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Group B (extended approval) primarily encompassed all patients who were initially denied but, after undergoing a multi-level appeal process, was ultimately approved. 14. 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. Dr. Sajan performs the following Facial Feminization Surgery procedures at his state-of-the-art facility in Seattle, Washington. Submission and review of initial authorization request (1 month); 2. Read on to find out why you might pay more or less, and whether the cost is really worth it. 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. Read more. Group B, consisting only of private insurance plans, are processes that initially resulted in denial, thereby requiring multi-level appeals. to maintaining your privacy and will not share your personal information without 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. Submission and review of IMR (1 month). The work cannot be changed in any way or used commercially without permission from the journal. Every state is different so start with Google and reach out to these services in your state, theyre here for you! Also referred to as Facial Gender Confirmation Surgery (FGCS), these procedures are becoming more and more popular, and increasingly are covered by insurance. ), You will also need to factor in the costs of airfare, transportation, and accommodation if youre not from the San Francisco Bay Area. One of the major issues among surgeons and patients with regard to insurance coverage for FFS is the lack of understanding of the process as coverage for gender healthcare is highly variable depending on state law and plan variabilities (Table 3). $8995. For both Groups B and C, the authorization process averaged approximately 6 months, a 6-fold increase compared with Group A. 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. 2018 Physician Compensation Report. FGCS is a collection of procedures designed to change the bone structure of the face and reshape features that resulted from testosterone exposure. Mallory C, Tentindo W. Medicaid coverage for gender-affirming care. It's an attempt to make the face as attractive as possible for as long as it lasts. Some of the procedures included in facial feminization surgery are: For more information, please refer to our Privacy Policy. Dr. Dorafshar is a highly distinguished plastic and reconstructive surgeon who specializes in gender-affirming facial surgery. Dr. Mundinger is a board-certified plastic surgeon with extensive training and expertise in craniofacial surgery, microsurgery and gender-affirming surgery. 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. FGCS is a treatment for gender dysphoria related to the secondary sex characteristics in the face, not a treatment for anxiety caused by the experience of having gender dysphoria or being a transgender person in an unkind world. Insurance coverage for FFS is an important issue for a number of reasons for both patients and surgeons. Complete New Patient Questionnaire. 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. Unlike California plans, self-insured plans are not under the CA DMHC and, thus, the final outcome is more variable. Values: "At Kamol Hospital we provide a complete spectrum of fine cosmetic surgical procedures, performed by elite plastic surgeons setting new technological achievements. Wolters Kluwer Health, Inc. All rights reserved. In fact, he is one of the most experienced gender surgeons in the world. Administrative time, including obtaining initial authorizations, appeals, IMRs, and additional phone calls, averaged to 7.2 1.0 hours spent per patient. . Call 913-588-6200 to request a consultation. 2016; 137:438448. Known for her surgical skill and artistry, Dr. Nghiems patients also love her kind and caring demeanor. Plastic surgery on the face. Male-to-female (MTF) facial feminization. . In general, patients who undergo FFS will stay overnight after their procedure and return home the following day. 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. Private insurances included health maintenance organizations and preferred provider organization. Your insurance might have a requirement about length of time in care with them, or degree level. I always advise people to try with the insurance they have before they switch to another plan. 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. Otherwise, your deposit will be applied towards your surgical balance. These procedures are also called Facial Feminization Surgery or FFS, but in agreement with the experts, I've shifted to using FGCS. Dr. Schnitt is a board certified cosmetic, plastic, reconstructive and craniofacial surgeon who has been practicing in South Florida since 2002. He subsequently completed a Gender Surgery Fellowship with Dr. Toby Meltzer and Dr. Ellie Zara Ley. Because Medicare patients (n = 4) do not need prior authorization, they were excluded from the time and cost analysis of the insurance appeal process for Group A. 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. I am working from the perspective that you are unable to pay in full and be reimbursed. 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. From the cohort, 3 subgroups were delineated. While facial feminization surgery has many potential benefits, the decision to proceed . Upon denial, an IMR is requested directly from the insurance plan. 2015; 136:560e561e. 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. Dr. Mangubat is a board-certified cosmetic surgeon in the Seattle area who has been performing transgender surgery procedures for over twenty years. 2018. https://links.lww.com/PRSGO/B648.) 11. All rights reserved. Staying in the hospital: Your procedure may be performed in a hospital or outpatient center. This might be the hardest part- no one should have to compromise quality, and the big names in FGCS have historically not taken insurance, though its my observation that this is rapidly changing. I recommend the pioneer of FGCS, Dr. Douglas Ousterhouts book, Facial Feminization Surgery: A Guide for the Transgendered Woman for those looking to learn more about what skill and training is involved and a breakdown of procedures as he performed them, but Ill attempt to summarize. For additional assistance with any information contained within this packet, please contact: Oakland MST Department: (510) 752-7149. J Gen Intern Med. 3. Group A averaged 1.1 months for approval, requiring 1.4 hours of administrative time translating to $38.18 per patient. Dr. Rodriguez is a board-certified plastic surgeon in San Francisco who is dedicated full time to providing surgical care for transgender 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. Gender-affirmation surgery gives transgender people a physical appearance that aligns with their gender. The FFS Surgeons listed below are highly qualified plastic, cosmetic and maxillofacial Surgeons who regularly perform FFS. Doctors and nurses take good care. Body-contouring. In total, the time and cost estimate of the insurance appeal process was 10.8 1.0 hours and $855.00 91.53 per patient, respectively. Secondly, the current study does not take into account the postsurgical administrative and billing time consumption and costs. 3. Leigh JP, Tancredi D, Jerant A, et al. Our practice does NOT contract with any insurance providers to allay the cost of your facial feminization surgery. 1) and surveying administrative personnel and physicians to determine the approximate time spent on each step. To filter results, enter information and 'click search icon' and/or select from the dropdown lists. Third, full-face, one-stage FFS is a highly time-consuming surgery due to the multiple anatomical areas addressed at once (averaging 8.5 hours in the senior authors experience). may email you for journal alerts and information, but is committed The standard premium for Medicare Part B in 2020 is $144.60 each month, and there is a $198 annual deductible cost. According to the World Professional Association for Transgender Health, facial feminization surgery is particularly inaccessible because almost all insurance companies deem it a cosmetic procedure . Such multi-level appeals begin with a surgeon-initiated appeal, which is then also denied. Dr. Javad Sajan, MD is a Cosmetic, Plastic and Reconstructive Surgeon in Seattle who specializes in Gender-Affirming Surgery including Top Surgery, Breast Augmentation, Body Sculpting and Facial Feminization. Fortunately, as insurance coverage for gender confirmation surgeries has increased, so has physician interest in training. The lady on the phone told me the surgery usually ranges from $60-100,000 dollars. Unlike Group B, patients within Group C only had plans that were self-insured under ERISA. There are 301 level topics not covered here- going out of network to an office who will only give you CPT codes performed, getting a network exception to go to a provider with skills not available among in-network surgeons, etc. surgical techniques and analysis of results. LGBT legal service projects? Patients who receive prior authorization are still required to pay for the cost of their facial feminization surgery in advance. 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). Support groups? Dr. Alan Dulin is a board-certified surgeon with many years of experience performing Male-to-Female Surgery in the Dallas area. We are looking forward to meeting you in person, hearing your aspirations, and tailoring a Surgical plan especially for you. 2. 1. Read more on our Insurance and Finance page. One of the major barriers for transgender patients is accessibility to gender-affirming surgeries due to the lack of insurance coverage or inability to afford surgery as a self-pay patient.1 In an analysis of the National Inpatient Sample, Canner and colleagues noted that between 2000 and 2014, 56.3% of patients undergoing gender-affirming surgery were not covered by any health insurance plan.2 Over the course of this period, particularly between 2012 and 2014, an increase in patients covered by private insurance and Medicare and Medicaid was noted.
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