Why Do Many BBL Surgeons Refuse To Work With Insurance For Transgender Individuals?

I personally know of NO health insurance company willing to reimburse for cosmetic surgery in the USA. But if you are willing to pay in advance (in full and understand no refunding if insurance does not pay anything or less then the charged fee) then many boarded surgeons would undertake your case. I would require a letter from the insurance stating you will be reimbursed, if you can not obtain this letter then the insurance company is wasting your time!

I don’t believe any insurance company will cover a BBL for any diagnosis. Transgenderism may be an exception that I am not aware of.

There isn’t even a billing CPT code for this procedure.

Once a physician accepts insurance reimbursement acceptance of that payment stipulates that the doctor cannot bill the patient.

Insurance reimbursement does not allow co-billing the patient.
Doctors either take medical insurance or they do not. That’s how medical insurance works. It’s not like dental insurance where the insurance pays a certain amount and the dentist can bill for the difference.
Insurance reimbursement is typically too low for most plastic surgeons to be interested in working with insurance reimbursement cases.

If reimbursed at typical insurance company would probably not pay more than $600 for this procedure. Compared to a typical price which may be $6000- $15,000 you can probably understand the reluctance of working with insurance companies.

Don’t blame the doctors for this.

Insurance companies are the ones that have set up the current rules.

Best,

Mats Hagstrom MD