Will My Insurance Cover My Transgender Facial Feminization Surgery?

Q: Dr. Eppley, I’m a transgender woman and am looking into possible feminisation surgery. I have heard you come highly recommend among the transgender community, I’m curious to know if my insurance with my employer would cover it? Could you give me some info on that? I appreciate any thing you can do.

A: Like all plastic surgery procedures that potentially may be covered by insurance, an insurance predetermination process needs to be done. This is where a letter is written from the surgeon with pictures and coding for the carrier to make that determination. Only by going through this process can the patient ever really know before surgery. It is not something the patient can find out by reading their policies or calling the insurance company themselves.

Even if coverage is approved for some or all of the facial feminization procedures, all expenses of surgery may not be covered. Because I do not perform these procedures in a hospital but in a surgery center, any implant items that may the used during surgery (e.g., plates and screws etc) will not be covered by insurance. This is more relevant for the brow bone reduction part of facial feminization surgery.

Dr. Barry Eppley 

Indianapolis, Indiana