The doctor said very encouraging. You will be asked to complete an intake questionnaire before your consultation. 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. The total costs of your Facial Feminization Surgery will be determined by the staff of the University of Miami. Group A averaged 1.1 months for approval, requiring 1.4 hours of administrative time translating to $38.18 per patient. 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. Dr. Thomas Satterwhite His experience in cosmetic and craniofacial surgery makes him an excellent choice for Facial Feminization (FFS) and Masculinization surgeries. 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]. Plast Reconstr Surg. 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*,. Facial Feminization Surgery: A Guide for the Transgendered Woman. 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? Get a bossy friend to make phone calls with you while you are dealing with the process. In addition to legislative changes, the rationale for increasing coverage may be related to calculations on the cost-effectiveness of coverage. Other costs to consider are: Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. In these circumstances, both complications and revisions are covered as reconstructive procedures, whereas self-pay patients may be responsible for secondary surgical costs. They will need letters of support from you for the preauthorization, following WPATHs Standards Of Care. The administrator hourly compensation set at our institution was used for the cost analysis. 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. Facial Feminization | Dr. Patel Chicago | MTF Facial Plastic Surgery FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure. Facial feminization surgery (FFS) uses a series of procedures to alter features to appear more classically female. Dr. KathleynBrandstetter. Some of our patients use Care Credit to cover some of the cost of their facial feminization surgery. He offers Facial Feminization and Masculinization Surgery as part of the Gender Affirmation Surgery Program at Rush university Medical Center. Two letters from mental health providers. Doctors and surgeons trained in facial feminization surgery are working to improve care for people living with gender dysphoria. Facial feminization surgery (FFS) is undertaken to reconstruct masculine facial features to present a feminine form. Dr. Hadeeds practice now has two locations: Beverly Hills, California and Miami, Florida. 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. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. We're gonna try really hard to get my insurance to cover it, but I'm not holding my breath. Dr. Mangubat is a board-certified cosmetic surgeon in the Seattle area who has been performing transgender surgery procedures for over twenty years. 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. In fact, he is one of the most experienced gender surgeons in the world. Generally, one provider should have a doctoral level degree (PhD, DSW, Psychiatrist MD) and the other can have a masters level degree (MSW, MHC, etc.) Plans that fall into this group include Medi-Cal, Medicare, and some private insurance plans. In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. He is also skilled at multiple techniques of Top Surgery, Breast Augmentation and Body Sculpting. We're gonna try really hard to get my insurance to cover it, but I'm not holding my breath. 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. As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. According to the Philadelphia Center for Transgender Surgery,. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. 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. 14. Location: Bangkok, Thailand. Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. 2018. Does Medicare Cover Facial Feminization Surgery? By browsing TransHealthCare.org, you consent to our use of cookies and other tracking technologies. 2016; 31:394401. Facial feminization surgery - Doctors & Departments - Mayo Clinic The time from initial consultation to final insurance denial required 5.1 0.7 months, nearly 5-fold higher than Group A (P = 0.003) (Fig. Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. 3). Though specifics required by insurance vary (and might be laid out explicitly in your Certificate of Coverage) I recommend every person have three letters of support. $8995. For example, some may be reluctant to perform an osteotomy of the anterior table of the frontal bone for setback in an outpatient surgery center and, thus, default to a less aggressive method of frontal bone recontouring, which may be an undercorrection for certain patients. 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. Disclosure: All the authors have no financial interest to declare in relation to the content of this article. While facial feminization surgery has many potential benefits, the decision to proceed . 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. Facial Gender Confirmation Surgery or Facial Feminization Surgery (FFS) is a technique utilized to change masculine facial features into softer feminine ones. Post Surgery Recovery. 2). 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. In addition to performing hundreds of gender-affirming procedures each year, Dr. Rumer also directs a 1-year gender surgery fellowship program. However, this has been a persuasive strategy in some cases. The analysis was done by identifying individual steps involved in the insurance process (Fig. FFS: money and choosing a surgeon : r/Transgender_Surgeries Physician wages across specialties: informing the physician reimbursement debate. Dr. Sajan places the highest priority on providing his transgender patients with excellent surgical care and natural-looking results. $4985. 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. Administrative time, including obtaining initial authorizations, appeals, IMRs, and additional phone calls, averaged to 7.2 1.0 hours spent per patient. Facial feminization surgery: the forehead. Based in Beverly Hills, California, Dr. Lee is as well-known for her surgical precision as she is for the compassion, care and understanding that she has for all of her patients. Based in Washington, D.C., Dr. Ramineni performs upwards of 600 surgeries a year and has a specialization in Gender Affirmation Surgery. 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. As with any surgical procedure, there are risks associated with FFS. 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). 2020; 8:e2618. 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 . Co-insurance past that? your express consent. Rhinoplasty. 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). 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. This is the point at which you will likely need legal support. 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. 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. 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. A total of 36 patients (90.0%) have been approved by insurance. During Your FFS Procedure How long it takes: This depends on what you are having done. Bariatric Surgery. 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. I cannot tell you what insurance plan to get that covers FGCS, there are too many variables. PDF Gender Confirming/Grs Surgeon List and Resources for Preparing for 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. 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.