However, some insurers are beginning to cover FFS from select surgeons. You should be able to have easy access to this document through your insurance provider. 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). Gender-Affirming Surgery: Original Article. Facial Feminization Surgery - Costs - What does FFS cost? - 2pass Clinic P. Daniel Knott, MD, and Andrea Park, MD from the UCSF Facial Plastic Surgery practice in the Division of Head & Neck Surgery. 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. The Ins & Outs of Traveling Abroad for FFS Surgery This might be the hardest part- no one should have to compromise quality, and the big names in FGCS have historically not taken insurance, though its my observation that this is rapidly changing. Ultimately this letter is between you and your provider, but here is some sample language that has been helpful to patients I've worked with: "Patient X has been adherent to two years of hormone replacement therapy including (specific estrogen regimen.) *, Time and cost of the insurance approval process for FFS. For example, a number of state-mandated denial overturns in Group B patients resulted in billing challenges postsurgery. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. In addition to following WPATHs SOC format, it is helpful if it is specifically tailored to FGCS. Additionally, the patients who exited their employer-based plans to buy health insurance on the exchange paid more for health insurance by foregoing employer contributions. Surgical Staff: 13 surgeons, each specialized in surgery ranging from plastic to maxillofacial surgery. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Yet, a number of studies have demonstrated that FFS is not only associated with improvement in quality of life for transfeminine patients, but also, for some patients, the most important aspect of transition.47 Although significant barriers exist, an improvement in insurance coverage for FFS has occurred over time, albeit navigation of the process is both laborious and confusing. See all insurance information. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. Plans that fall into this group include Medi-Cal, Medicare, and some private insurance plans. Plast Reconstr Surg. Now you will be denied! Listings for surgeons outside of the New York area are compiled only for surgeons who perform some combination of genital surgery or FGCS, . These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. JAMA. Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. 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.). (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. 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. Do you have a deductible to meet? Plastic surgeons at Michigan Medicine are proud to provide Facial Feminization Surgery. Historically, FFS hasn't been covered by health insurance or government healthcare. LGBT legal service projects? Our practice does NOT contract with any insurance providers to allay the cost of your 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. The generalizability of the findings presented here is limited by state laws. There are 301 level topics not covered here- going out of network to an office who will only give you CPT codes performed, getting a network exception to go to a provider with skills not available among in-network surgeons, etc. Procedures requested for facial feminization insurance authorization are detailed in Table 2. Please first read this resource for a general overview of insurance utilization for trans surgery. 2020; 8:e2618. Please read a few important elements consider when booking. In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Any reimbursement from the insurance company (if any) would be paid directly to the patient. James S, Herman J, Rankin S, et al. The benefits of such coverage far exceed the insignificant costs. After a person pays the deductible, Medicare pays 80% of the allowable costs . Facial Feminization Surgery (FFS) Preparation Guide. FFS is a cost-effective intervention that needs to be covered by insurance policies. The United States . 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. Facial Feminization Surgery Before & After Pictures - RealSelf 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. 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. 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. https://links.lww.com/PRSGO/B647.). 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. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. Location: Bangkok, Thailand. to maintaining your privacy and will not share your personal information without Copyright TransHealthCare.org & Trans Media Network, 2011-2022. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Only patients with insurance authorization decisions were included in this study (n = 40). 4. 2). You will be asked to complete an intake questionnaire before your consultation. Facial Feminization | Dr. Patel Chicago | MTF Facial Plastic Surgery However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Received for publication February 2, 2021; accepted February 27, 2021. One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. 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. Bottom Surgery: Cost, Recovery, Procedure Details, and More - Healthline Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Facial feminization surgery (FFS): The permanent . In most cases, it is still extremely difficult to get your FFS surgery reimbursed by your insurance. Starbucks health insurance plans include not only gender reassignment surgery (which had been covered since 2012), but now also a . Frequently Asked Questions | Facial Feminization Surgery | Dr Keojampa Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. Dr. Leys multiple plastic surgery sub-specialty fellowships and gentle manner allow her to provide superb surgical care for transgender and non-binary patients. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. Some insurance providers to provide coverage for facial feminization surgery and we will attempt to receive an approval for the procedures from . Everyone who is able to fight through it cracks the door open a little wider for the next person. Read on to find out why you might pay more or less, and whether the cost is really worth it. Wolters Kluwer Health 6. 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. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. The work cannot be changed in any way or used commercially without permission from the journal. These procedures may include: Tummy tuck, called abdominoplasty. ENQUIRE NOW. The Case For Facial Feminization Surgery - BuzzFeed News In total, 4 patients (10.0%) were ultimately denied despite multi-level appeals and IMR requests. 6. Doctors and surgeons trained in facial feminization surgery are working to improve care for people living with gender dysphoria. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. The surgeons listed below are highly qualified plastic, reconstructive, craniofacial, maxillofacial and cosmetic surgeons who offer gender-affirming facial surgery. Additionally, planning and recovering from any trans surgery is hard! These patients underwent a standard approval process no different from other reconstructive procedures (Group A). Transgender people report years of battles for health insurance coverage Dr. Dulin is a board-certified surgeon with many years of experience performing Top Surgery, Metoidioplasty, Breast Augmentation, FFS and Orchiectomy. Costs of health care administration in the United States and Canada. 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. Each letter should state "this procedure is medically necessary treatment. With all letters, I advise providers to be as authoritative in their tone as possible, and to explicitly claim an expert status if appropriate. How Much Does Facial Feminization Surgery Cost? | RealSelf Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. We identified all patients with gender dysphoria consulted for FFS under a single surgeon (JCL) at the University of California Los Angeles between January 2018 and February 2020 (n = 55). Dr. Mangubat is a board-certified cosmetic surgeon in the Seattle area who has been performing transgender surgery procedures for over twenty years. PDF Healthcare Laws and Policies: Medicaid Coverage for Transgender-Related 2018; 153:609616. Prior to meeting with the social worker, patients should complete this assessment document. Regardless, I recommend that you fight everything out in the preauthorization/pre service review process, and not after you have already paid and might be left holding the bill. These surgeries can reduce the size and shape of the forehead, alter and refine the nose, make the lips fuller and . 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. Surgical techniques and analysis of results. Requires supporting documentation that indicates specific type of FFS procedures requested. Dr. Charles Shih. 13. Policy Issued By: Anthem. According to the Philadelphia Center for Transgender Surgery,. Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. 2015; 136:560e561e. 15. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. On average, the authorization process required approximately 1 month to complete and cost on average $38 worth of time to coordinate administratively. 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. Dr. Alan Dulin is a board-certified surgeon with many years of experience performing Male-to-Female Surgery in the Dallas area. If they have referenced expert guidelines or current research in devising your care plan, they should state that and provide citations. Call 913-588-6200 to request a consultation. Paying for Transgender Surgeries - Investopedia The standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. Dr. Harris is a highly skilled, board-certified Surgeon in the Dallas area who has been developing an international reputation for transgender surgery. 3). Most trans women elect to have all facial feminization procedures performed at once, or in two phases (upper face and lower face). However, this has been a persuasive strategy in some cases. 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). These investigators reported patient satisfaction following facial feminization surgery, including outcome measurements after forehead slippage and chin re-modeling. Arch Intern Med. Dr. Youssef is a top Cosmetic Surgeon in the greater Los Angeles area and Director of the Transgender Surgery Institute of Southern California. 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. Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. Her surgery was performed by a craniofacial surgical team called the FACIALTEAM. Facial Feminization Surgery Cost - American Society of Plastic Surgeons Gender-Affirmation Surgery | Transgender Surgery | The University of Ask them how many FFS surgeries they perform within a year. In the standard approval process (Group A), patients were under both public and certain private insurance plans (39% of all privately insured patients in the cohort). The analysis was done by identifying individual steps involved in the insurance process (Fig. 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. 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. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. 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. For self-pay patients, cost will frequently dictate the operative and postoperative setting such that patients may be preferentially or solely performed in an outpatient setting. Your message has been successfully sent to your colleague. Facial Feminization Surgeons - Gender-Affirming FFS Surgeons Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. Available at: 2. This guide is 201 level, geared towards those who find themselves covered with an ACA exchange plan or private insurance, as Medicaid processes are much more state specific. 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. 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. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. Plastic and Reconstructive Surgery Global Open9(5):e3572, May 2021. All rights reserved. A total of 36 patients (90.0%) have been approved by insurance. Simplifying facial feminization surgery using virtual modeling on the female skull. FFS may include a brow lift, cheek augmentation, rhinoplasty, and lip augmentation. Subsequently, the process typically follows one of three paths: Group A (standard approval), Group B (extended approval), and Group C (denial). For trans men, women and gender-nonconforming clients in Los Angeles, Santa Monica, San Diego and elsewhere in Southern California, Dr. Youssef offers Top Surgery, Breast Augmentation and Facial Feminization Surgery. These IMRs are often requested through the California Department of Managed Healthcare resulting in state-mandated overturn of the insurance decision, or less commonly, through the insurance company for ERISA or self-insured plans which do not fall under state jurisdiction. 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. 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.

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