Financing

[Guest CharliTo]

So.... the final steps in transitioning is slowly becoming a reality for me. Unfortunately, because of my job choices I'm not exactly banking with lots of money right now.

I'm awkward at best right now at doing financing or anything like that since I never really get to discuss it with anybody. What did everybody else do here?

[Guest Michele H]

Not sure what you are asking, but the first step is to create a realistic budget of the expenses - it's more than just the surgery, you need to include transportation, lodging and food not only for yourself but for a companion. Most stateside surgeons require you have someone with you. I don't know about surgeons in other countries. Also budget for supplies you will need post surgery - for instance, you will go through a lot of pads. Once you have a realistic idea of the total cost, then you have a savings goal and can begin to plan how much you are going to set aside every paycheck.

[Paula ult]

In addition to what Michelle said, i cut back on anything around the house that i did not use and was plugged in, turned off but still using electricity, i canceled my cable, drive less, do not eat out, think lots of ramen. My GCS is being financed with my home equity loan and credit card, sometimes you can get a loan through a credit union if you belong to one, or a loan from a bank.

Remember that transitioning costs are now deductible with the IRS, i did this last year, it includes all meds, doctors fees, lab work, mileage, parking fees and GCS, whatever insurance did not cover if you are lucky enough to have insurance that covers it, of course it is only a portion of what you paid but something is better than nothing.

Paula

[Guest CharliTo]

...wait. So my srs can be tax deductible? As a self employed person that sounds like music to my ears. Lol.

How much should I think I'd be paying monthly with financing options for SRS?

[Guest nonamesleft]

...wait. So my srs can be tax deductible? As a self employed person that sounds like music to my ears. Lol.

How much should I think I'd be paying monthly with financing options for SRS?

Too bad you cannot pay for it with the money you get back from deducting it, lol. I actually paid for mine with the absurd tax refunds I have been getting since buying my house. I pay so much interest on this horrible mortgage that 2 years of refunds covered all the expenses. But it really depends on the surgeon you choose, since they all have different costs. The cost savings in Thailand can be quite substantial, even when you factor in airfare (which really is not much higher than a cross-country flight). There is no need to bring anyone with you, you will be surrounded by clinic staff and other patients, who also come by themselves 80% of the time. The airfare can be had for under $1000 if you shop around, food is dirt cheap, most of the supplies you will need for aftercare are included in the cost of the procedure, as well as the first week in the hospital. You could get everything, including a very qualified and experienced doctor, and all related costs for travel/food/lodging/etc for maybe $15k. So if you save $400 a month (a car payment), you could have the money in a little over 3 years. You can also take advantage of the Health Savings Account program to save the money, pre-tax, but I am not an accountant and will not say anything specific on that, other than to consider looking into it.

[Guest Hayley21]

What isurance pays for SRS if any? I thought I read somewhere

where it did?

Hayley

[Guest nonamesleft]

What isurance pays for SRS if any? I thought I read somewhere

where it did?

Hayley

Just about any insurance company will cover it...if you are willing to pay for the privilege. Health insurance is usually offered up to companies ala carte, which means the company will decide what benefits/co-pays/deductibles/exclusions they want to have in their policy. Since trans surgeries like SRS are expensive, and trans people are, in general, not well-liked or supported by society, most companies/gov't agencies opt not to include the coverage, as they are always looking to cut the costs as much as possible, especially since health care costs seem to be going up exponentially every year. Private companies are starting to come around, partly in response to increased activism by individuals like us, and groups like HRC, and there is an ever-increasing number of large corporations that do include trans/srs coverage in their policies, but it is still a small minority of the total companies out there. Government jobs almost never cover it (San Francisco is only one I know of which does). If you are self-employed, then I can only imagine the insurance companies would want to rake you over coals to include it on a small policy, because they know you would make a claim on it. In that case, you are better off paying on your own. There are a lot of restrictions and hoops to jump through if you do get SRS by insurance, so it is still a pain.

Companies which cover SRS:

http://www.hrc.org/issues/workplace/benefits/7644.htm

Schools which include trans coverage:

http://www.hrc.org/issues/transgender/college-university-transgender-benefits.htm

[Guest Ann Onymous]

In the absence of a healthcare reimbursement account and/or personal savings, other options beyond the conventional methods of bank/credit union loans or credit cards would include borrowing against cash value of insurance policies. Advantage there is that you don't get hit on the credit report with those loans in most cases, which helps to preserve the credit score and also helps to preclude adverse action from those lenders who get twitchy anytime there is a change to the report in the way of new loans or spikes in balances.

For those with retirement accounts, borrowing options might exist there as well. Not sure I would recommend margin borrowing for those with brokerage accounts though...market instabilities could present problems vis a vis a margin call when we get the next correction.

[Sally]

There is yet another financial consideration, you do not jump up and go back to work right away - you will need to have living expenses even if you are lucky enough to have a job to come back too.

I am afraid that too many people think that you can recover in the few weeks that they have you stay after the surgery and then straight back to work back to work - not so!

Everything must be carefully planned - do your research carefully and make sure that you have enough before you start.

Love ya,

Sally

[Drea]

Too bad you cannot pay for it with the money you get back from deducting it

You can, if you KNOW you will have SRS in a given year, adjust your witholding such that you get the money as you get paid. One can even alter it for a limited part of the year to accumulate the funds in a shorter window. One however MUST have the disipline to set the money aside and not touch it under any circumstance. And if one doesn't actually use the money for SRS, at tax time one has to come up with the money and most likely underwitholding penalties.

Of course the deduction only reduces the income. Thus if one is in the 25% tax bracket, the amount of tax savings on 20K deduction is only $5000. That helps.

Another factor is one can only deduct the amount that exceeds 7% of their income. So if one earns $80K per year, the first $5.6K doesn't count so only $14.4K will be deducted. So savings if in the 25% bracket would be on the order $3,600.

Many will be in a lower tax bracket so the tax reduction may be significantly less.

Another note, what counts in the year you pay for SRS, not necessarily the year you have SRS. So to pay before the year ends when SRS the following year allows taking the tax break earlier.

[Guest Isobelle Fox]

Has anyone here considered medical loans? Does anyone know if there are any reputable surgical loan companies with interest rates that are better than the credit cards?

[Guest Ann Onymous]

Has anyone here considered medical loans? Does anyone know if there are any reputable surgical loan companies with interest rates that are better than the credit cards?

A lot of the surgical loans offered through specialty lenders are at horrendous rates. One would be FAR better off to get a personal loan through their bank.

As to doing it on credit cards, there are still cards out there with rates that are not much more than prime plus one percent. I still regularly use a few cards with rates under six percent...

Regarding the question above about how long to pay a bank loan off...depends on what you structure with your lender, but depending on how much you borrow, expect three to five years. Let's face it, you are looking to borrow less than would be borrowed to purchase a new car, and those are still typically structured at five years or less.

Regarding

I am afraid that too many people think that you can recover in the few weeks that they have you stay after the surgery and then straight back to work back to work - not so!

This is all dependent upon the person. Back in the 90's, I was back in the office within two weeks of my return from Montreal. And since I was only up there for roughly a week, I was less than three weeks removed from surgery.

[Guest sybilpsychosis]

Does any one know of any states where medicaid in part or whole covers grs? I am disabled and I won't ever be able to save enough money to afford it, and unfortunately going to Tailand or something is definitely out of the question.

[Guest kelise]

Cigna insurance through Disney paid for mine 100%

[Guest Joyful Mama]

We have Cigna through my husband's company, but because it will be considered out-of-network, Cigna will be pay 60% of the total bill for our daughter's surgery. However, if Dr. McGinn was a participating doctor with Cigna, then it would be covered at 80%. We are very thankful for the 60%, but I wonder why she doesn't participate with Cigna so it could be considered in-network for her patients and make it more financially possible.. I am guessing, and hoping for everyone's sake, at some point more health care providers will cover it since the AMA deems the condition as biological. It seems discriminatory.

[Paula ult]

Mama, i am pretty sure Dr,. Mcginn does not take insurance because she does not have the office staff to handle the paperwork involved, she has Sara her office manager and i believe one nurse that may work part time, hopefully as her reputation increases and she gets busier she will expand her practice and start taking insurance.

Just a reminder, what your insurance does not pay you can now deduct on your income tax at the end of the year.

Paula

[Guest Joyful Mama]

Paula,

Thanks for sharing. I think you are right. When we were there for the initial appointment, her office was SO hectic - her practice is growing quickly now! fyi...when I called last week to ask a question, they said Sara is out of the office temporarily. She was very helpful when we initially set up the appointment.