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 Dr. Ramineni is a board-certified plastic and reconstructive surgeon with over 15 years of experience. 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. Two letters from mental health providers. Due to the gender non-discrimination laws of the state, the denial is typically overturned and the procedures are authorized. Facial feminization aims to find balance and harmony of the face between shadow and light, masculine and feminine, natural aging and youthfulness. Initially, you would need to be seen in the office for an examination/consultation to determine the scope of yoursurgeryto determine the exact cost of your facial feminization. William Hoffman, MD and Jason Pomerantz, MD from the UCSF Division of Plastic Surgery, and Drs. Care Credit approval amounts can vary from person to person. Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender patients. (See table 2, Supplemental Digital Content 2, which displays the total time and cost of the insurance approval process per group. Male-to-female (MTF) facial feminization. Included in Appendix D are the new letter referral suggestions for gender-affirming surgery (GAS). Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Facial feminization surgery (FFS) uses a series of procedures to alter features to appear more classically female. The average cost of facial feminization surgery (FFS) is $34,504, according to 213 reviews from RealSelf members. Dr. Gurjala joined Align Surgical Associates in 2019, after five years of performing gender surgery, microsurgery, and general reconstructive and aesthetic surgery in the Kaiser Permanente healthcare network. I always advise people to try with the insurance they have before they switch to another plan. Every state is different so start with Google and reach out to these services in your state, theyre here for you! 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. A total of 36 patients (90.0%) have been approved by insurance. After a person pays the deductible, Medicare pays 80% of the allowable costs . Dr. Crane is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. 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.) Recognized for his exceptional surgical skills and natural-looking results, Dr. Raminenis patients also praise his friendly, compassionate and professional nature. Submission and review of initial authorization request (1 month); 2. 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. For patients anticipating insurance coverage for your surgery, we appreciate that you may wish to seek insurance reimbursement for the cost of some or all of your feminization procedures and have outlined some general guidelines below. You will be asked to complete an intake questionnaire before your consultation. Patients seeking services from our practice arepersonally and fully responsible for paymentof all fees and costs related to your FFS surgery and medical care. Americans who are considering surgery as part of their transition can find the cost of gender-affirming surgery to be steep. In the rare instance that FFS Surgery is included in your health insurance policy, services may be incomplete or function only on a reimbursement basis. As much as possible, Dr. Salgado will do what he can to keep costs at a minimum. Here, we describe our institutional experience on navigation, time, and costs of the FFS insurance authorization process. Find Dental Health Services: Department of Health - Rhode Island For example, there are now many hospitals across the . The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. 1. Health insurance Medical Policies - Trans Health Project Raffaini M, Magri AS, Agostini T. Full facial feminization surgery: patient satisfaction assessment based on 180 procedures involving 33 consecutive patients. Insurance Requirements for Gender Confirmation Surgery - Verywell Health During Your FFS Procedure How long it takes: This depends on what you are having done. 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. 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. Brow Lift. In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. *. 12. JAMA. Simplifying facial feminization surgery using virtual modeling on the female skull. 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. Societal implications of health insurance coverage for medically necessary services in the U.S. Transgender population: a cost-effectiveness analysis. Facial Feminization Surgery FFS Insurance Coverage Ask to speak to people's supervisors. However, this is starting to change. 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. (See table 1, Supplemental Digital Content 1, which displays requested CPT codes and associated terminology for facial feminization surgery. Based on my conversations with friends who are very satisfied with their FGCS, I assure you that no surgery can completely resolve that anxiety. 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. 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. Dr. Salgado is a board-certified plastic surgeon with deep expertise in gender-affirming procedures. Cost of Facial Feminization Surgery (FFS) and Insurance Information Dr. Meltzer is widely recognized as one of the leading surgeons in the field of Gender Surgery, having completed over 4000 gender affirming surgeries. How to Pay for Gender-Affirming Surgery - NerdWallet Average time spent from administrator and surgeon in obtaining insurance approval for FFS (A). 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). Now you will be denied! However, we are not responsible for any insurance documentation, reimbursement, denials, or appeals. Second, while complications are not high in FFS, they may occur. Los Angeles, CA: University of California, Los Angeles School of Law; 2019. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. 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. 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. The total costs of your Facial Feminization Surgery will be determined by the staff of the University of Miami. Most other insurance plans do not cover FFS and consider it as cosmetic surgery. Transgender women may choose FFS as part of their male-to-female transition process. This is called facial feminization surgery. 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). 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. This study highlighted the successes and burdens associated with obtaining insurance authorization for FFS. 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. 1. Do you have access to out-of-network providers or in-network only. Publications See a list of publications about facial feminization by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine. 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. 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. Read your cover in detail and find out the following: Second, find out if yourCertificate of Coveragehas any inclusions (or exclusions) around transgender care. On average, Dr. Keojampa is booking 8-12 months out for Aesthetic Craniofacial Surgery and Facial Feminization Surgery. San Francisco, CA 94108. For self-pay patients, cost will frequently dictate the operative and postoperative setting such that patients may be preferentially or solely performed in an outpatient setting. Facial feminization surgery, or FFS, describes a set of complex procedures designed to "feminize" the face. Facial Feminization Surgery | Michigan Medicine - U of M Health FFS is a cost-effective intervention that needs to be covered by insurance policies. 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. 2. Until then, CCTS will continue to require all patients using insurance for . FFS can include hairline lowering, jaw reduction, rhinoplasty (nose reshaping), eyelid surgery, face or neck lift, and other facial changes. FFS: paying and picking a surgeon. Freaking out and need advice. With a view to clarifying this issue and answering frequently asked questions, we have compiled the following information in an effort to not only outline how Deschamps-Braly Clinic handles finance and insurance coverage but to also provide general information about how to approach your own health insurance company regarding the cost of your facial feminization. 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. He has been performing gender surgery since 2005. Facial Feminization Surgery - Need FFS? Find the Best FFS Surgeons Facial feminization surgery (FFS): The permanent . P < 0.05 was considered significant. A total of 33 patients between 19 and 40 years of age were referred for facial feminization surgery between January of 2003 and December of 2013, for a total of 180 procedures. Facial Feminisation Surgery | Nuffield Health Capitn L, Simon D, Kaye K, et al. Surgery referral assessment requirements | Gender Affirming Health Program Additionally, planning and recovering from any trans surgery is hard! Modeling performed by Padula and colleagues for employer-based insurance plans in Massachusetts indicated that, over the course of 5 years, coverage for transition-related services would lead to societal costs of $0.016 per month per member.3 The authors concluded that the relatively low societal cost, combined with the increase in quality-adjusted life years for transgender patients, supported coverage of transition-related services in employer-based plans. Dr. Notes.