Gender Reassignment Access: insurance, consultation, gender pronouns, and more
In today’s post, I will discuss the steps involved in getting from inquiry to gender reassignment surgery with Dr. Gallagher.
The first person you’ll meet when you begin to to explore your options with Dr. Gallagher is Nicole Jackson. Nicole is the Transgender Surgical Program Coordinator. She will help you with insurance and scheduling, among other things.
Upon my visit to meet Dr. Gallagher, meeting Nicole was my first stop. I found her to be not only helpful, she was informative and easy to talk to. One of my first impressions of Nicole came from the tagline in her email to me. Under her name and contact information, she listed her preferred gender pronouns “she/her pronouns.” This may not seem like a big deal, but how many professionals have you interacted with that have done this. I’m going to guess none. This simple tag-line with her preferred pronouns underscores that none of us should assume another’s preferred pronouns, even if it seems obvious.
For a cis-gender female to note her preferred pronouns is a strong statement of understanding for gender variance. I now include my gender pronouns in my tag line because of her email. (I encourage you to, also!).
One of the biggest obstacles to gender reassignment is finances. Fortunately, more and more insurance plans are covering gender-related care, including gender surgeries. Therefore, a big part of choosing a surgeon for GRS, SRS, chest surgery, and orchiectomy, revolves around insurance coverage and copay.
When considering Dr. Gallagher for your gender care, there are a few important steps you will need to initiate through Nicole first.
STEP ONE: Email Nicole Jackson
Contact the office here. Email is the quickest, most efficient way to explore costs for self-pay, or to learn your insurance coverage, if applicable.
To receive the quickest response, be preparted to provide the following information in this initial email:
- Your name (both legal and preferred, if different)
- Date of birth
- Preferred gender pronouns
- Copy of front and back of your insurance card (if applicable)
- Indicate your desired type of gender reassignment surgery
- Describe your current transition status: length of time on HRT, dates of legal name change, gender marker change and FT living start date as well as any prior procedures, if you have a letter(s) of referral (necessary for surgery but not for inquiry and consult)
STEP TWO: Receive surgery cost quote
Wait patiently for your response.
They will determine your benefits and coverage. Then she will respond by email with details about your out-of-pocket responsibility for the desired surgery.
STEP THREE: Scheduling Consult
Once the financials are established, Nicole will schedule a consult for you to meet with Dr. Gallagher. Not surprisingly, scheduling with Dr. Gallagher is taking longer as her schedule is rapidly filling. Scheduling a new consultation is currently up to two to three months wait. Scheduling is expected to eventually become a three to five month wait before long.
STEP FOUR: Consultation
If you are using insurance, your insurance will be billed for the cost of the consultation. You may be responsible for the copay at the time of your visit. This can be clarified with Nicole prior to your consultation. If you are self-pay (no insurance coverage), Nicole can also inform you directly of the fee for this consultation.
Consultations for top surgery are 30 minutes. For GRS, consultations are 45 minutes. You will see a presentation covering the surgery process, and you will meet with Dr. Gallagher and Nicole both separately.
STEP FIVE: Pre Determination Request
After your consult, Nicole will submit your Pre Determination request to your insurance. This is necessary for approval and pre-authorization of your surgery. This can take 30 to 60 days. Once an authorization/approval is received, surgery can be scheduled. Dr. Gallagher is currently scheduling 1 to 2 months out for surgery.
If paying out-of-pocket, Nicole will discuss forms, amounts and process for scheduling. Self-pay surgeries are also booked 1-2 months out. Payments must be made in full two weeks prior to surgery date. There are no payment arrangements or financing within IU Health or Plastic Surgery. Any loans, credit lines or payment arrangements will need to be made outside of IU Health.
STEP SIX: Gender Surgery
Surgery locations vary based on insurance parameters, availability of scheduling and the selected surgery. Currently, all vaginoplasty surgeries are done at Eskenazi. Top surgery and orchiectomies are typically performed at Senate Street Surgery Center, IU Health West Hospital and Eskenazi Hospital. Other IU Health locations are also used in certain circumstances.
IMPORTANT NOTE: No smoking for 6 weeks before surgery. You will be nicotine tested and surgery will be cancelled if you fail the test.
- Meet Dr. Gallagher
- Chest Reconstruction, process, procedures and outcomes
- Gender Reassignment Surgery: process, procedures and outcomes
- Orchiectomy: process, procedures and outcomes
- How to get a letter of referral for surgeries