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How to Pay for Top Surgery: Your Complete Guide

Introduction

Top surgery is an umbrella term for gender-affirming surgeries that reconstruct the chest to alter its contour. Chest reconstruction or mastectomy procedures, breast reductions, and breast augmentations can help patients experience greater alignment between their gender identity and their bodies. Common procedures include double incision top surgery, keyhole top surgery, periareolar top surgery, inverted T top surgery, aggressive breast reduction, and breast augmentation (with implants and/or fat grafting).

One of the challenges patients face is affording these procedures. The average cost of top surgery ranges from $8,000 to more than $15,000 for those paying without insurance, which can be a significant barrier to accessing medically necessary, gender-affirming care. There are many options for insurance coverage, payment plans, financing, crowdfunding, and grants to help you pay for MTF top surgery, FTM top surgery, or non-binary top surgery.

Top surgery is the most sought-after procedure offered by the Gender Confirmation Center (GCC). Through our insurance concierge service, we have helped 90% of patients secure payment for their surgical procedure. Our patients report increased feelings of freedom and comfort in their bodies, and our patient satisfaction rates for top surgery are astronomically high. 

Understanding the Cost of Top Surgery

Top surgery procedures range from chest reconstruction to breast reduction to breast augmentation procedures for feminization, masculinization, and non-binary patients who seek one or neither of these options for their chest.  While each procedure has its own cost, top surgery generally falls within the $8,000-$15,000+ range for patients paying without insurance.

Several factors influence costs, such as the surgeon’s experience, geographic location, and whether the procedure is performed in a hospital or an outpatient surgery center. The surgery itself is a significant portion of the total price, but consults, anesthesia, facility fees, pre-op testing, and other requirements are also necessary expenses.

It’s important to note that quotes for surgery often don’t include anesthesia and facility fees. These vary depending on how long you’re under anesthesia and the length of time you remain in the hospital, so it’s important to discuss those considerations when discussing pricing for your procedure. Additional items you may need to budget for include medications, travel costs, and additional recovery supplies besides the bandages, drains (not in all cases), and compression garments you wake up with after surgery.

Does Insurance Cover Top Surgery?

Coverage for top surgery varies by provider and state. Some plans are much more likely to cover the procedure than others. To be covered by insurance, a patient typically needs a gender dysphoria diagnosis in a support letter from a licensed mental health professional to prove that the surgery isn’t cosmetic. Insurance providers tend to only require 12 months of continuous hormone replacement therapy (HRT) to cover breast augmentation. HRT is not required to cover chest reconstruction or breast reduction top surgery. 

In the state of California, the following insurers may offer partial or complete coverage for top surgery:

• AETNA
• Anthem Blue Cross
• Blue Shield of California
• Brown and Toland Medical Group
• Meritain Health
• Oxford Health Plans

For a more extensive list of insurance providers that are in-network and out-of-network with the Gender Confirmation Center (GCC), click here.

How the Gender Confirmation Center Helps Patients Navigate Insurance

Our insurance advocacy team works with patients to address concerns, get referrals, and move through the complex red tape that can come with seeking coverage. With the right support and information, patients have a much higher chance of receiving insurance approval and coverage for their procedure.

If you experience an insurance denial, you may be able to appeal this decision. This depends on whether you’re denied because your insurance doesn’t cover gender-affirming care or because of other concerns raised. If your policy covers the surgery, your surgeon’s office can help you with an appeal.

Financing Options for Top Surgery

The most common financing options for top surgery are:

• Medical Credit Cards: CareCredit and Alphaeon Credit are two of the most popular medical credit options, but there are others. These may not work well for patients without good credit, as approval is similar to other types of credit cards.

• Personal Loans: Banks and online lenders may provide personal loan options for top surgery, but good credit and an adequate income may be barriers to approval.

• In-House Financing Plans: While some surgical centers do, the GCC does not offer financing plans for patients at this time. Patients must pay their full financial responsibility six weeks before their surgery date. Patients can have a payment plan before surgery, but not after the six-week pre-op mark.

• LGBTQ+-Friendly Lenders: Patients considering this option should carefully consider interest rates, repayment terms, and the impact on their credit.

Grants, Nonprofits, and Crowdfunding Resources

There are several ways to pay for top surgery and other procedures, even if your insurance doesn’t cover this type of care. For example, there are grants and scholarships for trans individuals through Point of Pride, Jim Collins Foundation, and Gender Bands..

Additionally, there are crowdfunding options through Givebutter, GoFundMe, and related platforms. Social media can be a powerful tool for telling stories, asking for support, and seeking solidarity. Honest, open interactions with like-minded individuals are among the best ways to succeed at crowdfunding and drum up community support.

Patients can locate more information and resources here to help them move toward surgery funding options.

Employer & Government Assistance Programs

Assistance may be available depending on where a patient works and what kind of assistance they qualify for. Some employer-sponsored health plans have DEI and trans-inclusive benefits that can help cover the cost of surgery.

Additionally, consider looking into options such as:

• Flexible Spending Accounts (FSA)
• Health Savings Accounts (HSA)
• Medicaid and state-level programs
• Veterans Affairs (VA)
• Disability and medical leave options for time off from work

Patients may be surprised at their options when they explore programs and benefits from their employer and other agencies.

Planning and Budgeting for Top Surgery

Planning and budgeting for top surgery can take some time. There are many hidden costs to account for, such as travel, time off work, and recovery supplies. However, there are some great ways to save money when traveling for surgery. With preparation, patients can be ready for gender-affirming surgery as quickly as possible.

Some of the most critical financial preparation tasks include:

• Booking flights
• Addressing any pre-op testing and concerns
• Booking a hotel or other location for recovery
• Arranging transportation
• Filling prescriptions
• Purchasing post-op supplies
• Hiring support or help for the immediate post-op period
• Attending follow-up appointments

While it’s impossible to plan for everything that could take place, having an overall plan and some extra room in the budget can make the process easier and less stressful.

Why Choose the Gender Confirmation Center for Top Surgery?

At the GCC (Gender Confirmation Center), we are among the top gender-affirming surgical practices in the world for transgender and nonbinary patients. Since opening our doors in 2009, we have performed over 3,000 mastectomies and breast reductions with only a 4% revision rate. We offer free virtual consultations to discuss your gender-affirming care goals. 

All of our board-certified plastic surgeons are dedicated to inclusivity in healthcare and offer a wide variety of surgical techniques for top surgery. We also work with high-BMI patients, those who are older or disabled, and those who haven’t chosen to take HRT. We also support patients who don’t explicitly identify as transmasculine or transgender. Our commitment is to working with patients on a case-by-case basis so they can access the highest-quality gender-affirming care.

Have questions about top surgery recovery? You can find the answers here.

We offer an expert support team for insurance issues, transparent pricing and financing information, testimonials from past patients, and more. Book a free consultation to discuss payment options for your unique surgical plan today.

Frequently Asked Questions about how to pay for top surgery

Can I use a payment plan or combine funding sources?

Yes, there are options for payment plans before surgery, as well as other funding options to pay for top surgery. These policies depend on your surgeon’s office, so be sure to speak with them about the unique options they offer patients.

Will my insurance cover just part of the surgery?

Possibly. This depends on the insurance company, its specific requirements, and the surgical procedure being considered. Generally speaking, if your health insurance covers gender-affirming care, you will need to provide a support letter from a licensed mental health provider to secure coverage.

What happens if I’m denied coverage?

In the event of a denial of insurance pre-approval to cover the costs of top surgery, you can file for an appeal. Appeals are usually not successful if the insurance provider has no gender benefits. If the insurance does cover gender-affirming care, your surgeon’s office can help you appeal the decision. If you’re denied coverage even though your insurance company and policy offer gender-affirming care, our insurance advocates can help you file an appeal.