The objective is to soften the facial . Days, a 50-year-old Berkeley resident, had just returned from a month-long trip to Spain in February, where she underwent a procedure known as facial feminization surgery, or FFS. Tseng P, Kaplan RS, Richman BD, et al. Dr. Esmonde is a plastic surgeon in Portland, Oregon who has extensive knowledge about Gender Affirmation Surgery and works almost exclusively with transgender and non-binary patients. Average months spent from initial facial feminization consultation to final insurance authorization decision. The total time from initial consultation to definitive authorization decision for Group A was 1.1 0.2 months (Fig. Bariatric Surgery. Read more on our Insurance and Finance page. 1. With a view to clarifying this issue and answering frequently asked questions, we have compiled the following information in an effort to not only outline how Deschamps-Braly Clinic handles finance and insurance coverage but to also provide general information about how to approach your own health insurance company regarding the cost of your facial feminization. Body-contouring. Dr. Nghiem is an Ivy League-educated, fellowship-trained plastic surgeon in Washington, D.C. who specializes in transgender surgery, including Chest Masculinization and Breast Augmentation. Modeling performed by Padula and colleagues for employer-based insurance plans in Massachusetts indicated that, over the course of 5 years, coverage for transition-related services would lead to societal costs of $0.016 per month per member.3 The authors concluded that the relatively low societal cost, combined with the increase in quality-adjusted life years for transgender patients, supported coverage of transition-related services in employer-based plans. Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Administering cosmetic fillers may take an hour or less, while complex facial surgery may take several hours. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. The remaining 10.0% of patients who were ultimately denied were counseled and in the process of exiting their job-based insurance plan and enrolling for coverage through plans under the health insurance exchange established by the Affordable Care Act, which fall under state jurisdiction. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Error bars denote standard error. N Engl J Med. Received for publication February 2, 2021; accepted February 27, 2021. Your health insurance company can't limit sex-specific recommended preventive services based on your sex assigned at birth, gender identity, or recorded gender for example, a transgender man who has residual breast tissue or an intact cervix getting a mammogram or pap smear. (See table 1, Supplemental Digital Content 1, which displays requested CPT codes and associated terminology for facial feminization surgery. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Notes. Error bars denote standard error. Plast Reconstr Surg. Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. Copyright TransHealthCare.org & Trans Media Network, 2011-2022. Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. Dr. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle In contrast, FFS under insurance coverage allows for inpatient care, which may be important, particularly to surgeon decision-making as well as patients who may have other medical conditions, pain control issues, or those who travel from long distances. Capitn L, Simon D, Kaye K, et al. Gender-Affirming Surgery: Original Article. Thus, coverage significantly increases accessibility. However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. Societal implications of health insurance coverage for medically necessary services in the U.S. Transgender population: a cost-effectiveness analysis. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. Thirdly, it is likely that the current work underestimated the total cost of the insurance approval process, as we could not quantify the cost of surgery cancelations, additional clinic visits, and unquantifiable administrative time. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. 2020; 8:e2618. It is of great importance to note that there is no one-size-fits-all solution for facial gender affirmation with respect to determining medical necessity of procedures. Compared with the published literature, patients within Groups B and C are multi-fold greater than the reported standard estimates in the former study without even taking into account time and costs of post-surgical billing activities. 5. Procedure. A second subgroup of patients (Group B), all of whom had private insurance, were approved for surgery but required multi-level appeals, peer-to-peer discussions, and, ultimately, an IMR. There is also a great deal of discussion on various internet forums and also on social media in terms of how to reduce the cost of your facial feminization surgery by claiming the procedure on your health insurance. Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps. The generalizability of the findings presented here is limited by state laws. Unlike Group B, patients within Group C only had plans that were self-insured under ERISA. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. Facial feminization surgery can be covered by health insurance in some instances. This could be a good time to join (or form!) His experience in cosmetic and craniofacial surgery makes him an excellent choice for Facial Feminization (FFS) and Masculinization surgeries. Facial feminization surgery: the forehead. I can't guarantee that you'll achieve coverage, but depending on how your insurance benefits are regulated and the support resources you have access to, it's definitely worth trying. Read more about our Clinics Finance and Insurance Policy here. For patients anticipating insurance coverage for your surgery, we appreciate that you may wish to seek insurance reimbursement for the cost of some or all of your feminization procedures and have outlined some general guidelines below. A Systematic Review of Tranexamic Acid in Plastic Surgery: Whats New? Plast Reconstr Surg. If you work for an employer who supports your gender confirmation surgery your first point of contact should be your in-house health insurance liaison. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. First, one of the most significant barriers to FFS for patients is the ability to pay for surgery, which ranges from $40,000 upwards for full-face, one-stage surgery. In addition to following WPATHs SOC format, it is helpful if it is specifically tailored to FGCS. Data is temporarily unavailable. Plastic and Cosmetic Surgery. Start with ensuring that you have an in-depth understanding of your insurance benefits. 2. For more information, please refer to our Privacy Policy. If the insurer refuses those attempts, you can appeal externally, but that will almost certainly require professional legal support. Get a bossy friend to make phone calls with you while you are dealing with the process. Plastic and Reconstructive Surgery - Global Open, Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), https://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF, https://blog.doximity.com/articles/doximity-2018-physician-compensation-report, PRSGO_9_5_2021_03_23_LEE_GOX-D-21-00105_SDC2.pdf; [PDF] (74 KB), Facial Feminization Surgery under Insurance: The University of California Los Angeles Experience, Articles in Google Scholar by Allison C. Hu, BA, Other articles in this journal by Allison C. Hu, BA, Factors Influencing the Choice of Plastic Surgery as a Specialty in Saudi Arabia, Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients, A Safe and Effective Lip Augmentation Method: The Step-by-Step (Phi) Technique, Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. TransHealthCare.org uses cookies and other tracking technologies to improve your browsing experience on our website, to analyze our website traffic, and to understand where our visitors are coming from. This is called facial feminization surgery. Available at: 2. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon The benefits of such coverage far exceed the insignificant costs. This guide may also be useful for people planning other procedures considered cosmetic and/or explicitly listed as not covered under their transgender benefits (breast augmentation, body contouring, facial masculinization surgery, etc.). They submit their own information, information about the procedure being performed, and information about you. FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure. These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. *, Time and cost of the insurance approval process for FFS. Submission and review of initial authorization request (1 month); 2. Osseous transformation with facial feminization surgery: improved anatomical accuracy with virtual planning. You need to be aware that there may be a difference between theallowed amount(maximum paid by the insurance company) and thebilled amount(the amount that the clinic charges for the surgery). The Plastic Surgery Clinic of Chicago personalizes each and every treatment we perform by completing a full facial evaluation and discussing all possible options with you. Facial Feminization Surgery (FFS) | Johns Hopkins Medicine Do you have access to out-of-network providers or in-network only. I could go on about this, but I hate to further the expectation that you must be very mentally ill in order for the "extreme" treatment of FGCS to be warranted. Complete New Patient Questionnaire. All rights reserved. One of the major barriers for transgender patients is accessibility to gender-affirming surgeries due to the lack of insurance coverage or inability to afford surgery as a self-pay patient.1 In an analysis of the National Inpatient Sample, Canner and colleagues noted that between 2000 and 2014, 56.3% of patients undergoing gender-affirming surgery were not covered by any health insurance plan.2 Over the course of this period, particularly between 2012 and 2014, an increase in patients covered by private insurance and Medicare and Medicaid was noted. Allure Esthetic & Insurance Coverage For FFS Allure Esthetic is Washington State's top destination for facial feminization surgery. From the *Division of Plastic and Reconstructive Surgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, Calif. UCLA Gender Health Program, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, Calif. Some of the procedures included in facial feminization surgery are: Though specifics required by insurance vary (and might be laid out explicitly in your Certificate of Coverage) I recommend every person have three letters of support. Please first read this resource for a general overview of insurance utilization for trans surgery. This could be replaced with language about how you are not eligible to take estrogen therapy for whatever reason, including fancy language for just not wanting to. Doctors and nurses take good care. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. Each patient is different and your expectations and desired results will be discussed fully in your consultation. The differences between male and female facial features vary with age, ethnicity, and how early hormonal therapy began. I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. Facial Feminization Surgery (FFS) is a group of facial procedures that alter the face to create more classically feminine characteristics, such as a higher brow, a more refined feminine nose, and less pronounced Adams apple. Insurance and facial feminization surgery - 2pass Clinic Read this first. Please enable scripts and reload this page. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. 7. Only if your insurance provider authorizes a Letter of Agreement. Dr. Crane is one of only a few surgeons in the world who is trained as both a plastic surgeon and urologist and has also completed fellowships in reconstructive urology and gender reassignment surgery. We have a dedicated Insurance Advocacy Team that handles the entire process of insurance approval for patients; we send all your documents to your insurance providers and work with them to try and secure coverage to the fullest extent. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. Facial Feminization Surgery: FFS Surgery in Thailand 15. The time from initial consultation to final insurance denial required 5.1 0.7 months, nearly 5-fold higher than Group A (P = 0.003) (Fig. Disclosure: All the authors have no financial interest to declare in relation to the content of this article. Requested CPT codes are detailed in Supplemental Digital Content 1. Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. information about insurance coverage: video.transcendlegal.org 2. The doctor said very encouraging. 3. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. For Bay Area trans women, facial feminization surgery helps complete Months required for definitive insurance authorization decisions for FFS. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . Facial feminization is the term given to a collection of procedures designed to make facial features more feminine. Her surgery was performed by a craniofacial surgical team called the FACIALTEAM. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 360 Post St. Suite 901 Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. Until then, CCTS will continue to require all patients using insurance for . Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. 2). Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Descriptive statistics were performed for demographic variables. 3). Analyses of variance with posthoc comparisons under the Tukey criterion were used to compare time from consultation to approval or denial, time spent obtaining insurance authorization, and cost. He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. It's an attempt to make the face as attractive as possible for as long as it lasts. One of the major issues among surgeons and patients with regard to insurance coverage for FFS is the lack of understanding of the process as coverage for gender healthcare is highly variable depending on state law and plan variabilities (Table 3). The Case For Facial Feminization Surgery - BuzzFeed News Especially with the establishment of multi-disciplinary gender health teams across the United States, coordination of care through a consistent group of trained administrative staff knowledgeable in the process and appeals process for gender health procedures would potentially reduce the burden on individual offices and surgeons. Upon denial, an IMR is requested directly from the insurance plan. The standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. And some health insurance plans do cover the costs associated with facial feminization surgery procedures, so we recommend contacting your insurance provider to find out what is and is not covered under your current plan. Arch Intern Med. Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). $8995. The United States . Patients were stratified into 3 groups based on authorization process: Group A (standard approval, n = 26, 65.0%) including public and private insurances; Group B (extended approval, n = 10, 25.0%) consisting of private insurance plans that initially denied and required multi-level appeals for denial overturn; and Group C (denial, n = 4, 10.0%), including private insurance plans that denied even after multi-level appeals. School-Based Dental Sealants; Licensed Rhode Island Dentists. 2014; 134:609619. Facial Feminization Surgeons - Gender-Affirming FFS Surgeons These letters, in addition to following the WPATH standards of care, are the place to communicate the severity of the dysphoria- does your dysphoria impede activities of daily living, for instance by making you unable to leave for work on time? LGBT legal service projects? Starbucks health insurance plans include not only gender reassignment surgery (which had been covered since 2012), but now also a . See all insurance information. He serves as Division Chief of Plastic & Reconstructive Surgery at Rush University Medical Center in Chicago, and Program Director of the Plastic & Reconstructive Surgery Fellowship. Post Surgery Recovery. These are usually self-insured employer plans which are administered by well-known insurers such as Blue Cross Blue Shield, United Healthcare, Harvard Pilgrim Healthcare, and Tufts Health Plan. Values: "At Kamol Hospital we provide a complete spectrum of fine cosmetic surgical procedures, performed by elite plastic surgeons setting new technological achievements. PDF Gender Confirming/Grs Surgeon List and Resources for Preparing for Surgery Try your local trans advocacy groups, LGBTI legal services, support group, etc. How NOT To Choose Your Facial Feminization Surgeon Furthermore, even in the challenging scenario for insurance authorization reported by Braun and colleagues, Groups B and C also exceed reported estimates. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. Facial Feminization Surgery - Costs - What does FFS cost? - 2pass Clinic Facial Feminization Surgery: A Guide for the Transgendered Woman. Tijuana, Cancun, Mexicali, and Monterrey are some of the more popular cities in Mexico for medical tourism and the flowing procedures: Dental treatments including dental surgery. Facial feminization surgery (FFS) is undertaken to reconstruct masculine facial features to present a feminine form. Dr. Rumer is a board-certified plastic and reconstructive surgeon in the Philadelphia tri-state area who has deep experience with gender reassignment surgery and a practice that is geared exclusively toward transgender patients. . Days, whose birth name was Douglas, came out as transgender in January, 2015. 8. Surgical techniques and analysis of results. Dr. Ellie Zara Ley, MD is an accomplished board-certified plastic surgeon who had more than 15 years of specialized training in plastic, craniofacial and micro surgery before learning the art of Gender Confirmation Surgery. The pre-surgical authorization process for patients in Groups B and C, constituting 60.8% of all private insurance patients in our cohort, is highly time-consuming due to the individual review periods required for each level. Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. a support group of people dealing with similar issues to you to help keep up your strength and spirits throughout planning and recovery. Conveniently Located to Serve Chicago and Illinois. Thus, coverage significantly increases accessibility. Woolhandler S, Campbell T, Himmelstein DU. Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. 2. 2018; 319:691697. Plast Reconstr Surg. Though WPATH has released the new SOC, it will take insurance companies time to evolve. However, the cost can range from $1,847 to $62,000, depending on a few key factors. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Privacy Policy (Updated December 15, 2022). Support groups? As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. Insurance For Facial Feminization Surgery | Allure Esthetic San Francisco, CA 94108. She has the skill and artistry to help produce the aesthetic goals that transgender and non-binary patients seek with Top Surgery, Breast Augmentation and Facial Gender Confirmation Surgery. Starbucks offers expanded benefits for trans people Find Dental Health Services: Department of Health - Rhode Island When it comes to facial feminization there is no substitute for experience. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. Based on my conversations with friends who are very satisfied with their FGCS, I assure you that no surgery can completely resolve that anxiety. *. 50% of transgender women either had or wanted facial feminization (surgery to make a face appear more feminine). As gender dysphoria is highly individual, such procedures will vary by anatomical areas associated with dysphoria for each individual patient as well as decision-making from the treating surgeon. By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. Research that Matters. Do you have out of network benefits, or are you limited to providers in the network? Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. The structure of this system sucks, but it's the one in which you find yourself and it is your responsibility to make it work for you. Health insurance Medical Policies - Trans Health Project Top facial feminization surgeons will typically undertake 2-3 facial full feminization procedures a week, this equates to at least 100 or more a year. Dr. Satterwhite is a board-certified Plastic and Craniofacial Surgeon in San Francisco who is dedicated to offering the highest level of surgical care to the transgender community. He has been performing gender surgery since 2005. Estimated costs of obtaining insurance approval for FFS (B). (link is external) for CGSP. ENQUIRE NOW. Facial Feminization Surgery: Everything You Need to Know - Verywell Health Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Lastly, a third subgroup of patients (Group C), all with private insurance, were denied for surgery despite multi-level appeals, peer-to-peer discussions, and IMR. Transgender health care coverage | HealthCare.gov 2015; 136:560e561e. In practice for more than 20 years, Dr. Salgado performs all aspects of transgender surgeries, from Facial Feminization and Top Surgery, to complex genital procedures such as Vaginoplasty and Phalloplasty. I always advise people to try with the insurance they have before they switch to another plan. For people without local connections, the facebook group, FFS Facial Feminization Surgery / Transgender TG TS and the FFS Forums on susans.org are good places to seek community support as well. Only patients with insurance authorization decisions were included in this study (n = 40). Submission and review of IMR (1 month). Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. HB2084 (2016) bans gender identity discrimination in health insurance and HB2405 (2022) bans categorical exclusions for gender-affirming care under any health plan, though the law does not . An estimated 10 patients (25.0%), all with private insurance, underwent an extended approval process requiring multi-level appeals and denial overturn after IMR and frequently, state intervention. They will need letters of support from you for the preauthorization, following WPATHs Standards Of Care.
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