The time and costs necessary to achieve approval from insurance plans for FFS are not trivial. 1. Co-insurance past that? Two letters from mental health providers. Look here for licensed dentists practicing in the state. Dr. Hadeed is a board-certified surgeon who specializes in Transgender Surgery, including chest/breast procedures, facial surgeries and body sculpting for both trans men and women. Most trans women elect to have all facial feminization procedures performed at once, or in two phases (upper face and lower face). .
Best FFS Surgeons: What to Know and Where to Go Facialteam 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. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. Gender-Affirming Surgery: Original Article. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. How soon can I book a surgery date? Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. 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. 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. See all insurance information. There are a few limitations in this study that deserve mention. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Facial Feminization Surgery A Complete Guide to FFS, Fat Transfer for Facial Feminization (FFS), Cheek Enhancement (Augmentation & Reduction), Ethno-Specific Facial Feminization Surgery, Forehead Reshaping (Contouring & Reduction), Chin Contouring (Genioplasty/Mentoplasty), Read more about our Clinics Finance and Insurance Policy here, Cheek Enhancement: Augmentation and Reduction, Adams Apple Surgery Augmentation via Natural Implant, Anesthesia and operating room fees (both of which are charged by the duration of time used), Any additional planning/coordination to complete the surgery (VSP, Orthodontic treatment, etc. This process will be long and draining, but it is worth it. Dr. Harris is a highly skilled, board-certified Surgeon in the Dallas area who has been developing an international reputation for transgender surgery. Now you will be denied! I don't philosophically agree with this. Qual Life Res. Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. 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%). 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. Dr. Meltzer is a plastic and reconstructive surgeon who has been performing Gender Reassignment Surgery since the early 90s. I tell everyone to plan for an initial denial- even if FGCS is covered in your plan clearly, its likely that portions of the procedure will be denied as cosmetic. 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. Error bars denote standard error.
Facial Feminization Surgery (FFS) | Johns Hopkins Medicine 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. 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. 2). Complete New Patient Questionnaire. 3). The addition of multi-level appeals in Groups B and C increased the total time for a definitive decision (7.0 and 5.1 months, respectively) and required both surgeon and administrative time to navigate the process (10.8 and 12.0 hours, respectively). 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.
Gender Affirming Surgery - Medical Clinical Policy Bulletins - Aetna Facial Feminization Surgery - A Complete Guide to FFS - DESCHAMPS-BRALY Ultimately this letter is between you and your provider, but here is some sample language that has been helpful to patients I've worked with: "Patient X has been adherent to two years of hormone replacement therapy including (specific estrogen regimen.) The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. This may influence the decision-making of surgeons with respect to the complexity of procedures to perform. 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.
Facial Feminization Surgery under Insurance: The University - LWW Some insurance providers to provide coverage for facial feminization surgery and we will attempt to receive an approval for the procedures from .
Facial Feminization in Korea - Everything You Need to Know! You need an understanding of your insurance benefits in general: What would any covered surgery cost you?
How Much Does Facial Feminization Surgery Cost? | RealSelf Cost of Facial Feminization Surgery (FFS) and Insurance Information 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. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. The work cannot be changed in any way or used commercially without permission from the journal. Plast Reconstr Surg Glob Open. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. Prior to meeting with the social worker, patients should complete this assessment document. One of the greatest joys in my trans community work is helping people navigate Facial Gender Confirming Surgery. 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 standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. Ainsworth TA, Spiegel JH. We performed a cost analysis of the pre-surgical insurance process for patients seeking FFS.
Facial Feminization Surgery Cost - American Society of Plastic Surgeons Facial Feminization Surgery (FFS) Preparation Guide.
Gender Affirmation Surgery - University of Utah This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. generic exclusions referenced under "general surgery guidelines" and "cosmetic procedures." South Dakota (0) State Medicaid has no . Ann Plast Surg. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. 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. Doximity. 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. JAMA. 2). 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. 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. Upon denial, an IMR is requested directly from the insurance plan. Error bars denote standard error. 3. For example, there are now many hospitals across the . You need to come in for an in-person consultation AND pay a deposit to secure your surgery datebeforewe will submit for prior authorization.
Facial Feminization Surgery: FFS Surgery in Thailand Surgical Staff: 13 surgeons, each specialized in surgery ranging from plastic to maxillofacial surgery. Please try again soon. The format for an appeals process and regulations/law/policy to cite within it vary widely depending on the mix of state and local regulations that apply to your specific plan. 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. 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. 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. The objective is to soften the facial . Some of the procedures included in facial feminization surgery are: 6. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. 10. 7. 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*,. We identified all patients with gender dysphoria consulted for FFS under a single surgeon (JCL) at the University of California Los Angeles between January 2018 and February 2020 (n = 55). James S, Herman J, Rankin S, et al. Dr. 1. 2020; 8:e2618. Health Insurance Utilizing coverage under a health insurance plan is often the most affordable way to pay for FFS. Lastly, the time consumption, costs, and difficulties to the patient were not assessed. Dr. Crane is one of only a few surgeons in the world who is trained as both a plastic surgeon and urologist and has also completed fellowships in reconstructive urology and gender reassignment surgery. Insurance authorization process for FFS.The insurance authorization process for FFS begins with submission of two letters of support from a mental health provider and primary care physician following surgical consult.
Facial Feminization Surgery (FFS) | University of Miami Health System If performed all at once, FFS usually takes between 4- 8 hours. Try your local trans advocacy groups, LGBTI legal services, support group, etc. You should be able to download this document through a web portal, but if not, you are legally entitled to a paper copy. 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. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Do you have out of network benefits, or are you limited to providers in the network? 50% of transgender women either had or wanted facial feminization (surgery to make a face appear more feminine). Unlike California-insured plans, job-based plans which are self-insured, also called Employee Retirement Income Security Act (ERISA)-plans, a second-level, patient-initiated appeal is typically required. Available at: 9. Tijuana, Cancun, Mexicali, and Monterrey are some of the more popular cities in Mexico for medical tourism and the flowing procedures: Dental treatments including dental surgery.
Dr. Hadeeds practice now has two locations: Beverly Hills, California and Miami, Florida. 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. A Systematic Review of Tranexamic Acid in Plastic Surgery: Whats New? However, I personally know multiple people who have achieved coverage for FGCS through state Medicaid in both NY and California.