You need an understanding of your insurance benefits in general: What would any covered surgery cost you? For example, there are now many hospitals across the . Facial Feminization Surgery (FFS) | Johns Hopkins Medicine Qual Life Res. Submission and review of initial authorization request (1 month); 2. The analysis was done by identifying individual steps involved in the insurance process (Fig. Please first read this resource for a general overview of insurance utilization for trans surgery. Dr. Facque joined the Gender Confirmation Centers team in September 2020 as a full-time Associate Surgeon specializing in Facial Gender Confirmation Surgery, Top Surgery and Body Contouring. A letter from your primary care provider or whoever prescribes your hormones. Dr. Thomas Satterwhite Gender-Affirming Surgery: Original Article. This study highlighted the successes and burdens associated with obtaining insurance authorization for FFS. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. Read more. $8995. 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. Unlike California-insured plans, job-based plans which are self-insured, also called Employee Retirement Income Security Act (ERISA)-plans, a second-level, patient-initiated appeal is typically required. Wolters Kluwer Health He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. This means that the surgeon is either already in network with your insurance and is willing to send a prior authorization, or has an office willing to do the legwork of doing a letter of agreement with your insurance. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Doximity. Total Staff: 34. Plastic and Reconstructive Surgery Global Open9(5):e3572, May 2021. Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. In Patient X's case, she has achieved the full extent of facial feminization that can be expected with hormone therapy. Starbucks offers expanded benefits for trans people I always advise people to try with the insurance they have before they switch to another plan. After a person pays the deductible, Medicare pays 80% of the allowable costs . Insurance For Facial Feminization Surgery | Allure Esthetic Body-contouring. A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. The total time from initial consultation to authorization approval in Group B required 7.0 1.1 months, a 6-fold longer process compared with Group A patients (P < 0.001) (Fig. Insurance and facial feminization surgery - 2pass Clinic Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. Facial Feminization Surgery under Insurance: The University - LWW Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. Dr. Hadeeds practice now has two locations: Beverly Hills, California and Miami, Florida. Error bars denote standard error. 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. information about insurance coverage: video.transcendlegal.org 2. 2018; 153:609616. 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. Your insurance might have a requirement about length of time in care with them, or degree level. Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. However, the cost can range from $1,847 to $62,000, depending on a few key factors. A total of 33 patients between 19 and 40 years of age were referred for facial feminization surgery between January of 2003 and December of 2013, for a total of 180 procedures. Doctors and nurses take good care. Do you have a deductible to meet? Health insurance Medical Policies - Trans Health Project 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. This operation is most commonly performed in transgender women or non-binary people as a type of gender-affirming surgery. Lastly, FFS coverage also allows for inclusion of technologies, such as virtual modeling and surgical planning, which may be cost prohibitive in self-pay patients despite evidence that accuracy is improved.10,11. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Thus, specifying any one procedure as medically necessary while excluding other facial procedures reflects a lack of understanding of the nature of the diagnosis. Dr. Mangubats excellent surgical skills, experience and dedication to transgender health have made him the most sought after surgeon for transgender surgery in the Pacific Northwest. Dr. KathleynBrandstetter. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. Are there transgender advocacy groups? Bariatric Surgery. LGBT legal service projects? Surgical techniques and analysis of results. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon P. Daniel Knott, MD, and Andrea Park, MD from the UCSF Facial Plastic Surgery practice in the Division of Head & Neck Surgery. 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. Ask to speak to people's supervisors. Call 913-588-6200 to request a consultation. See the list at the end of this article for surgeons who will accept some form of insurance benefits directly.What makes someone a FGCS surgeon anyway? However, California state law stipulates gender non-discrimination in health insurance, thus, Medi-Cal covers all procedures performed specifically for the purposes of gender affirmation. An estimated 90% of all patient consults were approved for FFS under insurance. Plast Reconstr Surg. Facial Feminization Surgery Cost - American Society of Plastic Surgeons 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. As stated above, all patients within this group were covered by private insurance plans that were not within the purview of the State of California and, thus, were not eligible for state intervention. Care Credit approval amounts can vary from person to person. The total costs of your Facial Feminization Surgery will be determined by the staff of the University of Miami. Dr. Hadeed is a board-certified surgeon who specializes in Transgender Surgery, including chest/breast procedures, facial surgeries and body sculpting for both trans men and women. Until then, CCTS will continue to require all patients using insurance for . Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. Received for publication February 2, 2021; accepted February 27, 2021. Brow Lift. 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? Dr. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle It involves plastic surgery techniques in which the jaw, chin, cheeks, forehead, nose, and areas surrounding the eyes, ears or lips are changed to create a more feminine appearance. I recommend the pioneer of FGCS, Dr. Douglas Ousterhouts book, Facial Feminization Surgery: A Guide for the Transgendered Woman for those looking to learn more about what skill and training is involved and a breakdown of procedures as he performed them, but Ill attempt to summarize. Your message has been successfully sent to your colleague. 6. Facial Feminisation Surgery | Nuffield Health Post-surgery garments; Medical tests and x-rays; When choosing a board-certified plastic surgeon for facial feminization surgery, remember that the surgeon's experience and your comfort with him or her are just as important as the final cost of the surgery. Find Dental Health Services: Department of Health - Rhode Island Read more on our Insurance and Finance page. On average, the authorization process required approximately 1 month to complete and cost on average $38 worth of time to coordinate administratively. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Facial Feminization Surgery A Complete Guide to FFS, Fat Transfer for Facial Feminization (FFS), Cheek Enhancement (Augmentation & Reduction), Ethno-Specific Facial Feminization Surgery, Forehead Reshaping (Contouring & Reduction), Chin Contouring (Genioplasty/Mentoplasty), Read more about our Clinics Finance and Insurance Policy here, Cheek Enhancement: Augmentation and Reduction, Adams Apple Surgery Augmentation via Natural Implant, Anesthesia and operating room fees (both of which are charged by the duration of time used), Any additional planning/coordination to complete the surgery (VSP, Orthodontic treatment, etc. Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. 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. The Group C authorization process, which resulted in denial of services, consumed a 9-fold higher amount of time (P < 0.001) and 26-fold higher cost (P < 0.001) when compared with Group A (Fig. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. Facial Feminization in Korea - Everything You Need to Know! 4. Average time spent from administrator and surgeon in obtaining insurance approval for FFS (A). Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. 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. Dr. Facque is a board-certified plastic surgeon in San Francisco, California who started providing gender-affirming care in 2012 and has worked exclusively with transgender and non-binary patients since 2020. Jess Ting - Plastic and Reconstructive Surgery - Mount Sinai Health System The blossoming of academic medical centers offering transgender surgical care also means that more well respected surgeons, with appropriate craniofacial and maxilliofacial reconstructive training, are able to do procedures through insurance. Private insurances included health maintenance organizations and preferred provider organization. The format for an appeals process and regulations/law/policy to cite within it vary widely depending on the mix of state and local regulations that apply to your specific plan. 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. This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. 12. 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. 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. Notes. Requires supporting documentation that indicates specific type of FFS procedures requested. You will be asked to complete an intake questionnaire before your consultation. may email you for journal alerts and information, but is committed Two letters from mental health providers. $4985. 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. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Jaw contouring contours the mandible and narrows a full jaw by reducing angles in the lower face. 2014; 134:609619. There are a few limitations in this study that deserve mention. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . Societal implications of health insurance coverage for medically necessary services in the U.S. Transgender population: a cost-effectiveness analysis. I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. 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. If performed all at once, FFS usually takes between 4- 8 hours. What's your out of pocket max? Hu, Allison C. BA*; Dang, Brian N. BS*; Bertrand, Anthony A. MD, MBA*; Jain, Nirbhay S. MD*; Chan, Candace H. BS*; Lee, Justine C. MD, PhD, FACS*,. Find a Surgeon for Gender Affirming Surgery - TransHealthCare Research that Matters. This could include either shaving down or entirely re-contouring the forehead/eyesockets/sinus area using osteotomies (cutting and repositioning bones), shaving the jaw line or a sliding genioplasty (reduction and/or re-positioning of the jaw bone), lifting the upper lip, rhinoplasty (nose job), and bringing the hair line further forward, in addition to other various soft tissue facial adjustments and reduction of the adams apple. Surgeons who practice facial gender confirming surgery often have special training in reconstructing facial features using bone grafting beyond a traditional plastic surgery residency. Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. In total, the time and cost estimate of the insurance appeal process was 10.8 1.0 hours and $855.00 91.53 per patient, respectively. Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. How NOT To Choose Your Facial Feminization Surgeon You may be trying to access this site from a secured browser on the server. Transgender women may choose FFS as part of their male-to-female transition process. Best Rated Facial Feminization Surgeon (FFS) in the World In most cases, it is still extremely difficult to get your FFS surgery reimbursed by your insurance. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Facial Feminization Surgery provides dramatic changes to the male face which helps facilitate Male to Female (MTF) Transgender patients to fully live in the female role and be perceived as a woman with confidence. The standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). 2016; 31:394401. We are often asked by our patients about the cost offacial feminizationand if their health insurance will cover them for thevariety of proceduresincluded in their surgery. 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. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Price on request Facial Feminization Surgery (FFS) View details & Read reviews CALL NOW. Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. Facial Feminization Surgery FFS Insurance Coverage Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Facial feminization surgery, or FFS, describes a set of complex procedures designed to "feminize" the face. *. It can be just as important or even more important than sex reassignment surgery (SRS) in reducing gender dysphoria and helping trans women integrate socially as women. Temporal trends in gender-affirming surgery among transgender patients in the United States. Dr. Andrew Kleinberger. Subsequently, in California-insured plans, an IMR is then requested from the California Department of Managed Healthcare (CA DMHC). These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. 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. 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. Tate, who has been with Starbucks for 15 years and now manages a store in Austin, Texas, is one of a growing number of Starbucks partners who have used the company's leading-edge benefits for transgender partners. Plast Reconstr Surg. Gender-Affirming Surgery Information - East Bay Location: Bangkok, Thailand. If it is substantial, they should name their years of experience working with transgender patients. Now you will be denied! Among the 26 patients (65.0%) who underwent the standard approval process, 13 patients had Medi-Cal, 4 patients had Medicare, and 9 patients had private insurance. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 360 Post St. Suite 901 Privacy Policy (Updated December 15, 2022). Descriptive statistics were performed for demographic variables. To access this service, refer to the process below: Fill out and return the Service Inquiry Form. Only patients with insurance authorization decisions were included in this study (n = 40). Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. Historically, FFS hasn't been covered by health insurance or government healthcare. She believes in a shared vision and works closely with her patients to deliver the best quality care that is in line with their needs. 6. 10. In NY, we have the benefit of a clear history of coverage through Medicaid, and plenty of pro-bono legal teams able to help patients with denials. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. 816-305-0943 Insurance Note:Utilizing insurance for Facial Feminization and Breast Augmentation procedures - Our office is experiencing reimbursement issues (claims NOT being paid by insurance companies) when filing facial feminization procedures and breast augmentation to insurance. Administrative time in this cohort included obtaining initial authorizations, which resulted in an average of 1.4 0.4 hours spent per patient at an estimated cost of $38.18 10.18 per patient (Fig. Once you've identified a surgeon who takes your insurance, ask them to submit a preauthorization. Wolters Kluwer Health, Inc. All rights reserved. Included in Appendix D are the new letter referral suggestions for gender-affirming surgery (GAS). In total, attempting and succeeding at obtaining insurance coverage for FFS is a significant time and cost burden that may be difficult to overcome for a number of plastic surgical practices, suggesting ramifications for patient accessibility.
