$8995. 3). 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. If they are a member of WPATH or other applicable professional associations, they should name that. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. 2). FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. Denver Health to Offer Facial Feminization Gender Confirmation Surgery 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. Despite the time, effort, and costs incurred, 90.0% of patients were approved for FFS under insurance. 3). Patients were stratified into 3 groups by authorization process. Insurances are constantly changing and we cannot make any guarantees concerning insurance coverage or approval. Please try again soon. 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. FFS: money and choosing a surgeon : r/Transgender_Surgeries Plans that fall into this group include Medi-Cal, Medicare, and some private insurance plans. Submission and review of second level, patient-initiated appeal (1 month); 4. 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. You should be able to have easy access to this document through your insurance provider. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon Facial Feminization Surgery (FFS) in Thailand - MyMediTravel Health insurance Medical Policies - Trans Health Project Until then, CCTS will continue to require all patients using insurance for . 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*,. 2020 Deschamps-braly clinic. Group A averaged 1.1 months for approval, requiring 1.4 hours of administrative time translating to $38.18 per patient. A total of 36 patients (90.0%) have been approved by insurance. LGBT legal service projects? 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. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Every state is different so start with Google and reach out to these services in your state, theyre here for you! (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Once CGSP receives your form, you will be referred to Plastic Surgery for a consultation. 2016; 137:438448. Facial Feminization Surgery FFS Insurance Coverage Dr. Esmonde is a plastic surgeon in Portland, Oregon who has extensive knowledge about Gender Affirmation Surgery and works almost exclusively with transgender and non-binary patients. P < 0.05 was considered significant. Plastic and Cosmetic Surgery. 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]. Average months spent from initial facial feminization consultation to final insurance authorization decision. In addition to following WPATHs SOC format, it is helpful if it is specifically tailored to FGCS. Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. No. There are a few limitations in this study that deserve mention. Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. Facial feminization surgery (FFS) is undertaken to reconstruct masculine facial features to present a feminine form. 2018; 80:198204. Upon denial, an IMR is requested directly from the insurance plan. Despite these reports, coverage continues to be variable from state to state, physician to physician, as well as depending on anatomical region. Facial Feminization Surgery: Everything You Need to Know - Verywell Health 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. Transgender health care coverage | HealthCare.gov (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. A surgeon who takes your insurance, hopefully in-network or willing to do the legwork of a single case agreement, with whom you are ready to move forward in planning surgery. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into. Care Credit approval amounts can vary from person to person. Doctors and nurses take good 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. For example, some may be reluctant to perform an osteotomy of the anterior table of the frontal bone for setback in an outpatient surgery center and, thus, default to a less aggressive method of frontal bone recontouring, which may be an undercorrection for certain patients. N Engl J Med. Facial Feminization Surgery, FFS Minneapolis and - Omni Cosmetic He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. 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 The generalizability of the findings presented here is limited by state laws. Some error has occurred while processing your request. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. 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. Please enable scripts and reload this page. Facial Feminization Surgery (FFS) | Johns Hopkins Medicine 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. Post Surgery Recovery. In contrast, FFS under insurance coverage allows for inpatient care, which may be important, particularly to surgeon decision-making as well as patients who may have other medical conditions, pain control issues, or those who travel from long distances. In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. https://links.lww.com/PRSGO/B647.). I can't guarantee that you'll achieve coverage, but depending on how your insurance benefits are regulated and the support resources you have access to, it's definitely worth trying. Schedule surgery information about insurance coverage: video.transcendlegal.org 2. Other medical procedures like dermatology, orthopedics, gynecology, and ophthalmology. The surgeons listed below are highly qualified plastic, reconstructive, craniofacial, maxillofacial and cosmetic surgeons who offer gender-affirming facial surgery. 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. 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. In most cases, it is still extremely difficult to get your FFS surgery reimbursed by your insurance. Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. 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. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Lastly, the time consumption, costs, and difficulties to the patient were not assessed. Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. Research that Matters. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Braun TL, Braun JL, Hernandez C, et al. 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. You may be trying to access this site from a secured browser on the server. Los Angeles, CA: University of California, Los Angeles School of Law; 2019. We hope our in-person consultation will answer all of your questions, provide your sense of confidence and also further your excitement of the path you are on. Gender Affirmation Surgery - University of Utah Transgender women may choose FFS as part of their male-to-female transition process. This could be replaced with language about how you are not eligible to take estrogen therapy for whatever reason, including fancy language for just not wanting to. During his plastic surgery residency, Dr. Esmonde worked in the Transgender Health Program at OHSU. 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. Canner JK, Harfouch O, Kodadek LM, et al. Days, whose birth name was Douglas, came out as transgender in January, 2015. 1. 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. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. Surgery referral assessment requirements | Gender Affirming Health Program Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. 6. 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. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. Co-insurance past that? Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). Every insurance company is "difficult" to work with. 15. Facial Feminization in Korea - Everything You Need to Know! 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. FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. A Systematic Review of Tranexamic Acid in Plastic Surgery: Whats New? Total Staff: 34. FFS is a cost-effective intervention that needs to be covered by insurance policies. Your message has been successfully sent to your colleague. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. Any reimbursement from the insurance company (if any) would be paid directly to the patient. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. $8995. Arch Intern Med. 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. Dr. Charles Shih. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. Facial feminization is the term given to a collection of procedures designed to make facial features more feminine. Please refer to theCare Credit websitefor further details. The benefits of such coverage far exceed the insignificant costs. Does Medicare Cover Facial Feminization Surgery? Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . 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. Look here for licensed dentists practicing in the state. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients.
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