Facial Feminization Surgery FFS Insurance Coverage – Dr Keojampa

yes, we are one of the few ffs centers that will accept health insurance if your health insurer provides coverage for ffs and willing to sign a letter of agreement to work with our center. we will work with your insurance to determine coverage which can sometimes cover up to 100% of the cost. FFS insurance coverage is uncommon and many insurers often place an exclusion on their health plans.

facial feminization surgery insurance coverage

Reading: How to get ffs covered by insurance

We have had success obtaining insurance coverage for facial feminization surgery from health plans of large technology companies such as apple, at&t, amazon, t-mobile, dell, boeing, oracle, google, microsoft, starbucks along with select massachusetts health insurance plans. most other insurance plans do not cover ffs and consider it as cosmetic surgery. These are generally self-insured employer plans that are administered by well-known insurers such as Blue Cross Blue Shield, United Healthcare, Harvard Peregrine Healthcare, and Tufts Health Plan. insurance is constantly changing and we cannot offer any guarantees regarding insurance coverage or approval.

why should facial feminization surgery be a covered benefit for a transgender patient?

We feel privileged to be trusted by the #transgender community with their gender transition and facial gender confirmation surgery. we believe that ffs facial feminization surgery is reconstructive surgery and not cosmetic surgery to align one’s outward appearance with one’s identified gender.

Facial feminization surgery is an essential part of the transition schedule for a transgender patient who has decided to live full-time as a woman. most patients first begin working with a therapist before and after starting hormones. After taking hormones for an extended period of time, patients will transition to “full time” and undergoing FF may be essential to increase acceptance of their new gender. the importance of “passing” and the role of facial features play a significant role in how transgender patients are perceived by the general public and others. The therapeutic goal of transgender surgeries is to enable a transgender person to successfully function socially as a member of their desired gender.

One of the most important components of gender identification is the face, which is why we believe that facial feminization surgery should be considered a medically necessary procedure. Although it is clearly possible to transition from male to female without facial feminization surgery, it can be extremely difficult for many people if their facial features are clearly masculine. even people who develop extremely feminine bodies as a result of hormones often find it extremely difficult to gain acceptance if their facial features are extremely masculine. how accepting individuals are is often directly related to how “congruent” they are with their gender. As a result, facial feminization surgery (FFS) is essential for many mtof transsexuals.

facial feminization surgery can affect the quality of daily life much more than any other therapeutic procedure for a transgender person, often more than genital reassignment surgery. facial features that are distinctly masculine can make people always appear “masculine” without surgery. facial feminization surgery can have a much more profound effect on a transgender person’s quality of life than genital reassignment surgery and why most patients choose to undergo ffs first and genital reassignment surgery later.

guide so that your facial feminization surgery is covered by insurance

Will insurance cover my surgery? And if so, how much will I have to pay?

Here are some guidelines to help answer these questions. the first step is to contact us for a consultation. You can request a consultation using the following form.

ffs query request form

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We have an insurance concierge who can work with your insurance and help you through the insurance approval process until approval is achieved, or to the point where it becomes clear you don’t have coverage.

To help us verify benefits, we need the following information:

full name date of birth procedures you wish to cover a scanned copy of your insurance card (front and back)

if available, front sheet indicating which ffs procedures are covered

once we have your information, we will contact the insurance company to determine what coverages are available. when we contact you, we will present one of the following scenarios:

Case 1: Your insurance company does not cover the cost of facial feminization surgery.

what you can do:

pay out of pocket for the procedure. finance your process with carecredit. It works like a credit card but is exclusive to health services. you can use your card multiple times for different procedures and products and still enjoy low monthly payments. finance your process with a loan. there are several lenders that offer loans specifically for plastic surgery procedures.

Scenario 2: Your medical insurance covers facial feminization surgery.

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what we will need from you for authorization approval:

a letter from a mental health provider stating that you meet the wpath guidelines for surgery notes from your visit to dr. keojampa that we will have ready 1-2 weeks after your inquiry. There may be additional requirements based on individual circumstances, such as a letter of agreement between our facility and your health insurance company.

The process of obtaining all necessary approvals for insurance coverage for facial feminization surgery can take several months depending on your insurer.

gender confirmation surgery with related services: examples of at&t benefits insurance

Beginning January 1, 2017 or as soon as administratively feasible thereafter, benefits provided under AT&T’s self-insured medical programs (currently administered by BCBS or UHC, depending on your program) will include coverage for gender confirmation based on the recommendations for medical standards of care issued by the world professional association for transgender health (wpath). Services currently included under this coverage are listed below.

Note: Members who meet the criteria for gender confirmation services may choose to have some or all of the appropriate services included. for example, a person may choose to have a breast modification, but not the full male-to-female or female-to-male surgery.

services covered by facial feminization surgery coverage

primary sex characteristics services female-to-male surgeries male-to-female surgeries1 secondary sex characteristics services thyroid chondroplasty reduction or trachea shaving (adaman’s apple reduction) blepharoplasty (eyelid rejuvenation) brow lift brow implants calf cheek implants chin or nose implants external penile implants prosthetics (vacuum erection devices) face lift (rhytidectomy) facial bone reconstruction/sculpting/reduction, including jaw shortening brow lift or contouring hair removal (may include donor skin sites) or hair transplant (electrolysis or hairplasty) laryngoplasty lip reduction or lip augmentation liposuction/lipofilling or body contouring or shaping of the waist, buttocks, hips and thighs neck lift reduction pectoral implants redundant skin removal/ excessive rhinoplasty (correction nose) skin rejuvenation

voice modification surgery voice (speech) therapy or treatment of voice lessons with hormone therapy or secondary surgeries of sexual characteristics for persons under the age of 18, that is, puberty-suppressing hormones or masculinizing/feminizing hormones abdominoplasty

testicular expanders

insurance cpt codes commonly used for facial feminization surgery

21139 reduction front; contoured & setback, frontal sinus anterior wall repair 67900, brow ptosis, (supraciliary/midfront/coronal approach) 61782 computer-assisted stereotactic procedure (navigation); cranial, extradural 14041 scalp advancement 15776 hair transplants; > 15 punch grafts 15876 suction assisted lipectomy; head & neck 20926 tissue grafts, other (eg, paratenon, fat, dermis) 21122 genioplasty; sliding osteotomies, 2+ osteotomies 21195 reconstruction, mandibular rami and/or body, sagittal split; without rigid internal fixation 21209 osteoplasty, facial bones; reduction 21270 malar augmentation, modifiers of prosthetic materials: -50 bilateral procedure 31599 tracheal shave 40652 lip lift 30410 rhinoplasty; primary; complete 30520 septoplasty 30140 turbinate resection with submucosal approach modifiers: -50 bilateral procedure

facial feminization surgery consultations

Based in the greater Los Angeles region, we provide in-office facial feminization consultations and Skype consultations for patients interested in facial feminization surgery. We routinely have patients who travel out of state and internationally to our center for facial feminization surgery. requests for in-office or skype consultations can be made by calling our office (310) 823-4444, emailing [email protected], or using the consultation request form.

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