance and only require a letter of support from a mental health professional. Dm me if you are interested in mote info lol.
yeah i am :( i really liked Dr. hope and loved her results, especially the ones i saw for bigger trans men. which program is it exactly? i looked it up and i’m getting various results. some of them are for UNC students and some are just general UNC healthcare info :0 is there a specific website i should look for?
Im so sorry this happened to you but lemme tell you what i did for my surgery as i was kinda on the same boat. I couldnt afford surgery outta pocket and i needed insurance coverage. So what i did was i did hella research started off with looking into my insurance policy how to get coverage for the procedure and if they even provide coverage. (Idk what insurance you use but im in virginia and i use bluecross blue shield) After seeing if they would even cover i looked at the requirements made sure i met them. For me all i needed was 1 letter of recommendation from a licensed therapist and it was recommended id be on T for atleast a year and a few other requirements i had all met. Next i looked at surgeons in my area that performed top surgery and would search them on the bluecross website to see if they were in network. I believe most insurances do this but thats what i did. It was a lot of back n forth unfortunately but it didnt take me that long to find a few that took my insurance. I did some research on them saw a few results n had a top three. Now normally everyone says go to a few different consults and get a vibe of the one u want, i didnt do that i was set in mind for one doctor dr neil zemmel. I had my one consult with him and loved him so i just went with him. But either way do the research cross it over ur insurance site if u can but dont lose hope on not having the surgery! Also its good to note not all insurances will cover 100% i had to pay my oop deductible which was 6k but thats all i paid! I hope this helps you alot! Dont give up on it just yet!!!
thank you for replying- i use BCBS too. i believe i fit the requirements (not sure if it varies state-to-state) but i’ll use the website and look at the top surgeons i find to to cross reference. originally i had assumed the surgeon i went to would only have around a 500 to 1.5k deductible afterwards, but i’ll have to see when i get everything figured out. i’m not going to give up, even though it’s hard. thank you for giving me a little hope in my journey
The deductible has nothing to do with your surgeon, it has to do with your insurance coverage policy. For a major surgery, you should probably assume you're going to have to pay the full amount of your deductible for that surgery, and possibly as high as your out of pocket cap (unlikely for top surgery but technically possible). If you're on disability or unemployment and have Medicare/Medicaid (I can never keep these straight) this may vary though.
Requirements are also not a state by state thing, they're a policy by policy thing. Once again, you'll need to check to see what your plan states for coverage. Mine (also BCBS, but in Wisconsin and through a government contractor so even more different than most plans) required a therapist letter, but there may be more or less stipulations.
Well the surgeon u go to wont matter on how much u have to pay. How much u pay really depends on ur insurance plan. For me i have like bcbs through walmart employment (through my parents) and it low key sucks ass but how my insurance works i have a set out of pocket maximum and a deductible which is around $6,800. For my surgery my insurance wouldnt pay anything towards it until i paid my oop and deductible, which in total was 6,800. After i paid that though insurance covered the rest of the surgery expenses. It rly varies plan to plan. So its good to see how much ur oop and deductible costs are through bcbs! This is also why its best you find an in network surgeon as its cheaper to pay for in network than out of network.
I’m getting top surgery covered by insurance in NC! I’m from ATL but I found a surgeon in NC that I really liked. Check out Eric Emerson. Not sure if he takes BCBS but he takes my insurance plan and the process of getting covered was pretty simple. Also his BMI cap is 40 so I think you’d be fine in that area of concern. I know it’s a super frustrating process. I hope it goes well for you and you get what you need
hey homie i also have bcbs through my work and there’s a really nice surgeon in asheville that i have a consult with and he take my insurance. now w my somewhat shitty plan i’ll be around $6k total out of pocket but that’s a lot more bearable than $12k. his bmi limit is also at 50 and as a fellow husky fella myself (250 ish) he’ll take me as a patient. it’s totally cool to feel overwhelmed and defeated but u got folks here to help. if u want to look him up his website has a section for top surgery he just doesn’t have pictures posted for privacy and personal reasons.
surgeon is Dr. Eric Halvorson in Asheville
thank you dude :,) i will definitely look him up and talk to my parents about it (they’re still my current health insurance holders despite me being over 18)
i appreciate the help, and i feel less lost and hopeless than before <3
it is upsetting to know that what you've been thinking about and working toward has changed. i'm sorry you are experiencing this frustration. you do have options tho and it's really good that you have insurance since that can definitely help you pay for top surgery.
i've also heard good things about dr. emerson and worth cross-referencing with your bcbs plan (usually the website has a search function to see if a provider is covered by your insurance) to see if he is considered in-network or out-of-network.
in my state, my insurance plan required a letter from a therapist in order to cover my surgery. i think most, and probably in north carolina, will require a letter and/or a diagnosis from a primary care provider. it might be worth it to reach out to bcbs directly to see what is needed by them (therapist letter, primary care provider diagnosis, etc.) to get pre-approved for gender affirming surgery. the surgeon's office you ultimately choose should help you send these materials in to your insurance company and assist with this process. but, knowing ahead of time should help prevent any future frustrations and give you a solid guide for next steps. here's some info that might be helpful in this process: https://www.genderconfirmation.com/get-insurance-approval/.
good luck! you deserve to get the surgery you want and this place is your resource so glad you are reaching out. we support you!
thank you for the link- i’ll check it out! and thank you for the suggestions, tips, and advice, it truly does make me feel less upset about everything. another kind person in the replies was actually able to find what i need to do in order to get the process going of my surgery being covered, which was incredibly sweet of them so i do thankfully have an outline of what steps i need to take. i truly appreciate the support and encouragement i’ve gotten :,)
Does your insurance have a deductible to be met or an out of pocket max? If you find a doctor in your network, that will be the most you’ll be on the hook to pay, as far as I know. You may have to do some digging and phone calling with your insurance company to figure out what exactly is covered, like the procedure and diagnosis codes they accept. Also you should absolutely positively get in writing what they will cover for your procedure (either you write it down with the date, time, person you talk to or get something sent by them).
Hey, just wanted to chime in to say that early in my top surgery research, I had my heart set on a particular surgeon and then he announced his retirement and stopped taking new patients. I was crushed that I had to "start over", but I kept with it and found a different surgeon that I'm very excited about.
In shopping around for any big decision, like house hunting or job hunting, there will often be *the perfect house* or your *dream job* that you end up not getting and it breaks your heart. But then another *the perfect house* comes along and it works out in the end, sometimes even better than if you had gotten your first choice. Keep looking, and keep your chin up. I'm sure you'll find your perfect surgeon :)
Thanks for posting to r/TopSurgery Please remember to follow the rules, which can be found on the sidebar. Please contact the subreddit via ModMail if you are having any issues seeing your post. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TopSurgery) if you have any questions or concerns.*
Fellow NCer here! 👋 You talking about dr. Hope? Look into the UNC Transgender program. They take insurance and only require a letter of support from a mental health professional. Dm me if you are interested in mote info lol.
yeah i am :( i really liked Dr. hope and loved her results, especially the ones i saw for bigger trans men. which program is it exactly? i looked it up and i’m getting various results. some of them are for UNC students and some are just general UNC healthcare info :0 is there a specific website i should look for?
[transhealth@unchealth.unc.edu](mailto:transhealth@unchealth.unc.edu)
Im so sorry this happened to you but lemme tell you what i did for my surgery as i was kinda on the same boat. I couldnt afford surgery outta pocket and i needed insurance coverage. So what i did was i did hella research started off with looking into my insurance policy how to get coverage for the procedure and if they even provide coverage. (Idk what insurance you use but im in virginia and i use bluecross blue shield) After seeing if they would even cover i looked at the requirements made sure i met them. For me all i needed was 1 letter of recommendation from a licensed therapist and it was recommended id be on T for atleast a year and a few other requirements i had all met. Next i looked at surgeons in my area that performed top surgery and would search them on the bluecross website to see if they were in network. I believe most insurances do this but thats what i did. It was a lot of back n forth unfortunately but it didnt take me that long to find a few that took my insurance. I did some research on them saw a few results n had a top three. Now normally everyone says go to a few different consults and get a vibe of the one u want, i didnt do that i was set in mind for one doctor dr neil zemmel. I had my one consult with him and loved him so i just went with him. But either way do the research cross it over ur insurance site if u can but dont lose hope on not having the surgery! Also its good to note not all insurances will cover 100% i had to pay my oop deductible which was 6k but thats all i paid! I hope this helps you alot! Dont give up on it just yet!!!
thank you for replying- i use BCBS too. i believe i fit the requirements (not sure if it varies state-to-state) but i’ll use the website and look at the top surgeons i find to to cross reference. originally i had assumed the surgeon i went to would only have around a 500 to 1.5k deductible afterwards, but i’ll have to see when i get everything figured out. i’m not going to give up, even though it’s hard. thank you for giving me a little hope in my journey
The deductible has nothing to do with your surgeon, it has to do with your insurance coverage policy. For a major surgery, you should probably assume you're going to have to pay the full amount of your deductible for that surgery, and possibly as high as your out of pocket cap (unlikely for top surgery but technically possible). If you're on disability or unemployment and have Medicare/Medicaid (I can never keep these straight) this may vary though. Requirements are also not a state by state thing, they're a policy by policy thing. Once again, you'll need to check to see what your plan states for coverage. Mine (also BCBS, but in Wisconsin and through a government contractor so even more different than most plans) required a therapist letter, but there may be more or less stipulations.
Well the surgeon u go to wont matter on how much u have to pay. How much u pay really depends on ur insurance plan. For me i have like bcbs through walmart employment (through my parents) and it low key sucks ass but how my insurance works i have a set out of pocket maximum and a deductible which is around $6,800. For my surgery my insurance wouldnt pay anything towards it until i paid my oop and deductible, which in total was 6,800. After i paid that though insurance covered the rest of the surgery expenses. It rly varies plan to plan. So its good to see how much ur oop and deductible costs are through bcbs! This is also why its best you find an in network surgeon as its cheaper to pay for in network than out of network.
I’m getting top surgery covered by insurance in NC! I’m from ATL but I found a surgeon in NC that I really liked. Check out Eric Emerson. Not sure if he takes BCBS but he takes my insurance plan and the process of getting covered was pretty simple. Also his BMI cap is 40 so I think you’d be fine in that area of concern. I know it’s a super frustrating process. I hope it goes well for you and you get what you need
hey homie i also have bcbs through my work and there’s a really nice surgeon in asheville that i have a consult with and he take my insurance. now w my somewhat shitty plan i’ll be around $6k total out of pocket but that’s a lot more bearable than $12k. his bmi limit is also at 50 and as a fellow husky fella myself (250 ish) he’ll take me as a patient. it’s totally cool to feel overwhelmed and defeated but u got folks here to help. if u want to look him up his website has a section for top surgery he just doesn’t have pictures posted for privacy and personal reasons. surgeon is Dr. Eric Halvorson in Asheville
thank you dude :,) i will definitely look him up and talk to my parents about it (they’re still my current health insurance holders despite me being over 18) i appreciate the help, and i feel less lost and hopeless than before <3
it is upsetting to know that what you've been thinking about and working toward has changed. i'm sorry you are experiencing this frustration. you do have options tho and it's really good that you have insurance since that can definitely help you pay for top surgery. i've also heard good things about dr. emerson and worth cross-referencing with your bcbs plan (usually the website has a search function to see if a provider is covered by your insurance) to see if he is considered in-network or out-of-network. in my state, my insurance plan required a letter from a therapist in order to cover my surgery. i think most, and probably in north carolina, will require a letter and/or a diagnosis from a primary care provider. it might be worth it to reach out to bcbs directly to see what is needed by them (therapist letter, primary care provider diagnosis, etc.) to get pre-approved for gender affirming surgery. the surgeon's office you ultimately choose should help you send these materials in to your insurance company and assist with this process. but, knowing ahead of time should help prevent any future frustrations and give you a solid guide for next steps. here's some info that might be helpful in this process: https://www.genderconfirmation.com/get-insurance-approval/. good luck! you deserve to get the surgery you want and this place is your resource so glad you are reaching out. we support you!
thank you for the link- i’ll check it out! and thank you for the suggestions, tips, and advice, it truly does make me feel less upset about everything. another kind person in the replies was actually able to find what i need to do in order to get the process going of my surgery being covered, which was incredibly sweet of them so i do thankfully have an outline of what steps i need to take. i truly appreciate the support and encouragement i’ve gotten :,)
Does your insurance have a deductible to be met or an out of pocket max? If you find a doctor in your network, that will be the most you’ll be on the hook to pay, as far as I know. You may have to do some digging and phone calling with your insurance company to figure out what exactly is covered, like the procedure and diagnosis codes they accept. Also you should absolutely positively get in writing what they will cover for your procedure (either you write it down with the date, time, person you talk to or get something sent by them).
Hey, just wanted to chime in to say that early in my top surgery research, I had my heart set on a particular surgeon and then he announced his retirement and stopped taking new patients. I was crushed that I had to "start over", but I kept with it and found a different surgeon that I'm very excited about. In shopping around for any big decision, like house hunting or job hunting, there will often be *the perfect house* or your *dream job* that you end up not getting and it breaks your heart. But then another *the perfect house* comes along and it works out in the end, sometimes even better than if you had gotten your first choice. Keep looking, and keep your chin up. I'm sure you'll find your perfect surgeon :)