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Facial Feminization Surgeries denials: what the review data shows

Independent reviewers have decided 36 published cases where an insurer denied Facial Feminization Surgeries — and they overturned the insurer 83.3% of the time. A denial for Facial Feminization Surgeries is a starting position, not a final answer.

Published decisions
36
2001–2026
Overturned
83.3%
30 denials reversed

By condition

Published outcomes when Facial Feminization Surgeries was denied for these conditions.
ConditionDecisionsOverturned
Gender Dysphoria31
83.9%
How to use this in your appeal

These are outcomes from California’s external review program — an independent physician panel that binds the insurer. Every state has an equivalent process, and internal appeals succeed even more often. Cite the outcome record for Facial Feminization Surgerieswhen you appeal: reviewers routinely find that denials like yours didn’t hold up.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Denied Facial Feminization Surgeries? 83.3% got it reversed.

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