Available at: 9. Hormone therapy alone has not sufficiently treated her gender dysphoria, and the next step in her treatment plan is Facial Gender Confirming Surgery." The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . Other medical procedures like dermatology, orthopedics, gynecology, and ophthalmology. This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. Descriptive statistics were performed for demographic variables. Next, you want an awareness of any explicit inclusions or exclusions for transgender care in your "Certificate of Coverage," the document that lays out what is covered in what circumstances. 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. 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. Subsequently, in California-insured plans, an IMR is then requested from the California Department of Managed Healthcare (CA DMHC). Beginning in June 2021, Dr. Esmonde will serve as a full-time Associate Surgeon with The Meltzer Clinic offering the full spectrum of gender-affirming procedures. Gender-Affirming Surgery Information - East Bay Any reimbursement from the insurance company (if any) would be paid directly to the patient. 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. Facial Feminization Surgery, FFS Minneapolis and - Omni Cosmetic From the cohort, 3 subgroups were delineated. 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. 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. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. This should be sent to you in written form, with the specific reason for the denial included. Facial feminization surgery (FFS) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. https://links.lww.com/PRSGO/B648.). Try your local trans advocacy groups, LGBTI legal services, support group, etc. They submit their own information, information about the procedure being performed, and information about you. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. Ask to speak to people's supervisors. Insurance Requirements for Gender Confirmation Surgery - Verywell Health However, the cost can range from $1,847 to $62,000, depending on a few key factors. On average, the authorization process required approximately 1 month to complete and cost on average $38 worth of time to coordinate administratively. The concept and treatments were developed with transfeminine patients in mind in the 1980s, led by a San Francisco-based surgeon who devised measurements for a "normal" female appearance by surveying anthropological skeletal records. Facial Feminization Miami | The Maercks Institute The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Everyone who is able to fight through it cracks the door open a little wider for the next person. Rhinoplasty. Thus, coverage significantly increases accessibility. What's your out of pocket max? Among the 26 patients (65.0%) who underwent the standard approval process, 13 patients had Medi-Cal, 4 patients had Medicare, and 9 patients had private insurance. Health insurance Medical Policies - Trans Health Project Facial Feminization Surgery: FFS Surgery in Thailand Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. Submission and review of second level, patient-initiated appeal (1 month); 4. Societal implications of health insurance coverage for medically necessary services in the U.S. Transgender population: a cost-effectiveness analysis. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. 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. 2003; 349:768775. Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. However, some insurers are beginning to cover FFS from select surgeons. 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. Body-contouring. For example, there are now many hospitals across the . Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. During Your FFS Procedure How long it takes: This depends on what you are having done. Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. The total costs of your Facial Feminization Surgery will be determined by the staff of the University of Miami. If the insurer refuses those attempts, you can appeal externally, but that will almost certainly require professional legal support. Facial Feminization in Korea - Everything You Need to Know! 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). As with any surgical procedure, there are risks associated with FFS. 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. 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. 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. 6. Lastly, a third subgroup of patients (Group C), all with private insurance, were denied for surgery despite multi-level appeals, peer-to-peer discussions, and IMR. This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). Facial feminization surgery - Mayo Clinic - Mayo Clinic - Mayo Clinic He has been performing gender surgery since 2005. 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. As gender dysphoria is highly individual, such procedures will vary by anatomical areas associated with dysphoria for each individual patient as well as decision-making from the treating surgeon. Tseng P, Kaplan RS, Richman BD, et al. FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure. If they have referenced expert guidelines or current research in devising your care plan, they should state that and provide citations. The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Submission and review of IMR (1 month). Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. 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. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. 2016; 137:438448. Among the total cohort, most patients had private insurance (n = 23, 57.5%), followed by Medi-Cal (n = 13, 32.5%), and Medicare (n = 4, 10.0%). 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. Surgeries are performed by our world experts in facial reconstructive surgery, including: Drs. Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. 2016; 31:394401. According to the Philadelphia Center for Transgender Surgery,. Plastic and Cosmetic Surgery. You will be asked to complete an intake questionnaire before your consultation. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Similarly, while Medicare does not require an authorization process to move forward with surgery, we have experienced significant billing challenges postsurgery. Denver Health to Offer Facial Feminization Gender Confirmation Surgery Surgical Staff: 13 surgeons, each specialized in surgery ranging from plastic to maxillofacial surgery. However, this has been a persuasive strategy in some cases. 2). Each patient is different and your expectations and desired results will be discussed fully in your consultation. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. Bariatric Surgery. Dr. Ley has joined Dr. Scott Mossers Gender Confirmation Center in San Francisco, where she will begin seeing patients in March 2022. Policy Title: Gender Affirming Surgery. We will commonly prescribe you with medications for common post-surgical side effects such as pain, nausea, and constipation. If it is substantial, they should name their years of experience working with transgender patients. How Much Does Facial Feminization Surgery Cost? | RealSelf The Ins & Outs of Traveling Abroad for FFS Surgery 2). Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. 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. Facial feminization surgery: the forehead. Transgender women may choose FFS as part of their male-to-female transition process. Brow Lift. This is the point at which you will likely need legal support. The report of the 2015 U.S. transgender survey. Though WPATH has released the new SOC, it will take insurance companies time to evolve. Gender-Affirmation Surgery | Transgender Surgery | The University of 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. Ousterhout DK. Arch Intern Med. In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. Facial Feminization Surgery: What You Should Know - Healthline San Francisco, CA 94108. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. Facial Feminization Surgery (FFS) is a group of facial procedures that alter the face to create more classically feminine characteristics, such as a higher brow, a more refined feminine nose, and less pronounced Adams apple. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. 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. Submission and review of initial authorization request (1 month); 2. 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. $8995. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. These procedures may include: Tummy tuck, called abdominoplasty. Do you have access to out-of-network providers or in-network only. Their credential as an MD/DO/NP/PA/MSW/PHD and signature on an essentially form WPATH conforming letter are not sufficient- they need to impress upon the medical reviewers that they are not simply approving your referral request, but are guiding your care as a treating provider, and that this surgery is part of your care plan. *. 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. 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. Have your facial features compromised your safety, making you a target for harassment and violence? 3. School-Based Dental Sealants; Licensed Rhode Island Dentists. Integral to this whole process is the FGCS surgeon. Average time spent from administrator and surgeon in obtaining insurance approval for FFS (A). Wolters Kluwer Health These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. 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. Furthermore, revisions may be indicated in some patients over time. The time from initial consultation to final insurance denial required 5.1 0.7 months, nearly 5-fold higher than Group A (P = 0.003) (Fig. Does Medicare Cover Facial Feminization Surgery? These are usually self-insured employer plans which are administered by well-known insurers such as Blue Cross Blue Shield, United Healthcare, Harvard Pilgrim Healthcare, and Tufts Health Plan. His experience in cosmetic and craniofacial surgery makes him an excellent choice for Facial Feminization (FFS) and Masculinization surgeries. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. 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. Javad Sajan - Facial Feminization Surgery (FFS) in Seattle Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. In fact, he is one of the most experienced gender surgeons in the world. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. a support group of people dealing with similar issues to you to help keep up your strength and spirits throughout planning and recovery. Leigh JP, Tancredi D, Jerant A, et al. 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. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. Facial Feminization Surgery: What Is FFS, Hairline - Cleveland Clinic As much as possible, Dr. Salgado will do what he can to keep costs at a minimum.