If you wish to apply for insurance coverage for top surgery and have an HMO insurance plan, (or are getting insurance through your school) it’s likely that our surgeons will be considered out-of-network. Your insurance supplies you with a list of in-network providers, and if our surgeons are not on that list, you will need a letter from your primary care physician (PCP) for a specialist referral in order to get a consultation with any of our surgeons.
The medical group that manages your insurance policy (listed on your insurance card) is responsible for authorizing the referral. If the medical group denies your referral, it usually because our facility is out-of-network. If that happens, they will re-route you to an in-network provider. It’s important to note that a denied referral can be appealed. To learn more about the appeals process, get in touch with our insurance advocacy team.
The virtual consultation will be billed to your insurance company. We will accept the insurance reimbursement as payment in full.