3. Plast Reconstr Surg. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization. Allure Esthetic & Insurance Coverage For FFS Allure Esthetic is Washington State's top destination for facial feminization surgery. Your scars may take up to a year to heal. They will need letters of support from you for the preauthorization, following WPATHs Standards Of Care. Requested CPT codes are detailed in Supplemental Digital Content 1. 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). 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. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. Only patients with insurance authorization decisions were included in this study (n = 40). Transgender health care coverage | HealthCare.gov How NOT To Choose Your Facial Feminization Surgeon In fact, he is one of the most experienced gender surgeons in the world. Plans that fall into this group include Medi-Cal, Medicare, and some private insurance plans. Starbucks offers expanded benefits for trans people 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. Padula WV, Heru S, Campbell JD. Thus, coverage significantly increases accessibility. Surgery referral assessment requirements | Gender Affirming Health Program FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin 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. Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized. This is also the point at which general 201 level guidance ceases to be useful. Dr. KathleynBrandstetter. She has a special interest in Facial Feminization and is also highly proficient in Vaginoplasty and Top Surgery. This study highlighted the successes and burdens associated with obtaining insurance authorization for FFS. https://links.lww.com/PRSGO/B648.). I am working from the perspective that you are unable to pay in full and be reimbursed. Your health insurance company can't limit sex-specific recommended preventive services based on your sex assigned at birth, gender identity, or recorded gender for example, a transgender man who has residual breast tissue or an intact cervix getting a mammogram or pap smear. The report of the 2015 U.S. transgender survey. However, some insurers are beginning to cover FFS from select surgeons. Administrative time, including obtaining initial authorizations, appeals, IMRs, and additional phone calls, averaged to 7.2 1.0 hours spent per patient. Read your cover in detail and find out the following: Second, find out if yourCertificate of Coveragehas any inclusions (or exclusions) around transgender care. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 360 Post St. Suite 901 Complete New Patient Questionnaire. 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. Plastic and Cosmetic Surgery. Listings for surgeons outside of the New York area are compiled only for surgeons who perform some combination of genital surgery or FGCS, . Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. KP FFS Surgeons. Resources in other locations are variable, but I'm attempting a general starter guide to FGCS through insurance. Bottom Surgery: Cost, Recovery, Procedure Details, and More - Healthline Facial feminisation surgery can involve a combination of all or some of the below cosmetic procedures. Unlike Group B, patients within Group C only had plans that were self-insured under ERISA. This is highly considered one of the most "life-altering" surgeries for a transgender patient because the impact is visible right away. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. surgical techniques and analysis of results. Facial feminization surgery (FFS) encompasses a series of surgical interventions designed to make your face appear more feminine. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. 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. 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 process will be long and draining, but it is worth it. 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. 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. 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. If they have referenced expert guidelines or current research in devising your care plan, they should state that and provide citations. Osseous transformation with facial feminization surgery: improved anatomical accuracy with virtual planning. Care Credit approval amounts can vary from person to person. This denial should also lay out your options for appeal- both internal (basically, asking the insurance company to reconsider) and external. 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. 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. Every state is different so start with Google and reach out to these services in your state, theyre here for you! 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. Co-insurance past that? This should be sent to you in written form, with the specific reason for the denial included. Rhinoplasty. We recommend you take at least two weeks off from work to recover, but expect up to six to eight weeks of decreased activity. Plast Reconstr Surg. Gray R, Nguyen K, Lee JC, et al. If they are a member of WPATH or other applicable professional associations, they should name that. While facial feminization surgery has many potential benefits, the decision to proceed . 2020; 8:e2618. 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 Subsequently, in California-insured plans, an IMR is then requested from the California Department of Managed Healthcare (CA DMHC). 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. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into. The time spent on the presurgical authorization process for Groups B and C translated to an over 20-fold increase in cost ($855.00 and $988.38, respectively) compared with Group A. Navigation of the insurance process for FFS is challenging and time-consuming; however, coverage is a reality in California provided that multi-level appeals are exhausted. 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. Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. The generalizability of the findings presented here is limited by state laws. 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. Thus, specifying any one procedure as medically necessary while excluding other facial procedures reflects a lack of understanding of the nature of the diagnosis. 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. Surgical techniques and analysis of results. Call 913-588-6200 to request a consultation. Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. Submission and review of physician-initiated appeal (1 month); 3. For example, there are now many hospitals across the . In total, the time consumption of the insurance process was 12.0 1.6 hours and cost $988.38 101.76 per patient. Dr. Harris is a highly skilled, board-certified Surgeon in the Dallas area who has been developing an international reputation for transgender surgery. Body-contouring. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Ultimately, you will need to contact your health insurance company or patient advocate for more specific information regarding costs. Out-of-pocket costs for FFS. Facial Feminization Surgery (FFS) | Gender Affirming Health Program Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. In this work, we detailed our institutional experience on obtaining insurance coverage for FFS. Letters - Crane Center for Transgender Surgery Some of the procedures included in facial feminization surgery are: And some health insurance plans do cover the costs associated with facial feminization surgery procedures, so we recommend contacting your insurance provider to find out what is and is not covered under your current plan. Dr. Keith is a board-certified and fellowship-trained Plastic Surgeon with expertise in Gender Affirmation Surgery. Read more about our Clinics Finance and Insurance Policy here. In the Group A patients, FFS under Medi-Cal still requires preauthorization, just like private insurances. Surgery will be carried out under general anaesthetic and can typically range from around 4 to 8 hours depending on the procedures. Transgender women may choose FFS as part of their male-to-female transition process. Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. As with any surgical procedure, there are risks associated with FFS. Facial Feminization Surgery: What Is FFS, Hairline - Cleveland Clinic When it comes to facial feminization there is no substitute for experience. Based on my conversations with friends who are very satisfied with their FGCS, I assure you that no surgery can completely resolve that anxiety. 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. JCL is additionally supported by the US Department of Veterans Affairs under award number IK2 BX002442 and the National Institutes of Health/NIDCR R01 DE0289098. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. Jaw contouring contours the mandible and narrows a full jaw by reducing angles in the lower face. All rights reserved. may email you for journal alerts and information, but is committed Surgery Scheduling, Rescheduling and Cancellations: Oakland Head and Neck . Facial Feminization Surgery Before & After Pictures - RealSelf Tate, who has been with Starbucks for 15 years and now manages a store in Austin, Texas, is one of a growing number of Starbucks partners who have used the company's leading-edge benefits for transgender partners. FFS is a cost-effective intervention that needs to be covered by insurance policies. 2018; 80:198204. The benefits of such coverage far exceed the insignificant costs. Read on to find out why you might pay more or less, and whether the cost is really worth it. How soon can I book a surgery date? 2019; 144:11591168. https://links.lww.com/PRSGO/B648.) She believes in a shared vision and works closely with her patients to deliver the best quality care that is in line with their needs. 11. Cost of Facial Feminization Surgery (FFS) and Insurance Information Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. 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. Dr. Esmonde is a plastic surgeon in Portland, Oregon who has extensive knowledge about Gender Affirmation Surgery and works almost exclusively with transgender and non-binary patients. Facial Feminization Surgery, FFS Minneapolis and - Omni Cosmetic 1. 2003; 349:768775. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Plast Reconstr Surg. 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. Integral to this whole process is the FGCS surgeon. Health insurance Medical Policies - Trans Health Project 1). Finally, Group C (denial) included private insurance plans under ERISA that resulted in denial despite multi-level appeals and IMR requested from the plan. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Specific surgical procedures were requested based on patient desires and clinical assessment, with the goal of completing FFS in a one-stage surgery. 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. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Facial Feminization Surgery - A Complete Guide to FFS - DESCHAMPS-BRALY He is the first surgeon in New Jersey to offer the full range of gender-affirming procedures, including Top Surgery, Phalloplasty, Vaginoplasty and Facial Feminization Surgery. Facial Feminization Surgery NYC | Board Certified Plastic Surgeon Administrative time in this cohort included obtaining initial authorizations, which resulted in an average of 1.4 0.4 hours spent per patient at an estimated cost of $38.18 10.18 per patient (Fig. 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. Dr. Rodriguez had 14 years of craniofacial, aesthetic and pediatric plastic surgery experience before becoming a Gender Surgeon. Highly Distinguished Facial Surgeon In Chicago Dr. Amir Dorafshar, MD is a plastic and reconstructive surgeon with fellowship training in craniofacial surgery who specializes in gender-affirming facial surgery. Thus, coverage significantly increases accessibility. Additionally, the timeline for authorization is relatively opaque, thereby causing more uncertainty in patients and surgeons. Available at: 9. Start with ensuring that you have an in-depth understanding of your insurance benefits. 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.) Please refer to theCare Credit websitefor further details. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington.