facial feminization cost and insurance
Often, our patients ask us about the cost of facial feminization and whether their health insurance will cover them for the variety of procedures included in their surgery. There is also a lot 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 medical insurance.
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For many trans people, insurance versus the cost of ffs is a minefield of confusion
In order to clarify this issue and answer frequently asked questions, we have compiled the following information in an effort to not only describe how clinic deschamps-braly handles finances and insurance coverage, but also to provide information general information on how to approach your own health insurance company regarding the cost of your facial feminization.
Note: The following is intended as a high-level summary and guide only and in no way constitutes legal or professional advice. Ultimately, you’ll need to contact your health insurance company or patient advocate for more specific cost information.
frequently asked questions (faq) about insurance coverage and cost of facial feminization surgery
1. How much does facial feminization surgery cost?
Initially, you will need to be seen in the office for an exam/consultation to determine the scope of your surgery to determine the exact cost of your facial feminization. Other costs to consider are:
- anesthesia and operating room fees (both are charged based on length of time used)
- overnight hospital stay
- hardware (any implants or inserts)
from the san francisco bay area
2. Does the Deschamps-Braly clinic have a contract with an insurance provider?
Our practice is not contracted with any insurance provider to mitigate the cost of your facial feminization surgery. Patients who request services from our practice are personally and fully responsible for payment of all fees and costs related to their surgery and ffs medical care.
For patients who anticipate insurance coverage for their surgery, we welcome your desire to apply for insurance reimbursement for the cost of some or all of your feminization procedures and have outlined some general guidelines below. However, it is important to note that the terms and conditions of many insurance policies do not recognize coverage for the cost of FFS, or may exclude coverage for services provided to you. If your insurance provider approves the authorization request, we may be able to file a one-time courtesy claim on your behalf. however, we are not responsible for any insurance documentation, reimbursement, denial, or appeal.
read more on our insurance and finance page.
3. should i contact my insurance provider directly to verify what, if any, out-of-network coverage is available for the cost of my ffs?
Upon receiving a deposit for your surgery, our practice may offer to submit a “prior authorization” request to your insurance provider. A “prior authorization” is not a guarantee of payment, therefore you must have funds available to cover all fees and costs related to your surgery in the event your request is denied. patients who receive prior authorization must still pay the cost of their facial feminization surgery up front. any insurance company reimbursement (if applicable) will be paid directly to the patient.
Read more about our clinic’s insurance policy and finances here.
4. how do i know if my insurance provider covers ffs?
Although your ffs may not be covered by your insurance company, it’s definitely worth looking into. Start by making sure you have a thorough understanding of your insurance benefits. read its cover in detail and discover the following:
- Do you have to pay a deductible?
- What is your maximum out-of-pocket cost?
- Do you have access to out-of-network providers or only in-network? of the network?
Second, find out if your Coverage Certificate has any inclusions (or exclusions) regarding care for transgender people. you should be able to easily access this document through your insurance provider.
5. my insurance says it covers ffs, so I’m fine, right?
You should be aware that there may be a difference between the “allowed amount” (maximum paid by the insurance company) and the “billed amount” (the amount that the clinic charges for the surgery).
6. Can I finance my facial feminization surgery through financing or payment plans?
Some of our patients use the care credit to cover part of the cost of their facial feminization surgery. care credit approval amounts may vary from person to person. see credit care website for details.
7. Can I get prior authorization from my health insurance before coming in for a consultation?
not. you must attend an in-person consultation and pay a deposit to secure your surgery date before we request prior authorization.
8. Is my deposit refundable if my insurance authorizes the cost of my feminization?
only if your insurance provider authorizes a letter of agreement. otherwise, your deposit will be applied to your surgical balance.
9. where can i get additional help and support for ffs?
If you work for an employer that supports your gender confirmation surgery, your first point of contact should be your in-house health insurance liaison. if not, remember that you are never alone and that there are a variety of transgender support agencies that you can access. Try your local trans advocacy groups, lgbti legal services, support groups, etc. every state is different, so start with google and contact these services in your state, they are here to help!