Temporal trends in gender-affirming surgery among transgender patients in the United States. Upon receipt of a deposit for your surgery, our practice may offer to submit a prior authorization request to your insurance provider. Surgery referral assessment requirements | Gender Affirming Health Program Facial feminization is the term given to a collection of procedures designed to make facial features more feminine. You should be able to have easy access to this document through your insurance provider. Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. JAMA Surg. First, one of the most significant barriers to FFS for patients is the ability to pay for surgery, which ranges from $40,000 upwards for full-face, one-stage surgery. How soon can I book a surgery date? The cheapest caesarean section is 48,000 baht (year 2020) including sterilization 53,000 baht. N Engl J Med. The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. The administrator hourly compensation set at our institution was used for the cost analysis. Bariatric Surgery. In fact, he is one of the most experienced gender surgeons in the world. All data were analyzed using SPSS software, version 25 (IBM, Chicago, Ill.). Months required for definitive insurance authorization decisions for FFS. 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. Bottom surgery, or changing the genitalia, costs an estimated $25,600 for male-to-female patients and about $24,900 for female-to-male, according to The Philadelphia Center for Transgender. Most trans women elect to have all facial feminization procedures performed at once, or in two phases (upper face and lower face). Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. As stated above, all patients within this group were covered by private insurance plans that were not within the purview of the State of California and, thus, were not eligible for state intervention. Facial feminization surgery: the forehead. I am working from the perspective that you are unable to pay in full and be reimbursed. Read on to find out why you might pay more or less, and whether the cost is really worth it. Also known as facial feminization surgery or FFS, this is a general term for a group of procedures designed to change the bone structure . This denial should also lay out your options for appeal- both internal (basically, asking the insurance company to reconsider) and external. Brow Lift. Among the various gender-affirming procedures, facial feminization surgery (FFS) is arguably the most commonly denied surgery, as insurance companies often deem the involved procedures as cosmetic and not medically necessary. 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 (FFS) - University of Utah Everyone who is able to fight through it cracks the door open a little wider for the next person. Feminizing surgery - Mayo Clinic 2018 Physician Compensation Report. In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. First, one of the most significant barriers to FFS for patients is the ability to pay for surgery, which ranges from $40,000 upwards for full-face, one-stage surgery. Gender-Affirmation Surgery | Transgender Surgery | The University of Policy Title: Gender Affirming Surgery. 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. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. 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]. P < 0.05 was considered significant. The benefits of such coverage far exceed the insignificant costs. Facial Feminization Surgery: A Guide for the Transgendered Woman. FFS consults (n = 40) at the University of California, Los Angeles (20182020) were reviewed for time and cost to definitive insurance authorization decision. Only patients with insurance authorization decisions were included in this study (n = 40). See all insurance information. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. Read this first. 6. The doctor said very encouraging. To access this service, refer to the process below: Fill out and return the Service Inquiry Form. A number of patients had multiple consultations, some consulted legal assistance, and, particularly patients in Groups B and C, some experienced significant distress over the repetitive denials and lack of clarity in the end result of the process. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. 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. This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. Please keep track of the mail being sent to the address on file with insurance, as you often are only able to appeal within certain time frames from the initial decision. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. We're gonna try really hard to get my insurance to cover it, but I'm not holding my breath. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Facial feminization surgery - Mayo Clinic - Mayo Clinic - Mayo Clinic (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. 2010; 19:10191024. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Included in Appendix D are the new letter referral suggestions for gender-affirming surgery (GAS). From an historical perspective, both private health insurance carriers and government insurance have declined claims for FFS. Plastic surgery on the face. may email you for journal alerts and information, but is committed Available at: 9. PDF Gender Confirming/Grs Surgeon List and Resources for Preparing for Surgery Most other insurance plans do not cover FFS and consider it as cosmetic surgery. Plast Reconstr Surg. How Much Does Facial Feminization Surgery Cost? | RealSelf Once you've identified a surgeon who takes your insurance, ask them to submit a preauthorization. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. Price (USD) Forehead Recontouring. Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. These patients underwent a standard approval process no different from other reconstructive procedures (Group A). In addition to legislative changes, the rationale for increasing coverage may be related to calculations on the cost-effectiveness of coverage. 2018; 80:198204. Jaw contouring contours the mandible and narrows a full jaw by reducing angles in the lower face. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. 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. This could be a good time to join (or form!) This is their communication with the insurance company verifying that the procedure is covered. Additionally, planning and recovering from any trans surgery is hard! Facial Feminization Surgery | Michigan Medicine - U of M Health Look here for licensed dentists practicing in the state. Facial feminization surgery (FFS): The permanent . Call 913-588-6200 to request a consultation. You need to come in for an in-person consultation AND pay a deposit to secure your surgery datebeforewe will submit for prior authorization. Costs of health care administration in the United States and Canada. Facial Feminization Surgery (FFS) | Johns Hopkins Medicine J Gen Intern Med. 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. generic exclusions referenced under "general surgery guidelines" and "cosmetic procedures." South Dakota (0) State Medicaid has no . Though WPATH has released the new SOC, it will take insurance companies time to evolve. The remaining 10.0% of patients who were ultimately denied were counseled and in the process of exiting their job-based insurance plan and enrolling for coverage through plans under the health insurance exchange established by the Affordable Care Act, which fall under state jurisdiction. Group A (standard approval) included patients who were approved after undergoing a standard authorization process, such as those with Medi-Cal, Medicare, and private insurance. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization 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. Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. Multiple procedures are typically included as part of gender-affirmation surgery, including facial procedures, top surgery (above the waist) and bottom surgery (below the waist). Does Medicare Cover Facial Feminization Surgery? This is called facial feminization surgery. Insurance and facial feminization surgery - 2pass Clinic The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Only if your insurance provider authorizes a Letter of Agreement. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. 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. Copyright TransHealthCare.org & Trans Media Network, 2011-2022. We will commonly prescribe you with medications for common post-surgical side effects such as pain, nausea, and constipation. insurance appeals for pediatric reconstructive surgery: a micro cost analysis and how-to guide. Leigh JP, Tancredi D, Jerant A, et al. 11. Furthermore, revisions may be indicated in some patients over time. FFS: money and choosing a surgeon : r/Transgender_Surgeries Surgical techniques and analysis of results. Otherwise, your deposit will be applied towards your surgical balance. Body-contouring. your express consent. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Plans that fall into this group include Medi-Cal, Medicare, and some private insurance plans. Woolhandler S, Campbell T, Himmelstein DU. Frequently Asked Questions | Facial Feminization Surgery | Dr Keojampa 1. Location: Bangkok, Thailand. Facial Reconstruction: Gender affirming facial surgery is considered reconstructive when all of the following criteria have been met: The individual is at least 18 years of age; and 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. Submission and review of initial authorization request (1 month); 2. Search by U.S. State, Procedure and Insurance Search by Country and Procedure Browse the Global Surgeon Maps. The cost of the administrative and attending craniofacial surgeon effort for Groups B and C averaged approximately $900, over 20-fold more than Group A. Plastic and Reconstructive Surgery Global Open9(5):e3572, May 2021. 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. Care Credit approval amounts can vary from person to person. 12. 3. 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. Facial Feminization Surgery (FFS) Miami, FL - Dr. Salgado Patients seeking services from our practice are personally and fully responsible for payment of all fees and costs related to your FFS surgery and medical care. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. Related Digital Media are available in the full-text version of the article on www.PRSGlobalOpen.com. FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure.