His experience in cosmetic and craniofacial surgery makes him an excellent choice for Facial Feminization (FFS) and Masculinization surgeries. The cost of the administrative and attending craniofacial surgeon effort for Groups B and C averaged approximately $900, over 20-fold more than 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. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. https://links.lww.com/PRSGO/B648.) Available at: 9. Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. 1. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into.
Find a Surgeon for Gender Affirming Surgery - TransHealthCare Facial Feminization Surgery (FFS) Miami, FL - Dr. Salgado Facial Feminization Surgery (FFS) | University of Miami Health System With a forehead reduction, our aim is to reduce a prominent brow or forehead bossing. 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. Dr. Mangubat specializes in Top Surgery, Breast Augmentation and Body Sculpting, Gender Confirming Facial Surgery and Hair Grafting. Read on to find out why you might pay more or less, and whether the cost is really worth it. Please note that before you can schedule . Historically, FFS hasn't been covered by health insurance or government healthcare. 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. While facial feminization surgery has many potential benefits, the decision to proceed . Dr. Thomas Satterwhite The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure. Brow Lift. Group A (standard approval) included patients who were approved after undergoing a standard authorization process, such as those with Medi-Cal, Medicare, and private insurance. Woolhandler S, Campbell T, Himmelstein DU. Submission and review of initial authorization request (1 month); 2. The generalizability of the findings presented here is limited by state laws. Most other insurance plans do not cover FFS and consider it as cosmetic 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 .
The Case For Facial Feminization Surgery - BuzzFeed News Data is temporarily unavailable.
Facial Feminization Miami | The Maercks Institute Please try again soon. 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. Dr. Freet leads a multidisciplinary team at the University of Texas that performs both male-to-female and female-to-male surgery procedures, including facial and chest surgeries as well as Vaginoplasty, Metoidioplasty and Phalloplasty. LGBT legal service projects? 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. In addition to following WPATHs SOC format, it is helpful if it is specifically tailored to FGCS. Care Credit approval amounts can vary from person to person. 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*,. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. 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.
Insurance and facial feminization surgery - 2pass Clinic There are a few limitations in this study that deserve mention.
Gender Affirming Surgery - Medical Clinical Policy Bulletins - Aetna Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). 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. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. 2019; 144:11591168. 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. Policy Issued By: Anthem.
Cost of Facial Feminization Surgery (FFS) and Insurance Information Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones.
Facial Feminization Surgery: What You Should Know - Healthline 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. This document is a general guide to national resources, but because of the state-specific nature of most insurance regulation, I highly suggest you attempt to reach out to local experts who are better able to advise you to your situation. See all insurance information. After a person pays the deductible, Medicare pays 80% of the allowable costs .
How NOT To Choose Your Facial Feminization Surgeon Transgender people report years of battles for health insurance coverage (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. 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.
Facial Feminization Surgery Timeline - Gender Confirmation 2). Rhinoplasty. Facial feminization surgery (FFS) uses a series of procedures to alter features to appear more classically female. Read this first. your express consent. 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. Bariatric Surgery. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. The time spent on the presurgical authorization process for Groups B and C translated to an over 20-fold increase in cost ($855.00 and $988.38, respectively) compared with Group A. Navigation of the insurance process for FFS is challenging and time-consuming; however, coverage is a reality in California provided that multi-level appeals are exhausted. Some of the procedures included in facial feminization surgery are: Requires supporting documentation that indicates specific type of FFS procedures requested. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Because the plastic surgeon is not paid on an hourly or salary basis, the national average salary was used.8,9 The estimated cost of the insurance process per patient was calculated by combining the hours spent per step and compensation rates. 1). Are there transgender advocacy groups? Facial Feminization Surgery (FFS) is becoming more and more popular, but it can be hard to narrow down the surgeons who best perform these complex surgeries. generic exclusions referenced under "general surgery guidelines" and "cosmetic procedures." South Dakota (0) State Medicaid has no . 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. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. How soon can I book a surgery date? 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. 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. Multiple procedures are typically included as part of gender-affirmation surgery, including facial procedures, top surgery (above the waist) and bottom surgery (below the waist). As with any surgical procedure, there are risks associated with FFS. FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. Though WPATH has released the new SOC, it will take insurance companies time to evolve. Ask them how many FFS surgeries they perform within a year. Until then, CCTS will continue to require all patients using insurance for . In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. Dr. I don't philosophically agree with this. Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Insurances are constantly changing and we cannot make any guarantees concerning insurance coverage or approval. Generally, one provider should have a doctoral level degree (PhD, DSW, Psychiatrist MD) and the other can have a masters level degree (MSW, MHC, etc.) All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). Canner JK, Harfouch O, Kodadek LM, et al. 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).
Dr. Gurjala joined Align Surgical Associates in 2019, after five years of performing gender surgery, microsurgery, and general reconstructive and aesthetic surgery in the Kaiser Permanente healthcare network. If they are a member of WPATH or other applicable professional associations, they should name that. These procedures may include: Tummy tuck, called abdominoplasty. However, its important to be aware that the terms and conditions of many insurance policies do not recognize coverage for the cost of FFS, or may exclude coverage for the services provided to you. 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.
Facial Feminization | Dr. Patel Chicago | MTF Facial Plastic Surgery In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. Error bars denote standard error. For additional assistance with any information contained within this packet, please contact: Oakland MST Department: (510) 752-7149. The differences between male and female facial features vary with age, ethnicity, and how early hormonal therapy began. Out-of-pocket costs for FFS. Have your facial features compromised your safety, making you a target for harassment and violence? 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.
Insurance - International Center for Transgender Care 4. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. In total, 4 patients (10.0%) were ultimately denied despite multi-level appeals and IMR requests. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California. The work cannot be changed in any way or used commercially without permission from the journal. 2018 Physician Compensation Report. As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. Additionally, planning and recovering from any trans surgery is hard! Get a bossy friend to make phone calls with you while you are dealing with the process. Costs of health care administration in the United States and Canada. Dr. Dulin is a board-certified surgeon with many years of experience performing Top Surgery, Metoidioplasty, Breast Augmentation, FFS and Orchiectomy.