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. A letter from your primary care provider or whoever prescribes your hormones. If performed all at once, FFS usually takes between 4- 8 hours.
See the list at the end of this article for surgeons who will accept some form of insurance benefits directly.What makes someone a FGCS surgeon anyway? Facial feminization surgery (FFS) uses a series of procedures to alter features to appear more classically female. FFS is a cost-effective intervention that needs to be covered by insurance policies. 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. Please note that before you can schedule . Plast Reconstr Surg. Here, we describe our institutional experience on navigation, time, and costs of the FFS insurance authorization process. 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*,. https://links.lww.com/PRSGO/B647.). 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. Until then, CCTS will continue to require all patients using insurance for .
Gender Affirming Surgery - Medical Clinical Policy Bulletins - Aetna Although your FFS may not be covered by your insurance company its definitely worth doing the research. 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. The time and costs necessary to achieve approval from insurance plans for FFS are not trivial.
Gender-Affirming Surgery Information - East Bay These surgeries can reduce the size and shape of the forehead, alter and refine the nose, make the lips fuller and . 3. Price on request Facial Feminization Surgery (FFS) View details & Read reviews CALL NOW. Woolhandler S, Campbell T, Himmelstein DU. Average time spent from administrator and surgeon in obtaining insurance approval for FFS (A). We detail our institutional experience to provide a roadmap for craniofacial surgeons to navigate the process in an effort to provide higher accessibility to transgender patients seeking facial reconstruction. Your scars may take up to a year to heal. 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.
Facial Feminization Surgery - A Complete Guide to FFS - DESCHAMPS-BRALY Health insurance might not cover surgical procedures considered cosmetic for the cisgender population people whose gender identity matches the one they were assigned at birth even though these procedures are . 2020; 8:e2618. These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. 2018; 153:609616. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. Tseng P, Kaplan RS, Richman BD, et al. Every state is different so start with Google and reach out to these services in your state, theyre here for you! However, some insurers are beginning to cover FFS from select surgeons. Once CGSP receives your form, you will be referred to Plastic Surgery for a consultation. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Facial feminization surgery (FFS) involves a comprehensive set of procedures to make your face appear more feminine. Doctors and surgeons trained in facial feminization surgery are working to improve care for people living with gender dysphoria. NOTE:The following is intended as ahigh-level overview and guide onlyand does not in any way constitute legal or professional advice. 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. 2018; 80:198204. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. I am working from the perspective that you are unable to pay in full and be reimbursed. By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. 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. During Your FFS Procedure How long it takes: This depends on what you are having done. Male-to-female (MTF) facial feminization. Everyone who is able to fight through it cracks the door open a little wider for the next person. He works exclusively with trans women, trans men and non-binary patients seeking gender-affirming surgeries, including Phalloplasty, Vaginoplasty and Facial Feminization. This work was supported by the Bernard G. Sarnat Endowment for Craniofacial Biology (JCL) and the Jean Perkins Foundation (JCL). Coordinating presurgical authorization required an average of 7.8 1.5 hours per patient for the administrator and 4.3 0.5 hours per patient for the attending craniofacial surgeon to navigate multi-level appeals. Integral to this whole process is the FGCS surgeon. Insurances are constantly changing and we cannot make any guarantees concerning insurance coverage or approval. Body-contouring. Physician wages across specialties: informing the physician reimbursement debate. Dr. Leys multiple plastic surgery sub-specialty fellowships and gentle manner allow her to provide superb surgical care for transgender and non-binary patients. Before getting into the nitty gritty details, let me be real with you, and let me be hopeful. What's your out of pocket max? Despite these reports, coverage continues to be variable from state to state, physician to physician, as well as depending on anatomical region. It is important to be aware of the side effects that will certainly occur, like swelling, bruising, and incisional scars. TransHealthCare.org uses cookies and other tracking technologies to improve your browsing experience on our website, to analyze our website traffic, and to understand where our visitors are coming from. Our surgeons specialize in a variety of facial feminization procedures, such as forehead reduction, jaw contouring, and chin surgery. In addition, many of them don't take insurance. 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 works exclusively with trans women, trans men and non-binary patients seeking Gender Confirmation procedures such as Vaginoplasty, Facial Feminization, and FTM Top Surgery. 2003; 349:768775. 2019; 144:11591168. If not, remember youre never alone and there are a range of transgender support agencies that you can tap into. Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. FFS is ideal for trans women and non-transgender women who want a more feminine facial appearance. Patients were stratified into 3 groups by authorization process. However, this is starting to change. We will commonly prescribe you with medications for common post-surgical side effects such as pain, nausea, and constipation. JAMA Surg. 2016; 137:438448. These letters, in addition to following the WPATH standards of care, are the place to communicate the severity of the dysphoria- does your dysphoria impede activities of daily living, for instance by making you unable to leave for work on time? Read this first. (See table 1, Supplemental Digital Content 1, which displays requested CPT codes and associated terminology for facial feminization surgery. Submission and review of initial authorization request (1 month); 2. In total, attempting and succeeding at obtaining insurance coverage for FFS is a significant time and cost burden that may be difficult to overcome for a number of plastic surgical practices, suggesting ramifications for patient accessibility. 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. These are difficult to quantify as our institutional billing activities are centralized and carried out by multiple administrators. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. 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. 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. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. 14.
Thus, coverage significantly increases accessibility. 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. Once you've identified a surgeon who takes your insurance, ask them to submit a preauthorization. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. Some people stress additional mental health conditions (anxiety, depression, ptsd) in these letters. 2. I can't guarantee that you'll achieve coverage, but depending on how your insurance benefits are regulated and the support resources you have access to, it's definitely worth trying. Dr. Lee has gained worldwide recognition as an FFS specialist after it was announced that he performed Caitlyn Jenners facial . However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. These issues will remedy themselves as you heal, but will often require several weeks to completely resolve. Error bars denote standard error. Dr. Thomas Satterwhite In the Group A patients, FFS under Medi-Cal still requires preauthorization, just like private insurances. Unlike Group B, patients within Group C only had plans that were self-insured under ERISA. After a person pays the deductible, Medicare pays 80% of the allowable costs . P < 0.05 was considered significant. your express consent. 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. A total of 40 transfeminine patients were identified (mean age 35.6 2.2 years) (Table 1). A prior authorization is not a guarantee of payment, therefore, you should have funds available to cover all fees and costs related to your surgery should your request be denied. This procedure can alter both soft tissues as well as the facial bone to achieve more feminine-looking facial features. For example, a number of state-mandated denial overturns in Group B patients resulted in billing challenges postsurgery. Additionally, the patients who exited their employer-based plans to buy health insurance on the exchange paid more for health insurance by foregoing employer contributions. Which, though I knew FFS is expensive, is a bigger estimate than I've ever seen for the procedure. Demographic, clinical, and administrative data were retrospectively collected (UCLA IRB #19-001482). It's an attempt to make the face as attractive as possible for as long as it lasts. 6. 2018; 319:691697. Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. Days, whose birth name was Douglas, came out as transgender in January, 2015. 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. Average months spent from initial facial feminization consultation to final insurance authorization decision. He has been performing gender surgery since 2005.
PDF Facial Feminization Surgery (FFS) Preparation Guide - Thrive 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) includes a series of plastic and craniofacial surgical procedures designed to feminize the face. Referral letters and supporting documentation should be sent to: UCSF Gender Affirming Health Program 1725 Montgomery St. Suite 250 San Francisco, CA 94111 Phone: 415-885-7770 Fax: 415-353-3399 transcare@ucsf.edu Requires supporting documentation that indicates specific type of FFS procedures requested.
Find a Surgeon for Gender Affirming Surgery - TransHealthCare Most other insurance plans do not cover FFS and consider it as cosmetic surgery. A report last year from the Center for American Progress found that 40 percent of transgender respondents and 56 percent of trans respondents of color said their health insurance companies.
For Bay Area trans women, facial feminization surgery helps complete Requested CPT codes are detailed in Supplemental Digital Content 1. Post Surgery Recovery. When it comes to facial feminization there is no substitute for experience.
Paying for Transgender Surgeries - Investopedia Prior to meeting with the social worker, patients should complete this assessment document. 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. The generalizability of the findings presented here is limited by state laws. Forehead (frontal bone recontouring, recontouring of superior orbital rim, hairline lowering). Group A is similar to other medically necessary reconstructive procedures where authorization is requested and procedures are authorized.
Bottom Surgery: Cost, Recovery, Procedure Details, and More - Healthline 10. The total time from initial consultation to authorization approval in Group B required 7.0 1.1 months, a 6-fold longer process compared with Group A patients (P < 0.001) (Fig.
Letters - Crane Center for Transgender Surgery Most trans women elect to have all facial feminization procedures performed at once, or in two phases (upper face and lower face). This operation is most commonly performed in transgender women or non-binary people as a type of gender-affirming surgery. Call Your Insurance Company to Ask if Gender Affirming Surgery is a Covered Benefit. 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. Jaw contouring contours the mandible and narrows a full jaw by reducing angles in the lower face. They accept most major insurances and work to help you get your surgery fully covered whenever possible. In contrast to Group A, patients who required significant efforts in the form of multi-level appeals, peer-to-peer reviews, and IMRs were designated Groups B and C, depending on ultimate approval versus denial as the outcomes, respectively. 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. Dr. Ley has joined Dr. Scott Mossers Gender Confirmation Center in San Francisco, where she will begin seeing patients in March 2022.
FFS: money and choosing a surgeon : r/Transgender_Surgeries 3.
Male-to-Female Surgery in Texas - Dr. Dulin - MTFsurgery.net Facial feminization surgery: the forehead. One patient may have severe dysphoria over their forehead, while one may have dysphoria over their upper lip. Facial feminization surgery (FFS) is a group of cosmetic procedures that reconstruct facial features that appear masculine and alter them to become more feminine. $8995. 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 .
Facial Feminization Surgery | Michigan Medicine - U of M Health 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. This is highly considered one of the most "life-altering" surgeries for a transgender patient because the impact is visible right away.