Adulting (i.e. Costs and Tips for Saving $)

Here is a run-down of most of my expenses and out-of-pocket costs for my Phalloplasty. I'll admit, I was not prepared for the full extent of some of these costs (i.e. hair removal). I plan on updating this list along the way. Please feel free to add suggestions for cost savings in the comment section.

Phallo Consultation with Crane in Austin, TX ($487)

• $0  Flight and Hotel (covered by credit card miles - approx $600)
• $187 Car Rental/Transportation
• $300 Consultation Fee (will seek reimbursement)

Dr. Crane Office Fees ($2,150)

• $2,000 Deposit to Secure Surgery Date
• $150 Insurance Processing Fee (for Out-of-Network)

Preparations ($2,420 as of Oct 30)

• TBD ($30-$300 pending insurance approval) Session Fee with Therapist for 2nd Letter
• $30 Co-Insurance Fee for Mole Removal
• $2,265 for approx 27.5 hours of electrolysis. I will likely need 15-20 additional hours (Approx $1736 more). I will be submitting to insurance and seeking reimbursement for some of these costs. 
• $125 Post-op Supplies (At least $300 worth of additional supplies were gifted to me via a registry)
• $0 Will and Medical Power of Attorney Preparation (covered by my employer)

Surgery, Stay, Travel, etc. ($1856 as of Oct 30)

• TBD Out-of-Pocket Surgery Costs (Anticipated in-network $0; Out-of-network $2,500). I've met my in-network out-of-pocket max already and have about $2,500 remaining to meet my out-of-network max. Crane's office is currently trying to make an agreement with Cigna for this to be considered an in-network service. If so, that will save me $2,500.
• TBD ($1,500 estimate) for Pet/House Sitter for 5 weeks
• $1856 for AirBnB 30-day stay (cheaper than most extended-stay hotel options)
• TBD (approx. $700-$1,000) Travel/Lodging 6-8 hotel stays and gas

TOTALS

Paid as of Oct 30: $6,913

Pending/Approximations: $3,966-$7,016

Possible Reimbursements: $2,000 Deposit; Approx. $1,800 from Electrolysis; and, $270 from Consultation

Suggestions for Saving $ (Warning: I am not a Financial Advisor)

• Consider switching to a credit card with better cash back rates. The best ones can get you anywhere from 2% back on all purchases to 6% on select purchases. You can find reviews/tips here and here.
• If you have a Flexible Spending Account through your employer, considering electing the maximum amount possible. For me this is $2,250, which doesn't even hit the in-network out-of-pocket max for my insurance coverage. Even if insurance covers your surgery, you'll likely have out-of-pocket costs like deductibles, co-insurance, and supplies that these funds can be used towards. You are not taxed on this (a plus) and it can be used anytime but comes out of regular paychecks, which can help spread the payments across the year. Warning: These are often use-it-or-lose-it accounts and only some have roll-over options, so be sure you're scheduled to have surgery during the year you make this election for.
• If you have options for health insurance, compare them by adding up the annual premiums and your in-network and out-of-network out-of-pocket maximums. This will give you a better overall picture of what your annual expenses will be and help you choose the best option. For example, one plan might have lower monthly/annual premium, but a high out-of-pocket max for in-network services. Since a phalloplasty will definitely bring you up to that max, it might be less expensive to pick a plan with a higher premium, but low out-of-pocket max.
• Look to see if your employer covers things like Will and Medical Power of Attorney preparation. You'd be surprised how many offer these legal services for free or at reduced cost. 
• Make longer hair removal appointments. If insurance does reimburse you, it will likely be by appointment, not length of time. 
• Shop around for travel/lodging. I found cheaper rates for 30+ day AirBnB rentals and short term apartment rentals than extended-stay hotels. The monthly rates for AirBnB rentals were at least 40% discounted from the nightly rates.
• If out-of-network, find a surgeon that will negotiate with your insurance for these to be in-network services. This will save me at least $2,500, but that could have been up to $5,000 had I not already incurred many out-of-network expenses this year.
• Try a GoFundMe campaign, meal train, or a gift registry. With my savings and help from family, I can afford some of the large out-of-pocket expenses, but it's still a stretch. I opted to use myregistry.com to build a registry of my post-op supplies. Since they range from $3 to $35 for each item, this made it easier for friends with diverse funds to send me a gift. I added the option of Amazon gift cards, which half of the people opted to do. Approximately 2/3rds of my supplies were purchased by friends.
• Consider options on debt that you currently hold (or may incur) in order to minimize the amount of interest you owe. Start by comparing the interest rates for big purchases/loans. For example, if you plan on putting surgery expenses on a credit card or taking out a medical loan, chances are those interest rates will be higher than something like a car loan or possibly even a mortgage. If you can, extend the length of the loan with lower interest rates (which will lower those monthly expenses) in order to free up that cash to pay off the loans with the higher interest rates sooner. Once the higher-rate loans are paid off, you can put more cash towards paying off other loans. Many (but not all) lending companies will allow you to pay more than your monthly minimum payment, which can help you pay off your loan sooner and with less interest. This definitely will not work for all loans/debt. Please consult a financial advisor before making these decisions.