National Variation of Insurance Coverage for Gender-Affirming Facial Feminization Surgery

Gadkaree, Shekhar K.; DeVore, Elliana Kirsh; Richburg, Kayla; Lee, Linda N.; Derakhshan, Adeeb; McCarty, Justin C; Seth, Rahul; Shaye, David A.

doi:10.1089/fpsam.2020.0226

Cited by 35 publications

(30 citation statements)

References 28 publications

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“…2,3 Absence of insurance coverage remains a barrier to care for transgender individuals seeking GAS, especially FFS. 21 Between the dates covered in this study, state Medicaid policies on GAS varied considerably, with only three states (Connecticut, Massachusetts, and Washington) guaranteeing "extensive" FFS coverage without a case-by-case clause. 7 Other states including California, Oregon, and Maryland cover FFS either on a case-by-case basis or cover only specified procedures, making access in these states fall below the "extensive" coverage defined by Gorbea et al 7,18 More recently, the Centers for Medicaid and Medicare Services approved expansion of Colorado's Essential Health Benefits plan to require all individual and small group health insurers cover FFS including jaw, cheek, and eye modifications, face tightening, and facial bone remodeling starting in 2023.…”

Section: Discussionmentioning

confidence: 99%

Limited Access to Facial Feminization Geographically Despite Nationwide Expansion of Other Gender-Affirming Surgeries

Hauc

Mateja

Long

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Facial feminization surgery (FFS) is an integral aspect of genderaffirming surgery (GAS) for individuals seeking to align secondary sex characteristics and gender identity. Despite the importance of FFS in treating gender dysphoria, current trends and prevalence remain unknown. We sought to examine trends in GAS and FFS and investigate the payer status of facial feminization procedures in the United States. Methods: Data was extracted from the National Inpatient Sample from 2008 to 2017 by using International Classification of Diseases Ninth or Tenth diagnosis codes for gender identity disorder and procedure codes for FFS. Results: From 2008 to 2017, 3015 patients underwent GAS. The yearly number of cases increased as did the average cost of GAS, which rose from $13,657 in 2008 to $50,789 in 2017. From 2015 to 2017, when FFS data was available, 110 of 1215 (9.1%) GAS patients had FFS. Most were non-Hispanic White (66.7%) or Black (23.8%). Fifty percent of FFS cases occurred in the West, followed by the Northeast (31.8%), South (13.6%), and Midwest (4.8%) (P = 0.015). By payer the cases were, 36.4% self-pay, 31.8% Medicaid, and 27.3% private insurance (P < 0.0001). Approximately, 18% of patients undergoing male-to-female transition received FFS. Conclusions: From 2008 to 2017, GAS cases increased nationwide while the average cost of surgery rose steeply. FFS cases were primarily in the Western and Northeast United States. Despite high cost, roughly 18% of transgender women in our sample received FFS, highlighting the importance of FFS in gender transition.

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Section: Discussionmentioning

confidence: 99%

Limited Access to Facial Feminization Geographically Despite Nationwide Expansion of Other Gender-Affirming Surgeries

Hauc

Mateja

Long

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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show abstract

“…Despite recent improvements, access to GAS remains limited. Less than half of state Medicaid programs provide for GAC, and in 2020, only 18% of the 3 largest private health plans by state had policies favorable for facial feminization surgeries . Policies supporting insurance coverage for GAC may have a role in expanding access to GAS.…”

Section: Discussionmentioning

confidence: 99%

Association of Health Policy With Payment and Regional Shifts in Gender-Affirming Surgery

et al. 2022

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Important insurance coverage policy changes for genderaffirming care (GAC) occurred in the past decade. Several states added Medicaid coverage for GAC, and Medicare lifted its ban on gender-affirming surgery (GAS) in 2014. 1 In 2016, the Department of Health and Human Services ruled that the ACA prohibits discrimination based on gender identity in federally funded insurance plans. 2 Although this measure was blocked by court injunction, similar state-level measures were increasingly seen. 3 Little is known about the association of these changes with access to GAS. We examined shifts in GAS by region and insurance use during periods when key antidiscrimination policies took effect.

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“…rience of the microvascular anastomosis with using the Vitom3D (Carl Storz, Tuttlingen, Germany), 2,3 and Ahmed et al also concluded that the usability of the ORBEYE (Olympus Corp., Tokyo, Japan) was not inferior to the optical microscope for microsurgery. 4 However, there was a limitation for the usability in supermicrosurgery, defined as anastomosis of small vessels ranging from 0.3 to 0.8 mm because of the resolution under the large manipulation of the digital microscope.…”

Section: Ichikawa Et Al and Piatkowski Et Al Reported The Expe-mentioning

confidence: 99%

“Facing Violence: The Protective Impact of Facial Gender Affirming Surgery”

Parker¹,

Brydges²,

Kimberly³

et al. 2022

Plastic &Amp; Reconstructive Surgery

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National Variation of Insurance Coverage for Gender-Affirming Facial Feminization Surgery

Cited by 35 publications

References 28 publications

Limited Access to Facial Feminization Geographically Despite Nationwide Expansion of Other Gender-Affirming Surgeries

Limited Access to Facial Feminization Geographically Despite Nationwide Expansion of Other Gender-Affirming Surgeries

Association of Health Policy With Payment and Regional Shifts in Gender-Affirming Surgery

“Facing Violence: The Protective Impact of Facial Gender Affirming Surgery”

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