Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. Dr. Freet accepts both insurance and Medicare. Error bars denote standard error. 2016; 137:438448. Facial Feminization Surgery: What You Should Know - Healthline Days, whose birth name was Douglas, came out as transgender in January, 2015. Transgender people report years of battles for health insurance coverage Based in Beverly Hills, California, Dr. Lee is as well-known for her surgical precision as she is for the compassion, care and understanding that she has for all of her patients. 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. Only if your insurance provider authorizes a Letter of Agreement. Co-insurance past that? 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. Out-of-pocket costs for FFS. Forehead (frontal bone recontouring, recontouring of superior orbital rim, hairline lowering). Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. PDF Healthcare Laws and Policies: Medicaid Coverage for Transgender-Related Hoang H, Bertrand AA, Hu AC, et al. All patients with public insurance (Medi-Cal or Medicare) as well as a small subset of private insurance plans were approved after initial submission of authorization request or did not require approval before surgery (Medicare) (Fig. 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. FGCS is a treatment for gender dysphoria related to the secondary sex characteristics in the face, not a treatment for anxiety caused by the experience of having gender dysphoria or being a transgender person in an unkind world. JAMA. 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. We're gonna try really hard to get my insurance to cover it, but I'm not holding my breath. Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. However, this is starting to change. Ann Plast Surg. FHS/FFS (Facial Harmonization Surgery / Facial Feminization Surgery) Metoidioplasty/Phalloplasty Vaginoplasty/Vulvoplasty Classes cover the following material: Surgical options and techniques Surgery planning and pathway at Kaiser Post-operative care and recovery Most sessions also include a patient panel Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Dr. Thomas Satterwhite Now you will be denied! Starbucks offers expanded benefits for trans people 5. For example, there are now many hospitals across the . 4. 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). You need to come in for an in-person consultation AND pay a deposit to secure your surgery datebeforewe will submit for prior authorization. Facial Feminization Miami | The Maercks Institute Frequently Asked Questions | Facial Feminization Surgery | Dr Keojampa Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. Procedures requested for facial feminization insurance authorization are detailed in Table 2. Second, while complications are not high in FFS, they may occur. Dr. Satterwhite works exclusively with trans women, trans men and non-binary patients seeking Gender Confirmation procedures such as Vaginoplasty, Facial Feminization, and FTM Top Surgery. 1). Because Medicare patients (n = 4) do not need prior authorization, they were excluded from the time and cost analysis of the insurance appeal process for Group A. Facial feminization surgery - Doctors & Departments - Mayo Clinic We will commonly prescribe you with medications for common post-surgical side effects such as pain, nausea, and constipation. Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. 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 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. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization. Furthermore, even in the challenging scenario for insurance authorization reported by Braun and colleagues, Groups B and C also exceed reported estimates. Surgery referral assessment requirements | Gender Affirming Health Program With a forehead reduction, our aim is to reduce a prominent brow or forehead bossing. Dr. Mangubat is a board-certified cosmetic surgeon in the Seattle area who has been performing transgender surgery procedures for over twenty years. Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Transgender health care coverage | HealthCare.gov (link is external) for CGSP. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Does Medicare cover gender reassignment surgery? - Medical News Today Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. 2018; 153:609616. generic exclusions referenced under "general surgery guidelines" and "cosmetic procedures." South Dakota (0) State Medicaid has no . 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. Submission and review of physician-initiated appeal (1 month); 3. Dr. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle Facial Feminization Surgery | Michigan Medicine - U of M Health 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. Facial Feminisation Surgery | Nuffield Health Submission and review of initial authorization request (1 month); 2. As an example, the typical timeline for our Group B and C patients is as follows: 1. Facial feminization surgery, or FFS, describes a set of complex procedures designed to "feminize" the face. Facial Feminization Surgery Timeline - Gender Confirmation 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. 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. Before getting into the nitty gritty details, let me be real with you, and let me be hopeful. Find a Surgeon for Gender Affirming Surgery - TransHealthCare The Case For Facial Feminization Surgery - BuzzFeed News 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. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Post Surgery Recovery. 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. See all insurance information. . Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. FFS: money and choosing a surgeon : r/Transgender_Surgeries Privacy Policy (Updated December 15, 2022). Jess Ting - Plastic and Reconstructive Surgery | Mount Sinai - New York Home Profiles Mount Sinai Doctors Video Visit Available Accepting New Patients Jess Ting, MD Plastic and Reconstructive Surgery 4.6 Star s | 32 Responses CTMS 212-870-8270 View location details Book an Appointment About Me Clinical Focus Video Education & Certifications Awards I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). Administrative costs associated with physician billing and insurance-related activities at an academic health care system. 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 is the term given to a collection of procedures designed to make facial features more feminine. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. Notes. 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. As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. Dr. Facial Feminization Surgery, FFS Minneapolis and - Omni Cosmetic Health Insurance Utilizing coverage under a health insurance plan is often the most affordable way to pay for FFS. Ask them how many FFS surgeries they perform within a year. Copyright TransHealthCare.org & Trans Media Network, 2011-2022. 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. Facial Feminization Surgery: A Guide for the Transgendered Woman. 12. Temporal trends in gender-affirming surgery among transgender patients in the United States. Physician wages across specialties: informing the physician reimbursement debate. The generalizability of the findings presented here is limited by state laws. 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 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. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. 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. P < 0.05 was considered significant. 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. Facial Feminization Surgery - A Complete Guide to FFS - DESCHAMPS-BRALY Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. Transgender women may choose FFS as part of their male-to-female transition process. What's your out of pocket max? 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. 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. These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. 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. Care Credit approval amounts can vary from person to person. Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. These procedures may include: Tummy tuck, called abdominoplasty. FFS is a cost-effective intervention that needs to be covered by insurance policies. During his plastic surgery residency, Dr. Esmonde worked in the Transgender Health Program at OHSU. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. Although your FFS may not be covered by your insurance company its definitely worth doing the research. Our current work highlights the high likelihood of success in FFS coverage under insurance in California, but also details the challenges that plastic surgeons and plastic surgery practices incur for coverage to occur. FFS may include a brow lift, cheek augmentation, rhinoplasty, and lip augmentation. 2014; 134:609619. Dr. Mangubat specializes in Top Surgery, Breast Augmentation and Body Sculpting, Gender Confirming Facial Surgery and Hair Grafting. Administering cosmetic fillers may take an hour or less, while complex facial surgery may take several hours. Upon denial, an IMR is requested directly from the insurance plan. Included in Appendix D are the new letter referral suggestions for gender-affirming surgery (GAS). In addition to legislative changes, the rationale for increasing coverage may be related to calculations on the cost-effectiveness of coverage. Requiring letters from therapists and physicians appeals to some hospitals, surgeons, and care providers, who may look at this system as legally defensible if necessary. Facial Feminization | Dr. Patel Chicago | MTF Facial Plastic 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. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon 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. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. Want to use our data? The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Are there transgender advocacy groups? 2). $4985. 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. If there is a section on transgender care that explicitly denies coverage for the procedures in Facial Gender Confirming Surgery, as many do, you can still attempt to advocate for them to be deemed medically necessary. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. Some error has occurred while processing your request. 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. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. Dr. Javad Sajan, MD is a Cosmetic, Plastic and Reconstructive Surgeon in Seattle who specializes in Gender-Affirming Surgery including Top Surgery, Breast Augmentation, Body Sculpting and Facial Feminization. Disclosure: All the authors have no financial interest to declare in relation to the content of this article. Group A averaged 1.1 months for approval, requiring 1.4 hours of administrative time translating to $38.18 per patient. 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? Facial feminization surgery: the forehead. 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. Feminizing surgery - Mayo Clinic Woolhandler S, Campbell T, Himmelstein DU. Plast Reconstr Surg. You should be able to have easy access to this document through your insurance provider. 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? One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. 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. 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. Body-contouring. 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 differences between male and female facial features vary with age, ethnicity, and how early hormonal therapy began. Health insurance is unnecessarily difficult when it comes to gender affirming surgery.