Compared with the published literature, patients within Groups B and C are multi-fold greater than the reported standard estimates in the former study without even taking into account time and costs of post-surgical billing activities. You should be able to have easy access to this document through your insurance provider. Insurance Coverage for FFS Surgery abroad Medical inequality for trans people means that access to quality trans healthcare is absent or limited in many regions. 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. 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. See all insurance information. How Do I Pay For Facial Feminization Surgery? - drbastidas.com The benefits of such coverage far exceed the insignificant costs. However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California. 13. Facial feminization surgery can be covered by health insurance in some instances. 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 Allure Esthetic & Insurance Coverage For FFS Allure Esthetic is Washington State's top destination for facial feminization surgery. Out-of-pocket costs for FFS. The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Get a bossy friend to make phone calls with you while you are dealing with the process. The Case For Facial Feminization Surgery - BuzzFeed News Facial Feminization Surgery | Michigan Medicine - U of M Health Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Facial feminization surgery (FFS) is undertaken to reconstruct masculine facial features to present a feminine form. 1. Read more on our Insurance and Finance page. 1. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 360 Post St. Suite 901 Unlike Group B, patients within Group C only had plans that were self-insured under ERISA. Ainsworth TA, Spiegel JH. Medi-Cal, the California state equivalent of Medicaid, authorizes all gender-affirming surgeries including FFS and Medicare does not require prior authorization. FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. 2015; 136:560e561e. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Plastic and Reconstructive Surgery - Global Open, Get new journal Tables of Contents sent right to your email inbox, Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), https://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF, https://blog.doximity.com/articles/doximity-2018-physician-compensation-report, PRSGO_9_5_2021_03_23_LEE_GOX-D-21-00105_SDC2.pdf; [PDF] (74 KB), Facial Feminization Surgery under Insurance: The University of California Los Angeles Experience, Articles in Google Scholar by Allison C. Hu, BA, Other articles in this journal by Allison C. Hu, BA, Factors Influencing the Choice of Plastic Surgery as a Specialty in Saudi Arabia, Outcomes of Implant Removal and Capsulectomy for Breast Implant Illness in 248 Patients, A Safe and Effective Lip Augmentation Method: The Step-by-Step (Phi) Technique, Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. Tseng P, Kaplan RS, Richman BD, et al. Facial Feminization Surgery, FFS Minneapolis and - Omni Cosmetic 3. Post Surgery Recovery. 3). FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. Capitn L, Simon D, Kaye K, et al. This is called facial feminization surgery. 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. To filter results, enter information and 'click search icon' and/or select from the dropdown lists. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. Values: "At Kamol Hospital we provide a complete spectrum of fine cosmetic surgical procedures, performed by elite plastic surgeons setting new technological achievements. What's your out of pocket max? Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. 11. Brow Lift. In addition, many of them don't take insurance. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. The Ins & Outs of Traveling Abroad for FFS Surgery By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. Facial feminization surgery is more often referred to as "gender reaffirmation surgery", and is performed on . PDF Gender Confirming/Grs Surgeon List and Resources for Preparing for Surgery Forehead (frontal bone recontouring, recontouring of superior orbital rim, hairline lowering). This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. 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. I don't philosophically agree with this. He joined the Austin branch of the Crane Center for Transgender Surgery in 2021, where he offers Top Surgery and Breast Augmentation, Facial Feminization and Vaginoplasty. When it comes to facial feminization there is no substitute for experience. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. One potential consideration for reducing time and costs is to centralize administrative staff for gender health insurance authorizations. 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]. Read more about our Clinics Finance and Insurance Policy here. In fact, he is one of the most experienced gender surgeons in the world. 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. 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. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. 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. $4985. No. 2018. 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. Support groups? Dr. KathleynBrandstetter. Dr. Lee is a fellowship-trained and board-certified plastic surgeon with deep expertise in aesthetic and reconstructive procedures for the chest/breast and face. Privacy Policy (Updated December 15, 2022). Gender Affirmation Atlanta GA | Facial Feminization Alpharetta 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. Surgeries are performed by our world experts in facial reconstructive surgery, including: Drs. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons To access this service, refer to the process below: Fill out and return the Service Inquiry Form. Descriptive statistics were performed for demographic variables. They will need letters of support from you for the preauthorization, following WPATHs Standards Of Care. 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. Leigh JP, Tancredi D, Jerant A, et al. 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. If it is substantial, they should name their years of experience working with transgender patients. Error bars denote standard error. 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. Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. Data is temporarily unavailable. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. 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 Surgery: FFS Surgery in Thailand FFS: money and choosing a surgeon : r/Transgender_Surgeries Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. The work cannot be changed in any way or used commercially without permission from the journal. Dr. Nghiem is an Ivy League-educated, fellowship-trained plastic surgeon in Washington, D.C. who specializes in transgender surgery, including Chest Masculinization and Breast Augmentation. The generalizability of the findings presented here is limited by state laws. . Cost of Facial Feminization Surgery (FFS) and Insurance Information 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. Paying for Transgender Surgeries - Investopedia Every insurance company is "difficult" to work with. Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. I could go on about this, but I hate to further the expectation that you must be very mentally ill in order for the "extreme" treatment of FGCS to be warranted. generic exclusions referenced under "general surgery guidelines" and "cosmetic procedures." South Dakota (0) State Medicaid has no . FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. As many professions say, past performance does not guarantee future results. However, the tide of change is beginning to roll in- often where Medicaid begins, private plans will be forced to follow, so the clear coverage in California and New York bodes well for everyone. School-Based Dental Sealants; Licensed Rhode Island Dentists. Gender Affirmation Surgery - University of Utah Health insurance Medical Policies - Trans Health Project Hormone therapy alone has not sufficiently treated her gender dysphoria, and the next step in her treatment plan is Facial Gender Confirming Surgery." 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. Gender-Affirming Surgery: Original Article. 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. 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. These surgeries can reduce the size and shape of the forehead, alter and refine the nose, make the lips fuller and . However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. FFS: paying and picking a surgeon. Freaking out and need advice. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Gender-Affirmation Surgery | Transgender Surgery | The University of Plastic and Cosmetic Surgery. Despite improved insurance coverage for gender confirmation surgeries in the United States, coverage for facial feminization surgery (FFS) continues to be difficult. Facial feminization surgery (FFS) for our male-to-female (M2F) patients can sometimes be the most important decision in your transition. Specific surgical procedures were requested based on patient desires and clinical assessment, with the goal of completing FFS in a one-stage surgery. Furthermore, even in the challenging scenario for insurance authorization reported by Braun and colleagues, Groups B and C also exceed reported estimates. Please try again soon. If they have referenced expert guidelines or current research in devising your care plan, they should state that and provide citations. 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. Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. Transgender health care coverage | HealthCare.gov 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. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Compared with Group A, the amount of time spent acquiring the authorization was 8-fold higher (P < 0.001), with a 22-fold higher cost (P < 0.001) for the Group B authorization process (Fig. 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 Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation 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. Facial feminization surgery encompasses a broad range of procedures to change the shape of the face to look feminine. Please enable scripts and reload this page. There are a few limitations in this study that deserve mention. HB2084 (2016) bans gender identity discrimination in health insurance and HB2405 (2022) bans categorical exclusions for gender-affirming care under any health plan, though the law does not . Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. It involves plastic surgery techniques in which the jaw, chin, cheeks, forehead, nose, and areas surrounding the eyes, ears or lips are changed to create a more feminine appearance. 2014; 134:609619. Requires supporting documentation that indicates specific type of FFS procedures requested. In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. Co-insurance past that? Dr. Read on to find out why you might pay more or less, and whether the cost is really worth it. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. Only patients with insurance authorization decisions were included in this study (n = 40). Here, we describe our institutional experience on navigation, time, and costs of the FFS insurance authorization process. You need an understanding of your insurance benefits in general: What would any covered surgery cost you? Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. If the insurer refuses those attempts, you can appeal externally, but that will almost certainly require professional legal support. Historically, FFS hasn't been covered by health insurance or government healthcare. surgical techniques and analysis of results. 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. 2010; 170:17281734. 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. Ousterhout DK. insurance appeals for pediatric reconstructive surgery: a micro cost analysis and how-to guide. The major difference between approval (Group B) versus denial (Group C) was that the former primarily consisted of plans insured by California and, thus, under the jurisdiction of California law, whereas Group C plans were entirely self-insured employer (ERISA) plans, which are exempt from state regulation. Days, whose birth name was Douglas, came out as transgender in January, 2015. Initially, you would need to be seen in the office for an examination/consultation to determine the scope of yoursurgeryto determine the exact cost of your facial feminization. I always advise people to try with the insurance they have before they switch to another plan.
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