Disclosure: All the authors have no financial interest to declare in relation to the content of this article. 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. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. They submit their own information, information about the procedure being performed, and information about you. You will be asked to complete an intake questionnaire before your consultation. Patients seeking services from our practice are personally and fully responsible for payment of all fees and costs related to your FFS surgery and medical care. 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. Insurance authorization process for FFS.The insurance authorization process for FFS begins with submission of two letters of support from a mental health provider and primary care physician following surgical consult. 3). Lastly, the time consumption, costs, and difficulties to the patient were not assessed. Please read a few important elements consider when booking. 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. To access this service, refer to the process below: Fill out and return the Service Inquiry Form. 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. Patients who are definitively denied (Group C) may then exit their employer-based plan and switch to a plan under California jurisdiction on the health insurance exchange. Justine C. Lee, MD, PhD, FACS, University of California, Los Angeles, Division of Plastic and Reconstructive Surgery, 200 Medical Plaza, Suite 460, Los Angeles, CA 90095-6960, E-mail: [emailprotected]. As many professions say, past performance does not guarantee future results. However, the tide of change is beginning to roll in- often where Medicaid begins, private plans will be forced to follow, so the clear coverage in California and New York bodes well for everyone. JCL is additionally supported by the US Department of Veterans Affairs under award number IK2 BX002442 and the National Institutes of Health/NIDCR R01 DE0289098. In addition, many of them don't take insurance. to maintaining your privacy and will not share your personal information without Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. 1. As an example, the typical timeline for our Group B and C patients is as follows: 1. In fact, he is one of the most experienced gender surgeons in the world. These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. Find Dental Health Services: Department of Health - Rhode Island Coordinating presurgical authorization required an average of 7.8 1.5 hours per patient for the administrator and 4.3 0.5 hours per patient for the attending craniofacial surgeon to navigate multi-level appeals. However, this has been a persuasive strategy in some cases. Have your facial features compromised your safety, making you a target for harassment and violence? 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. Health insurance is unnecessarily difficult when it comes to gender affirming surgery. It's hard for any person to find their voice to self-advocate when such deeply personal needs are up for debate and judgement as "cosmetic" among random insurance company reviewers. Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps. Dr. Ley has joined Dr. Scott Mossers Gender Confirmation Center in San Francisco, where she will begin seeing patients in March 2022. 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. Doximity. Total Staff: 34. 3. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Insurance Coverage for FFS Surgery abroad Medical inequality for trans people means that access to quality trans healthcare is absent or limited in many regions. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. How Do I Pay For Facial Feminization Surgery? - drbastidas.com Please keep track of the mail being sent to the address on file with insurance, as you often are only able to appeal within certain time frames from the initial decision. I tell everyone to plan for an initial denial- even if FGCS is covered in your plan clearly, its likely that portions of the procedure will be denied as cosmetic. Everyone who is able to fight through it cracks the door open a little wider for the next person. The United States . Read your cover in detail and find out the following: Second, find out if yourCertificate of Coveragehas any inclusions (or exclusions) around transgender care. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . Using Insurance for Facial Gender Confirming Surgery or "FFS" Dr. Freet accepts both insurance and Medicare. Read on to find out why you might pay more or less, and whether the cost is really worth it. Some error has occurred while processing your request. Hormone therapy alone has not sufficiently treated her gender dysphoria, and the next step in her treatment plan is Facial Gender Confirming Surgery." Post Surgery Recovery. Brow Lift. Facial feminization surgery (FFS) uses a series of procedures to alter features to appear more classically female. 2019; 144:11591168. 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. Facial Feminization Surgery (FFS) in Thailand - MyMediTravel Insurance For Facial Feminization Surgery | Allure Esthetic Allure Esthetic & Insurance Coverage For FFS Allure Esthetic is Washington State's top destination for facial feminization surgery. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. There are a few limitations in this study that deserve mention. Choose from multiple implant types and sizes. a support group of people dealing with similar issues to you to help keep up your strength and spirits throughout planning and recovery. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Tseng P, Kaplan RS, Richman BD, et al. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. In September 2022, WPATH released the Standards of Care (SOC) version 8, for trans and gender-diverse medical and mental healthcare. Plastic surgery on the face. 14. Second, while complications are not high in FFS, they may occur. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Dr. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle 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*,. 1. Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. 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. For example, there are now many hospitals across the . Cost of Facial Feminization Surgery (FFS) and Insurance Information He is the first surgeon in New Jersey to offer the full range of gender-affirming procedures, including Top Surgery, Phalloplasty, Vaginoplasty and Facial Feminization Surgery. Based on my conversations with friends who are very satisfied with their FGCS, I assure you that no surgery can completely resolve that anxiety. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. Co-insurance past that? See all insurance information. Until then, CCTS will continue to require all patients using insurance for . Start with ensuring that you have an in-depth understanding of your insurance benefits. 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. Among the total cohort, most patients had private insurance (n = 23, 57.5%), followed by Medi-Cal (n = 13, 32.5%), and Medicare (n = 4, 10.0%). Dr. Alan Dulin is a board-certified surgeon with many years of experience performing Male-to-Female Surgery in the Dallas area. Ann Plast Surg. I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. Forehead (frontal bone recontouring, recontouring of superior orbital rim, hairline lowering). Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. https://links.lww.com/PRSGO/B648.). your express consent. This denial should also lay out your options for appeal- both internal (basically, asking the insurance company to reconsider) and external. A total of 36 patients (90.0%) have been approved by insurance. 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. FFS may include a brow lift, cheek augmentation, rhinoplasty, and lip augmentation. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. The benefits of such coverage far exceed the insignificant costs. 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. $4985. . A number of patients had multiple consultations, some consulted legal assistance, and, particularly patients in Groups B and C, some experienced significant distress over the repetitive denials and lack of clarity in the end result of the process. 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. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. Transgender health care coverage | HealthCare.gov 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. 5. These delicate procedures change the male facial patterns to a softer, feminine appearance. Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. Transgender women may choose FFS as part of their male-to-female transition process. 2015; 136:560e561e. 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. Read more about our Clinics Finance and Insurance Policy here. Dr. Thomas Satterwhite Paying for Transgender Surgeries - Investopedia Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Look here for licensed dentists practicing in the state. In addition to administrative time, multi-level appeals required time from the attending craniofacial surgeon for peer-to-peer reviews, writing appeal letters, and patient counseling over the 6-month period, in total averaging 3.6 0.5 hours per patient. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). Only patients with insurance authorization decisions were included in this study (n = 40). Doctors and surgeons trained in facial feminization surgery are working to improve care for people living with gender dysphoria. Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). For Bay Area trans women, facial feminization surgery helps complete 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. He currently performs approximately 200 genital reconstruction surgery cases per year in Scottsdale, Arizona and Portland, Oregon. The addition of multi-level appeals in Groups B and C increased the total time for a definitive decision (7.0 and 5.1 months, respectively) and required both surgeon and administrative time to navigate the process (10.8 and 12.0 hours, respectively). Your insurance might have a requirement about length of time in care with them, or degree level. Facial Feminization Surgery: What You Should Know - Healthline 2016. Furthermore, even in the challenging scenario for insurance authorization reported by Braun and colleagues, Groups B and C also exceed reported estimates. School-Based Dental Sealants; Licensed Rhode Island Dentists. This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. 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. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. Similarly, while Medicare does not require an authorization process to move forward with surgery, we have experienced significant billing challenges postsurgery. Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. If they are a member of WPATH or other applicable professional associations, they should name that.