Our insurance negotiation team is amazing and we would love to add more insurance plans to this list. If you need help taking the next step, our specially trained team can help coordinate with our clinical teams to guide you on your gender-affirming journey. Services, drugs, or supplies you receive while you are not enrolled in this Plan. Services, drugs, or supplies that are not medically necessary. Any dental or oral surgical procedures or drugs involving orthodontic care, the teeth, dental implants, periodontal disease, or preparing the mouth for the fitting or continued use of dentures, except as specifically described in Section 5(g). This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. 1 0 obj Self Plus One biweekly premiums will be $36.11 Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc. : , , . UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. endstream endobj 1153 0 obj <. Often, with the efforts of both patient and physician, we can get an individual covered. ART-20203231. Self and Family biweekly premiums will be $10.67, Blue Cross Blue Shield FEP Dental Premiums in 2022*, High Option: Before making a final decision, please read the Plans federal brochure (RI 71-005). For example, your policy will likely exclude coverage of surgery to improve the appearance of your breasts. WebMD does not provide medical advice, diagnosis or treatment. ? Services, drugs, or supplies you receive from noncovered providers. Find out who qualifies for Blue Cross Blue Shield breast reduction coverage. The exclusions in this Section apply to all benefits. Self Plus One biweekly premiums will be $18.44 It will, though, cover breast implants for women who have had mastectomies due to breast cancer. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. Alternative medicine services including, but not limited to, botanical medicine, aromatherapy, herbal/nutritional supplements (see page. Member Service 1-800-472-2689(TTY: 711). If you have prescription drug coverage with us and are having trouble refilling a prescription, help is available. Medicare. hb```,RQ Incontinence products such as incontinence garments (including adult or infant diapers, briefs, and underwear), incontinence pads/liners, bed pads, or disposable washcloths. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Charges which the enrollee or Plan has no legal obligation to pay, such as excess charges for an annuitant age 65 or older who is not covered by Medicare Parts A and/or B (see page. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Self Plus One biweekly premiums will be $196.13 Blepharoplasty/Brow reduction/brow lift (removal of redundant skin of the upper and/or lower eyelids and protruding periorbital fat) III. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Self Only biweekly premiums will be $53.14 Good luck. BCBS FEP Dental has also released a suite of new features for its mobile app, which will allow members to view benefit, coverage and claim information, and access their ID card, all in one location. WebSome have been more receptive than others. In such circumstances the specialty drug Were partnering with clinicians to ensure access to care in Massachusetts. Were proud to provide comprehensive services and compassionate support for our transgender members. Mental Health and Substance Use Disorder Benefits, 5(h). Mastectomy is the removal of all or part of a breast and is typically performed as a treatment for cancer, or in some cases for the treatment of benign disease. 500 Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Standard Option: Two companies provided coverage on a case-by case basis; one Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. : , , : .. In the U.S., breast augmentation surgery -- getting breast implants for cosmetic reasons -- cost an average of $6550 (including 1114 0 obj <>stream Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members. Regardless, we work extremely hard to help our patients navigate the insurance system. Reconstructive breast surgery is defined as those surgical procedures performed that are designed to restore the normal appearance of a breast. Any advice? New Supplemental International Travel Insurance This information does not apply to members who have Medicaid or Medicare plans. The following is an outline based on some of these variables:1. The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Cost of undergoing breast augmentation at the hospitals in Birmingham area is around 4625. $40copay for specialists1, $0 for first 2 visits Ask your health insurance company ahead of time so you know what to expect. One (1) every 24 months for silicone prostheses per affected side. You will have no success getting breast implants surgery covered by any insurance plan. Most physicians will offer financing through an outside fin Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Member Discounts Take advantage of member-only discounts on health-related products and services. **Painas an isolated symptom is an inadequate indication for implant removal. Applied behavior analysis (ABA) services and related services performed as part of an educational program; or provided in or by a school/educational setting; or provided as a replacement for services that are the responsibility of the educational system. Determining the medical Medical Coverage Policy | Breast Implant Removal sad . Learn how were working to make health care more equitable. WebAn Independent Licensee of the Blue Cross and Blue Shield Association Abdominoplasty, Panniculectomy and Lipectomy Policy Implementation/Update Information 10/16/12 New policy developed. Self Plus One biweekly premiums will be $7.11 Registered Marks of the Blue Cross and Blue Shield Association. : , . The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Before making a final decision, please read the Plans federal brochure (RI 71-005). Hi,Thanks for your question. Insurance companies don't cover breast implants for "cosmetic" purposes. Don't give up hope though because there are s Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele1-800-472-2689 TTY: 711). Includes codes L8000, L8001, L8002, L8015, and S8460. Having breast implants may also affect your insurance rates later on. sf%paPEs4J WebMinimum proposed specimen weights (both breasts combined) (glandular tissue) should be 0.4 kg for women weighing less the 60 kg (132#), 0.7 kg for women weighing 60-80 kg (132-176#), and 1 kg for women weighing more than 80 kg (176#). Medical technology is constantly evolving, and the Company reserves the right to review and update medical policy periodically. This is all new to me & I've wanted implants since my teenage years. Mastectomy is the removal of all or part of a breast and is typically performed as a treatment for cancer, or sometimes for the treatment of benign disease. hbbd```b``3A$dll{0&S*`@RfKk@d7 Dm`:$5s2012 e bh This procedure is most often performed to treat breast cancer. Additional sources are used and can be provided Self Only biweekly premiums will be $9.22 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower. One (1) within 24 months for silicone prostheses per affected side. HMOs. Includes codes L8020, L8030, L8031, L8032, and L8035. Grade IV: Breast is hard, painful, cold, tender, and distorted. Eligible participants will have an opportunity to make their coverage decisions during Open Season, which runs from Nov. 8 through Dec. 13, 2021. Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type, Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type, Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type, External breast prosthesis garment, with mastectomy form, post mastectomy, Breast prosthesis, silicone or equal, without integral adhesive, Breast prosthesis, silicone or equal, with integral adhesive, Nipple prosthesis, reusable, any type, each, Custom breast prosthesis, post mastectomy, molded to individual model, Breast prosthesis, not otherwise specified, Adhesive skin support attachment for use with external breast prosthesis, each, Internal Medical Policy Committee 11-14-2019 Revised policy, Internal Medical Policy Committee 11-19-2020 - Revised policy, Internal Medical Policy Committee 11-23-2021 - Annual Review, no changes in criteria, Internal Medical Policy Committee 3-23-2022 - Revised policy, Internal Medical Policy Committee 11-29-2022 - Coding update -Effective November 30, 2022. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. The information on RealSelf is intended for educational purposes only. As with other types of cosmetic hbbd``b`~ H ,f@]bXu $UW4 bV+X ``0 \] Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. %%EOF You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. ID 1-800-472-2689TTY 711). Most physicians will offer financing through an outside financing company. Services, drugs, or supplies you receive without charge while in active military service. Is there a Dr. that has a monthly payment plan or any kind of special offer or assistance with the price of breast implants? Please call 1-888-243-4420 for more information. There are a lot of variables to account for after breast augmentation and what to expect in the recovery process. D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). Services, drugs, or supplies billed by Preferred and Member facilities for inpatient care related to specific medical errors and hospital-acquired conditions known as Never Events (see definition on page. Experimental or investigational procedures, treatments, drugs, or devices (see Section 5(b) regarding transplants). Personal comfort items such as beauty and barber services, radio, television, or phone. Additional information about 2022 benefits is available online or by calling the National Information Center. 5(a). We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. Thank you for your question. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Applied behavior analysis (ABA) and related services for any condition other than an autism spectrum disorder. Pain: In general, breast augmentation is tolerated very well. For some reason, FTM/N chest reconstruction has had a better reception within some insurance programs for approval. 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