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面部女性化手术覆盖的差异:大众健康与马萨诸塞州的私人保险覆盖
Jessica J Farzan1, Quynh Anh Annie Phan1, Janelle P Renterghem1
1From the UMass Chan Division of Plastic Surgery, Worcester, MA.
Plastic and reconstructive surgery. Global open
|July 18, 2025
概括
面部女性化手术 (FFS) 覆盖范围在马萨诸塞州因保险类型而异. 与公共保险相比,私人保险导致更高的自付费用和更多的拒绝对跨性别患者的索赔.
科学领域:
- 整形外科 整形外科 整形外科
- 医疗保健服务研究 医疗服务研究
- 确认性别的护理
背景情况:
- 面部女性化手术 (FFS) 是跨性别女性性别肯定护理的组成部分,旨在提高生活质量和减少心理痛苦.
- 这项研究调查了保险覆盖,相关成本,以及马萨诸塞州常见的FFS程序的索赔拒绝模式.
研究的目的:
- 为了比较公共和私人保险计划之间的特定FFS程序的保险覆盖,自付费用和索赔拒绝率.
- 识别FFS的跨性别患者在医疗保健获取和财务负担方面的差异.
主要方法:
- 来自马萨诸塞州卫生信息与分析中心索赔数据库 (2016-2021) 的656个FFS索赔的分析.
- 专注于包括额头骨缩小,眉毛提升,白唇整形,鼻腔整形,鼻腔整形,阴茎整形和气管剃须等手术.
- 公共和私人保险类型的成本和拒绝率的比较.
主要成果:
- 气管剃须和鼻美术是最常被要求的FFS手术.
- 与公共保险相比,私人保险导致患者的自付费用高出2至4倍,而公共保险通常没有共同支付.
- 私人保险计划的索赔拒绝率明显高于公共保险计划.
结论:
- 根据马萨诸塞州的保险类型,FFS保险覆盖,报销和索赔拒绝存在显著差异.
- 这些差异是由不同的医疗必要性解释和FFS程序的复杂性影响的.
- 进一步的结果研究对于提高FFS的疗效,了解潜在的并发症和加强对跨性别患者的综合护理至关重要.
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