2). may email you for journal alerts and information, but is committed 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. The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. 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.) 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. 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. Other medical procedures like dermatology, orthopedics, gynecology, and ophthalmology. Facial feminization surgery (FFS) encompasses a broad range of procedures to alter typically masculine facial features to bring them closer in shape, size, and aesthetics to typically feminine facial features. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . The multi-level appeal process included physician-initiated appeal, patient-initiated appeal, and independent medical review (IMR). Dr. Dulin offers transgender women the following surgical services: Breast Augmentation: Get the curves you desire. 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. Ask to speak to people's supervisors. In total, the time and cost estimate of the insurance appeal process was 10.8 1.0 hours and $855.00 91.53 per patient, respectively. 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 encompasses a broad range of procedures to change the shape of the face to look feminine. 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. 2018; 80:198204. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Historically, FFS hasn't been covered by health insurance or government healthcare. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. 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. 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. 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. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. 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. 11. 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. Out-of-pocket costs for FFS. 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. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. I don't philosophically agree with this. 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. 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. Third, full-face, one-stage FFS is a highly time-consuming surgery due to the multiple anatomical areas addressed at once (averaging 8.5 hours in the senior authors experience). Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. Subsequently, the process typically follows one of three paths: Group A (standard approval), Group B (extended approval), and Group C (denial). 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. One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. JAMA. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. surgical techniques and analysis of results. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. Dr. Thomas Satterwhite Facial Feminization Surgery (FFS) Preparation Guide. 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. You may be trying to access this site from a secured browser on the server. Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. 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. James S, Herman J, Rankin S, et al. Before getting into the nitty gritty details, let me be real with you, and let me be hopeful. This is highly considered one of the most "life-altering" surgeries for a transgender patient because the impact is visible right away. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. Data is temporarily unavailable. Plast Reconstr Surg Glob Open. Values: "At Kamol Hospital we provide a complete spectrum of fine cosmetic surgical procedures, performed by elite plastic surgeons setting new technological achievements. These issues will remedy themselves as you heal, but will often require several weeks to completely resolve. If your insurance provider approves the authorization request, we may be able to submit a one-time complimentary claim on your behalf. 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. I always advise people to try with the insurance they have before they switch to another plan. It can be just as important or even more important than sex reassignment surgery (SRS) in reducing gender dysphoria and helping trans women integrate socially as women. 7. 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. Procedures requested for facial feminization insurance authorization are detailed in Table 2. This process will be long and draining, but it is worth it. Ainsworth TA, Spiegel JH. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Please read a few important elements consider when booking. Are there transgender advocacy groups? Los Angeles, CA: University of California, Los Angeles School of Law; 2019. Two letters from mental health providers. Error bars denote standard error. 6. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. The United States . In total, attempting and succeeding at obtaining insurance coverage for FFS is a significant time and cost burden that may be difficult to overcome for a number of plastic surgical practices, suggesting ramifications for patient accessibility. Costs of health care administration in the United States and Canada. Available at: 9. 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. 15. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. 6. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. Especially with the establishment of multi-disciplinary gender health teams across the United States, coordination of care through a consistent group of trained administrative staff knowledgeable in the process and appeals process for gender health procedures would potentially reduce the burden on individual offices and surgeons. You should be able to have easy access to this document through your insurance provider. Tseng P, Kaplan RS, Richman BD, et al. However, this is starting to change. One potential consideration for reducing time and costs is to centralize administrative staff for gender health insurance authorizations. This is called facial feminization surgery. Conveniently Located to Serve Chicago and Illinois. Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. There is also a great deal of discussion on various internet forums and also on social media in terms of how to reduce the cost of your facial feminization surgery by claiming the procedure on your health insurance. Otherwise, your deposit will be applied towards your surgical balance. For example, a number of state-mandated denial overturns in Group B patients resulted in billing challenges postsurgery. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. Want to use our data? If you work for an employer who supports your gender confirmation surgery your first point of contact should be your in-house health insurance liaison. All rights reserved. Your scars may take up to a year to heal. 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. Ann Plast Surg. information about insurance coverage: video.transcendlegal.org 2. Call 913-588-6200 to request a consultation. 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.
ffs surgeons who take insurance