Which Doctors Accept Insurance for MTF Transexual Breast Augmentation Surgery?

My partner has got great insurance that covers all of her transition surgeries 100 percent. But she is running into doctors who are in network, but will not take insurance for breast augmentation. Are there any plastic surgeons who are able to perform MTF breast augmetation, and will accept insurance payments directly instead of charging her and having her submit to her insurance company? She has microsofts blue cross blue shield insurance.

Doctor Answers (3)

MTF surgery

+1

Chances are you will have to,pay for the procedure up front ( no pun intended ), then wait to get reimbursed by the insurance company.  It will be very difficult to find a surgeon willing to perform the surgery and  risk not getting paid.


San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast Augmentation and Insurance Coverage

+1

I am not aware of any insurance companies that pay for breast augmentation regardless of the underlying reason.  This is one of those times that if you want the surgery you will have to pay directly to the PS

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 9 reviews

Insurance-coverage of Male-to-Female Breast Augmentation

+1

Since they do not pay out of pocket for medical services, very few Americans are aware of how much their doctors were compensated for their care. This is responsible for fostering an apathy for personal responsibility and believing the propaganda and glossy websites put out by insurance companies. As a rule, today's doctors are progressively paid less than yesterday's while their stress levels, obligations and regulations have increased exponentially.

The word COVERAGE implies full payment. However, anyone familiar with the perverse insurance lingo would tell you that coverage is the amount your insurance  pays the doctor AFTER
- your particular procedure was approved subject to the terms of your policy (which takes the sending of long, detailed photographically supported letters with supporting medical literature. These letters are commonly ignored for weeks and often "lost". When denied, you may "appeal" frequently with similar results...)
- your particular DEDUCTIBLE (which must be prepaid) and COPAY
 

Since the simple mention of ANYTHING resembling cosmetic surgery is frequently denied by ALL insurers, it is always an uphill battle to get insurers to "cover" and fairly compensate Breast Reconstruction cases making it an very frustrating experience for most Plastic surgeons and their patients. When it comes to transgender patients the experience is made even more challenging by a variety of additional hurdles. As a result, most Plastic surgeons would prefer not to engage in this mostly losing, always frustrating battle with insurers.

Bootom line and not popular, when compared to other cosmetic procedures, is relatively reasonable and should probably be paid by the person wishing to look better.

 

Peter A Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 61 reviews

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.