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Kaiser's nasty surprise


Guest Markietoo

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Guest Markietoo

I've been using Kaiser for my health care for the past 3 years. Two years ago I began utilizing their services for a gender therapist and a HRT doctor. During all this time I was told that if I wanted the have SRS it would be covered by my insurance plan. Specifically they said they would let me chose which of two MD's I wanted to do the procedure: Toby Meltzer in Scottsdale or Curtis Crane in San Francisco. My GT and the HRT doc sent in the formal request for a consultation visit recently and the Kaiser Transgender Center contacted me a couple of days ago.

Let's say that the call was not what I expected and left me with my head lying on the table. Since Kaiser does not have surgeons of their own who do the procedures, they contract it out. I am 65 years old and had to sign up with Medicare as required at that age. The nurse who called told me that since I now have Medicare as my primary payer, Kaiser can't use the contract surgeons since NO MD's accept Medicare for SRS procedures! None. I was stunned to say the least. One day I can have the surgery with no issues and the next I can't.

She continued to tell me that Kaiser is in the process of setting up their own surgeons to perform the procedures but it is not yet available. The theoretical state date is sometime in 2016. The surgeons have to be trained first. Oh joy. When it is available, the surgeons will be relatively new to doing it, not experienced, proven surgeons with this specialty. They offered to let me still go through with the half day surgical evaluation: I have to meet with two therapists, a Registered Nurse, a Social Worker and I get to talk to the surgeon who is being trained so I can ask him questions and hear what he has to say. Should be an interesting day, September 21st.

They told me that Dr. Meltzer has a 6 month waiting list just for the consultation visit and another 12 months for a surgery date. That made me think about the time frames and how it could play out for me. If they get the surgeon up and running it's likely that Kaiser can provide for my care and earlier than it would be if I'd gone to see Dr. Meltzer or Crane. All is not lost yet. That made me feel somewhat better but still I feel so let down by how this played out as a total surprise.

So, I write this as a cautionary tale for those of you with Kaiser coverage if you're an older grandmother like me. I survived this far in my life dealing with GD and all the awful years I lived dealing with that horror show. Now, for the past 20 months living full time and legally female, I will prevail over this setback too.

One way or the other, none of this will stop me from being the person I've always known myself to be, a woman named,

Markie Anna

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Huggs, Markie Anna.

I had heard rumors of this at SCC last year.

I don't think this is a Kaiser "exclusive."

I feel this may be a situation for anyone on Medicare.

Then again, what do I know, I'm n the Great White North. :P

Huggs, :wub:

Joann

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  • Forum Moderator

As another trans* grandma i'm simply hoping that medicare will start to cover SRS and more surgeons will accept their rate of payment. My doctor doesn't accept insurance payment. I don't think she needs to hassle with insurance companies with the demand that exists. Over time i'm sure there will be more qualified surgeons but that doesn't help us older girls. Fortunately i could afford my surgery.

Hugs,

Charlize

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  • Admin

It is possible that you may really come out ahead on this one Markie. Looks like I did not lose anything really because I had been on Medicare for 2 weeks when Bowers did my surgery, and it was a year before Kaiser would have paid for my surgery anyway. I had no idea about that. If Kaiser does train a surgeon though it will be through one of the ones they have on contract. When I had my surgery with Bowers, she had told me that she was working with a couple of their doctors as trainees, so I think you may get very good surgery and results. Even the "old pros" are realizing that they need coverage for the demand that is available.

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save your money and go to Thailand it cose less in time and money ask some of the members here because some have been there

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Guest Loren-t

save your money and go to Thailand it cose less in time and money ask some of the members here because some have been there

My question is Thailand claims to be the experts in SRS but in reality im not sure that im willing to trust some one over seas I would much rather try to trust those who hold a Medical License here in the US personally..

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