Facial Feminization Insurance
Does Insurance cover MTF Gender Affirmation?
Overview:
Does Insurance Pay For Facial Feminization?
Some insurance companies do cover facial feminization. Out of the common gender affirming procedures performed in the United States, facial feminization is less likely to be covered than others. Many insurance companies have stipulations that they will only cover procedures for gender identifying characteristics. Some insurance companies exclude facial feminization for this reason.
Additionally, they may cover individual facial procedures such as a rhinoplasty or lip lift when it comes to gender affirmation surgery. However, the same company or plan may not cover other procedures sometimes included in FFS. Every state and individual insurance company differs. Therefore, this makes navigating insurance for FFS extremely complicated and time consuming.
Finding Insurance That Covers FFS
If you have health insurance through your workplace, peruse all of the available plans to see if one offers coverage for gender affirming procedures and specifically facial feminization. In Washington, many of the larger carriers will have some coverage for gender related surgeries. Though, the exact coverage will still vary.
If your workplace does not offer insurance that covers FFS or you do not have health insurance, Washington’s insurance marketplace is a great resource. It can help find an insurance plan that fits your budget and covers your needs. Outside of Washington, this may not be available.
Getting FFS Covered By Health Insurance
Even if your insurance does cover FFS, it often requires jumping over many hurdles to get it fully covered. Allure Esthetic can act as a liaison to simplify communication between you and your insurance company.
First Steps
At Allure Esthetic our insurance coordinators will help with all of the steps needed to help get you insurance coverage. Our insurance coordinators are trained specifically to advocate for gender affirming procedures and we will do our best to be your ally. Our insurance coordinators will help you with the below steps, however, if you choose to do them on your own, below are the steps to generally follow.
First, confirm coverage by contacting your insurance company and determining if the insurance company will offer coverage for facial feminization surgery. Next, if you have coverage, ask your insurance company what your out-of-pocket costs will be. Next, ensure that your chosen provider takes your insurance or that they can be billed out of network. Dr. Sajan is an in-network provider for all major commercial insurance carriers.
Finally, all insurance companies will have different requirements for covering surgery. Make sure that both you and your provider know what is necessary to move forward with surgery.
Things You May Need
Insurance companies sometimes require:
- Letter of support from a mental health professional
- Diagnosis of gender dysphoria from mental health professional
- Confirmation that you meet WPATH guidelines
- Medical clearances
- Letter of agreement between Allure Esthetic and your insurance
- Documentation of hormone therapy or other transgender care
- Have identified in present gender for at least a year
- Proof that other mental and medical conditions are well treated
- The exact requirements of your insurance will vary based on your company, plan, and state. You can often find this information online or by calling your insurance company.
FAQ
What If My Insurance Does Not Cover FFS Or You Do Not Take My Insurance?
Outside of insurance coverage, there are financing options. Allure Esthetic does work with financing companies such as Care Credit. This can help you undergo surgery without needing to pay the full amount out of pocket and upfront. Patients do and always can pay out of pocket if they are able.
Are There Parts Of FFS Insurance Will Not Cover?
Yes, health insurance companies can decide what particular procedures to cover and which they do not. This is up to each company and can even vary by plan. Most companies will list out the procedures that can be covered with FFS.
If you find yourself in a position where insurance will not cover all of the procedures you want, you can finance the rest, pay out of pocket, or alter the surgical procedure so that it is all covered. Our insurance coordinators will help you navigate this to get the fullest coverage possible.
Is There Anyone To Help Me Get My FFS Covered?
Allure Esthetic employs dedicated insurance coordinators. They will work with both you and your insurance company to get your procedure covered. They also have insight into the industry which makes them extremely talented and literate when it comes to insurance for FFS.
Do You Take Out Of State Insurance?
There are cases when out of state insurance can be billed. However, this is largely on a case-by-case basis. If you are a facial feminization patient from outside Washington and want to know if your insurance may cover FFS at Allure Esthetic, contact our insurance coordinators by giving us a call or otherwise contacting us online.
How Much Is Facial Feminization Out Of Pocket?
Facial feminization is a procedure that is difficult to quantify because it can include thousands of different combinations of facial procedures. The best way to find out the cost of facial feminization is to schedule a consultation with Dr. Sajan. At this appointment, he will make a surgical treatment plan with you. Once he gets a unique understanding of your needs, you will receive a customized price quote.
Allure Esthetic & Insurance Coverage For FFS
Allure Esthetic is Washington State’s top destination for facial feminization surgery. They accept most major insurances and work to help you get your surgery fully covered whenever possible. Health insurance is unnecessarily difficult when it comes to gender affirming surgery. Allure Esthetic works to make the process easier and less stressful.
While Allure Esthetic does not currently work with Washington state based plans (Medicare/Medicaid), they work with out of state Medicaid plans on a case by case basis. Alternatively, they are happy to refer you to another Medicaid provider.
Dr. Javad Sajan is a leading plastic surgeon who performs facial feminization and gender affirming surgeries. He is one of the top in the field and has performed hundreds of facial and body gender surgeries. To learn more and schedule a consultation, call us at 206.990.0060. You can also reach out online using chat or online form.
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