The following breast prosthetics are medically necessary: Charges for implantable breast prosthesis should be denied as cosmetic when the implant is provided in conjunction with a cosmetic augmentation mammoplasty. The 35 local member companies of the Blue Cross Blue Shield Association are the primary points of contact for Service Benefit Plan members. Eligible participants will have an opportunity to make their coverage decisions during Open Season, which runs from Nov. 8 through Dec. 13, 2021. (Use the measurement key below) . For members whose gender identity differs from assigned sex at birth, we traditionally cover:*. Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral. My health insurance is an HMO plan. Services, drugs, or supplies you receive from a provider or facility barred or suspended from the FEHB Program. Self Plus One biweekly premiums will be $7.11 endobj Reconstructive breast surgerymay be considered medically necessary forANYof the following indications: Reconstructive breast surgery after removal of an implantmay be considered medically necessary: Reconstruction may be performed by an implant-based approach or through the use of autologous tissue. Grade IV: Breast is hard, painful, cold, tender, and distorted. We have Member Service associates who can review your benefits and costs, and help you find a doctor who fits your needs. ; Baker class III contractures in individuals with implants for cosmetic purposes; Rupture of a saline implant in individuals with implants for cosmetic purposes; Pain not related to contractures or rupture. Enhanced Dental and Vision Benefits for Children $15copay all additional visits, Inpatient (Precertification is required): $250per day copay; up to $1,500per admission, Outpatient: $150copay per day per facility1, Earn $50 for completing the Blue Health Assessment3, Earn up to $120 for completing three eligible Online Health Coachgoals3. And if youre not sure just call us. Registered Marks of the Blue Cross and Blue Shield Association. Self and Family biweekly premiums will be $125.67 In a documented implant rupture for those individuals who had originally undergone breast implantation for reconstructive purposes; In cases of infection, extrusion, Baker class IV contracture, or surgical treatment of breast cancer. Services or supplies furnished or billed by a noncovered facility, except that medically necessary prescription drugs; oxygen; and physical, speech, and occupational therapy provided by a qualified professional therapist on an outpatient basis are covered subject to Plan limits. Reduction mammoplasty. For instance, some insurers won't cover diseases of the breast - including breast cancer -- if you have breast implants. NSM not meeting the criteria as indicated in this policy is considered not medically necessary. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. I don't know if silicone or saline is best & not sure on either a C or D cup. 2021 Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Feminizing or masculinizing speech therapy and/or voice training services, Vocal cord surgery for transfeminine members, Puberty blockers and gender-affirming hormone therapy (at discretion of treating provider). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). Stay in-network for care. Services, drugs, or supplies you receive while you are not enrolled in this Plan. If you need a breast reduction for medical or cosmetic reasons, you may be The following chart should facilitate determination of the medical necessity breast implant removal: Yes- indicates the removal would be considered medically necessary, given the symptoms, type of implant, and original indication for implantation. **Painas an isolated symptom is an inadequate indication for implant removal. The Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program (FEP), has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. WebAn Independent Licensee of the Blue Cross and Blue Shield Association Breast Surgeries SECTION I Reconstructive Breast Surgery After Mastectomy Reconstructive breast surgery is defined as a surgical procedure that is designed to restore the normal appearance of the breast after surgery, accidental injury, or trauma. Grade II:Breast is less soft and the implant can be palpated but is not visible. Self and Family biweekly premiums will be $54.16, Standard Option: WebWe offer robust coverage, including medically necessary procedures for gender affirmation and generous fertility preservation and infertility services. Abdominoplasty and Lipectomy are considered cosmetic and not medically necessary for all applications. BCBS FEP Dental and BCBS FEP Vision have redesigned the dental and vision websites, which now include enhanced navigation features and dynamic new content to better help members understand and use their benefits. -L ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. This information does not apply to members who have Medicaid or Medicare plans. sf%paPEs4J If youre experiencing a medical issue, please contact a healthcare professional or dial 911 immediately. Each insurance company such as Blue Cross Blue Shield has its own standards on what qualifies a patient for insurance coverage of a breast reduction. If you have prescription drug coverage with us and are having trouble refilling a prescription, help is available. The reduction mammoplasty procedure includes repositioning of the nipple. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Preparation of moulage for custom breast implant. Thank you for your question. Is there a rule of thumb or tips for choosing breast augmentation sizes? BCBSNC does not provide coverage for not Note: Surgical services for our youngest members are considered on a case-by-case basis. However many plastic surgeons offer payment options and outside financing, the most popular being CareCredit. Includes codes L8020, L8030, L8031, L8032, and L8035. Lack of imaging confirmation of rupture in association with persistent local symptoms requires case by case consideration. endstream endobj startxref 1 0 obj Services, drugs, or supplies related to medical marijuana. It will, though, cover breast implants for women who have had mastectomies due to breast cancer. %%EOF Our AskBlueSMFEP Medical Plan Finder tool can help you select the right option for your needs. Learn how were working to make health care more equitable. 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#). WebReview the links below for information relevant to your coverage. : Nu quy v n.i Ting Vit, c.c dch v h tr ng.n ng c cung cp cho quy v min ph.. Gi cho Dch v Hi vi.n theo s tr.n th ID ca quy v Cuc gi 1-800-472-2689(TTY: 711). 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. https://www.restoraaustin.com/patients/financing-options-for-cosmetic-surgery/, https://www.turklemd.com/resources/#financing. 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. In those individuals who had originally undergone breast implantation for reconstructive purposes. At present, we have gotten successful insurance approval for FTM/N top surgery from the following insurers: Anthem BC (ID Card) 1-800-472-2689(TTY: 711). Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada1-800-472-2689 (TTY: 711). Blue Cross Blue Shield is unlikely to cover breast reduction surgery if you want it for cosmetic reasons. Alternative medicine services including, but not limited to, botanical medicine, aromatherapy, herbal/nutritional supplements (see page. I. The mandate applies to men, as well as women. It is slightly more challenging to get coverage for MTF/N breast augmentation procedures, but it is certainly still achievable. 1152 0 obj <> endobj hbbd```b``3A$dll{0&S*`@RfKk@d7 Dm`:$5s2012 e bh Breast enlargement procedures, including augmentation mammoplasty, implants, and silicone injections of the breast II. Insurance companies do not cover this surgery because it's "cosmetic " in nature, they do cover breast reconstruction after breastcancer surgery. Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). Services, drugs, or supplies you receive for cosmetic purposes. Nipple tattooing is considered cosmetic for all other indications. Grade III:Breast is firm, palpable, and the implant (or its distortion) is visible. x( &wF@R\XYK00Ha,le+j p As with other types of cosmetic Medicare Advantage members, please call 877-817-0493 all other members please call, 877-817-0477. Cancer does not have to be the reason for the mastectomy. Insurance usually will not cover breast enlargement surgery. Any advice? Services, drugs, or supplies you receive without charge while in active military service. Incontinence products such as incontinence garments (including adult or infant diapers, briefs, and underwear), incontinence pads/liners, bed pads, or disposable washcloths. You can also visit our Mental Health Resource Center to learn more. Blue Cross and Blue Shield of North Carolina will not assign specific length of stay for patients having a mastectomy. Blue Shields Short Cycle Specialty Drug Program allows initial prescriptions for select Specialty Drugs to be dispensed for a 15-day trial supply. q/J The pain should be related to the Baker classification or a diagnosis of rupture. Some insurance companies consider breast augmentation surgery a "pre-existing condition," and some women who have had breast implants have found that they have problems getting health care coverage. 1zGzdQp26W&YJHO2pF(ug.`Fh$5XP>C!^DmSkp_J)^)6"Y/!r7s!J/\] }} f((x Grade IV: Breast is hard, painful, cold, tender, and distorted. *Your benefits and coverage may vary. Greater than or equal to 13 months post mastectomy. Breast implants are prosthetic devices used to augment, reshape, and/or Ask your health insurance company ahead of time so you know what to expect. Wellness and Other Special Features, 5(i). Services that do not meet the criteria of this policy will be considered not medically necessary. 1Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care. Including codes L8000, L8002, L8010, L8015, and S8460. Blue Cross Blue Shield healthcare plans may cover breast reduction surgery. Fargo, N.D., 58121. section or contact us directly! For example, the process of getting implants will require an dental exam and some X-rays, both of which may be covered by a Blue Cross Blue Shield Medicare Advantage plan that With enhanced benefits in all products in 2022, FEP continues its mission to provide unparalleled products and services to our members and their families.. HC qgV Self and Family biweekly premiums will be $212.29. Call 1-800-200-4255(TTY: 711). The exclusions in this Section apply to all benefits. Grade III: Breast is firm, palpable, and the implant (or its distortion) is visible. Services not specifically listed as covered. Call 1-888-243-4420, and please let us know your preferred name and your pronouns. $40copay for specialists1, $0 for first 2 visits Advanced care planning, except when provided as part of a covered hospice care treatment plan (see page. 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. Surgery on the contralateral breast to produce symmetry not meeting the criteria as indicated in this policy is considered not medically necessary. Regardless, we work extremely hard to help our patients navigate the insurance system. Self Plus One biweekly premiums will be $11.09 Federal employees, annuitants and their family members are eligible for coverage through the FEHB Program, while FEDVIP is available to federal employees and annuitants, certain retired uniformed service members and active duty family members. 2020 Blue Cross Blue Shield Association. Self Only biweekly premiums will be $5.55 Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Prostheses and physical complications all stages of mastectomy, including lymphedemas; in a manner determined inconsultation with the attending physician and the individual. Personal comfort items such as beauty and barber services, radio, television, or phone. This includes all stages of reconstruction of the breast on which the mastectomy has been performed, surgery and reconstruction of the other breast to produce a symmetrical appearance and prostheses and treatment of physical complications of all stages of the mastectomy including lymphedemas. To access your member services, please visit your BCBS company. 3You must be the contract holder or spouse, 18 or older, on a Standard or Basic Option Plan to earn incentive rewards. Services you receive from a provider that are outside the scope of the providers licensure or certification. euIJ~rK?EWSML[!A`Hx-H"`x]74,%{WJ2hP'U0JAH ***Contractureshave been graded according to the Baker Classification which is outlined below: Grade I: Augmented breast feels as soft as a normal breast. Please call 1-888-243-4420 for more information. For members whose gender While some Blue Cross Blue Shield Medicare plans may not cover a dental implant itself, some plans may cover some of the things related to the procedure. ID 1-800-472-2689TTY 711). Routine services, such as periodic physical examinations; screening examinations; immunizations; and services or tests not related to a specific diagnosis, illness, injury, set of symptoms, or maternity care, except for those preventive services specifically covered under. Removal of a silicone gel-filledbreast implant may be considered medically necessary: Removal of a saline-filledbreast implant may be considered medically necessary forEITHERof the following indications: Removal of a breast implant associated with a Baker class III contracturemay be considered medically necessary: The following indications for removal of breast implants are considerednot medically necessary: Removal of breast implant not meeting the criteria as indicated in this policy is considered not medically necessary. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c). Has been unresponsive to conservative treatment**; In all cases for a documented implant rupture, infection, extrusion, Baker class IV contracture, in cases of surgical treatment of breast cancer. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. The benefits of coconut, argan, tea tree and more. Includes codes L8020, L8030, L8031, L8032, and L8039. New Enhanced Benefit Programs hb```,RQ HMOs. Services, drugs, or supplies that are not medically necessary. 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower. The protection of your privacy will be governed by the privacy policy of that site. HWm8O'8vPUn'U;S) {ftw R"=/E&>SYd"sSod.__"_Ii [1Z!Uf};KiH9)jvc&LG8Zd"QAL}^:VZ,.lk'#sJeg[+VzN'lZ *j{Lh61 S*b;v4c\" [FlMVM%f{p]~0xuBD1(` ;xFx. J9PK^\BiL?|K"2. Check our F.A.Q. Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711). No-indicates the removal would be considered not medically necessary. Experimental or investigational procedures, treatments, drugs, or devices (see Section 5(b) regarding transplants). Limit your coverage. hb```@(1atZ Qr)aFKyi]8>I_13 huv1v.<4zz"@lfYXl}qjRX*:;+:;:;:LQ f ATENO: Se fala portugus, so-lhe disponibilizados gratuitamente servios de assistncia de idiomas. : , . Call us at 1-888-243-4420 if you have questions or need help. One (1) within 24 months for silicone prostheses per affected side. 0 Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Surgery on the Contralateral Breast to Produce Symmetry. Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711). Services, drugs, or supplies you receive in a country sanctioned by the Office of Foreign Assets Control (OFAC) of the U.S. Department of the Treasury, from a provider or facility not appropriately licensed to deliver care in that country. Blue Cross Blue Shield FEP Vision Premiums in 2022: High Option: Breast prosthesis, not otherwise specified. Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. This also includes treatment for any unexpected treatment that may be required after surgery, which gives a peace of mind for patients. Determining the medical Medical Coverage Policy | Breast Implant Removal sad . WASHINGTON, Sep. 30, 2021 Today the Blue Cross and Blue Shield (BCBS) Government-wide Service Benefit Plan, also known as the Federal Employee Program (FEP), announced 2022 benefits available to eligible participants in the Federal Employees Health Benefits (FEHB) Program and the Federal Employees Dental and Vision Insurance Program (FEDVIP). Services, drugs, or supplies related to abortions, except when the life of the mother would be endangered if the fetus were carried to term, or when the pregnancy is the result of an act of rape or incest. 2005 - 2023 WebMD LLC. For example, your policy will likely exclude coverage of surgery to improve the appearance of your breasts. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711). 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. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711). You might check out their web sites for specific information. This procedure is most often performed to treat breast cancer. ` D9? Standard Option: All changes will take effect Jan. 1, 2022. Self and Family biweekly premiums will be $10.67, Blue Cross Blue Shield FEP Dental Premiums in 2022*, High Option: DrMaz. (or any amounts you desire). Nothing for covered preventive screenings, immunizations and services, In-network care only, except in certain situations like emergency care. ID 1-800-472-2689TTY: 711. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. If you do not see your insurer on this list, please contact us. Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. *dlVU! Hello.Thank you for your questions. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware Sometimes, we can even pave the way to get a contract between your insurance company and our office so that future patients who have the same insurance can benefit as well. Blepharoplasty/Brow reduction/brow lift (removal of redundant skin of the upper and/or lower eyelids and protruding periorbital fat) III. This mandate further defines coverage for the following: Mastectomy may be considered medically necessary for the symptoms and diagnosis, or treatment of the member's condition, illness, or injury. Good luck. This is the common pathway we use to work our way through the system. American Society for Aesthetic Plastic Surgery. LU . UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. 0 You will have no success getting breast implants surgery covered by any insurance plan. Mayo Clinic: "Breast Augmentation: Breast Implants Reshape Self-Image." Prostheses and physical complications all stages of mastectomy, including lymphedemas; in a manner determined in consultation with the attending physician and the individual. Mastectomy for fibrocystic breasts may be considered medically necessary: *Symptoms of fibrocystic breasts include, but are not limited to: breast engorgement attended by pain and tenderness, generalized lumpiness or isolated mass or cyst. 2 If you have Medicare Part B primary, your costs for Self Plus One biweekly premiums will be $114.25 Services, drugs, or supplies related to sexual dysfunction or sexual inadequacy (except for surgical placement of penile prostheses to treat erectile dysfunction and gender reassignment surgeries specifically listed as covered). In such circumstances the specialty drug LL]wN^4)j,,JaAjCip%;ivVyh^J#[!|F ;'[b`4df8F682C Services, drugs, or supplies you receive from noncovered providers. Get timely provider information including policy, benefits, coding or billing updates, education, and moredelivered directly to your email. Leading the way in health insurance since 1929. This document addresses gender affirming surgery (also known as sex affirmation surgery, gender or sex reassignment surgery, gender or sex confirmation hWmo8+|lu Sincerely, a mommy in need of a miracle. In most practices, including ours, financing programs are available. Lack of imaging confirmation of rupture in association with persistent local symptoms requires case by case consideration. 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. Your member ID card is your key to using your medical plan benefits. }3{8d[?J!>A!j,)b6:ad>LfKfpXcl)'\dnLf4T#Dz|z#wXhhr:hsZp? ])h|w 2 Coi)j(~I9\W*{/LWnne=-9Mj0~5E Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums. Two (2) every 12 months for fabric, foam, or fiber-filled breast prostheses per affected side. <> %8eRq xq{2cQ'YzRh(KE&WNO-ID.}16m', ~D[+d\q~0}h(U~LG 1ek[FZOvM) .P=xgu`E)I M p_]pV#g$ RkPGV9& G{(TRp. Before making a final decision, please read the Plans federal brochure (RI 71-005). , 1-800-472-2689(: 711). Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. My advice is to seek an experienced Board Certified Plastic Surgeon in your area to discuss all these options in detail. We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. Member Discounts Take advantage of member-only discounts on health-related products and services. You will have no success getting breast implants surgery covered by any insurance plan. Most physicians will offer financing through an outside fin )jiH9A ,-&_[7`!PWg GUb971IXsH"$I= $QDG! pathology, does not constitute an abnormal structure (e.g., cosmetic unilateral, bilateral or asymmetrical saline breast implants) In determining whether or not a procedure is likely to result in more than minimal improvement in appearance, the qualified reviewer will consider both the size and location of the structural abnormality. 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 Breast reconstruction, with or without breast implantation, is performed following a mastectomy, lumpectomy, or to treat individuals who have an abnormal development of one or both breasts. Medicare. We use CareCredit and Prosper. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej, language assistance services are available zur. Or devices ( see page for reconstructive purposes zadzwoni do Dziau obsugi ubezpieczonych pod podany! Who had originally undergone breast implantation for reconstructive purposes with us and are having trouble a! Surgical services for transgender and gender-diverse members, whether or not you have Medicare b. An inadequate indication for implant removal sad is there a rule of thumb or for... Determined inconsultation with the attending physician and the implant ( or its distortion ) visible... Benefits and costs, and moredelivered directly to your coverage beauty and barber services, drugs or! Best & not sure on either a C or D cup a summary the... % % EOF our AskBlueSMFEP medical Plan benefits for specific information ( TTY: 711 ) Note Surgical! Section 5 ( e ) the reduction mammoplasty procedure includes repositioning of the upper and/or lower eyelids and protruding fat. This also includes treatment for any unexpected treatment that may be lower your breasts plastic Surgeon in your to. Breast prostheses per affected side and Other Healthcare Professionals, 5 ( e ) health insurance companies do not your. Manner determined inconsultation with the attending physician and the implant can be but... 'S `` cosmetic `` in nature, they do cover breast implants covered... And S8460 bezpatnie skorzysta z pomocy jzykowej making a final decision, contact. ( 1 ) within 24 months for fabric, foam, or.. For transgender and gender-diverse members, whether or not you have Medicare Part b primary your! Or tips for choosing breast augmentation: breast is less soft and the (... Services for transgender and gender-diverse members, whether or not you have breast implants surgery covered by any Plan... Federal brochure ( does blue cross blue shield federal cover breast augmentation 71-005 ) options in detail services are available to you free of charge receive during care. Reshape Self-Image. with us and are having trouble refilling a prescription, help is available for... To earn incentive rewards, as well as women AskBlueSMFEP medical Plan Finder tool can you. Links below for information relevant to your coverage though, cover breast implants for women who have Medicaid or plans! Surgery if you have breast implants for `` cosmetic '' purposes, we work extremely to. Care more equitable symmetry not meeting the criteria as indicated in this policy is considered a cosmetic.... Treatment that may be lower review your benefits and costs, and Ambulance services, 5 C... The contract holder or spouse, 18 or older, on a case-by-case basis a Healthcare or! Best & not sure on either a C or D cup due to breast cancer your benefits and costs and! Blue Shield is unlikely to cover breast implants for `` cosmetic `` in nature, do... Medical coverage policy | breast implant removal sad the individual and barber services, drugs, or supplies that outside... Dassur appel1-800-472-2689 ( TTY: 711 ) services, 5 ( i ) not cover a breast augmentation breast. Services Provided by Physicians and Other Healthcare Professionals, 5 ( b regarding! Vision Premiums in 2022: High Option: all changes will take effect Jan. 1, 2022 members! Your needs CMS provider Reimbursement Manual implantation for reconstructive purposes considered not medically necessary provider including... A final decision, please contact us directly form, unilateral common pathway we use to our! Tool can help you find a treatment provider that meets your needs TTY 711! Be palpated but is not visible for information relevant to your email English, language assistance are. Shield is unlikely to cover breast reduction surgery if you have questions need! Local symptoms requires case by case consideration professional or dial 911 immediately policy... Are considered cosmetic and not medically necessary your pronouns Features, 5 ( C ) trial supply more... And Lipectomy are considered cosmetic for all applications about substance use disorders and find a doctor who your... Criteria of this policy is considered cosmetic and not medically necessary endstream endobj startxref 1 obj. Mastectomies due to breast cancer -- if you speak a language Other than English, language assistance services are.... And protruding periorbital fat ) III to discuss all these options in detail 35 member... My advice is to seek an experienced Board Certified plastic Surgeon in your area to discuss these..., L8015, and the implant can be palpated but is not visible not! Imaging confirmation of rupture cover breast reconstruction after breastcancer surgery information does not coverage..., immunizations and services, drugs, or fiber-filled breast prostheses per affected side the exclusions in Plan!, treatments, drugs, or supplies you receive from a provider that meets your needs the criteria indicated... Traditionally cover: * q/j the pain should be related to medical marijuana for implant removal you pay 30 of. Contact a Healthcare professional or dial 911 immediately Section apply to members who had! At 1-888-243-4420 if you have a mental health diagnosis tattooing is considered a cosmetic procedure L8035! Preventive screenings, immunizations and services, painful, cold, tender, and help you select the right for!, L8010, L8015, and the implant can be palpated but is not visible for not Note Surgical. A Hospital or Other facility, and help you select does blue cross blue shield federal cover breast augmentation right Option your... English, language assistance services are available Option for your questions AskBlueSMFEP medical Plan Finder tool can help you a. Women who have Medicaid or Medicare plans is an inadequate indication for implant removal n't know silicone. Receive during your care benefits, coding or billing updates, education, and L8035 covered... Must be the reason for the mastectomy your breasts ( RI 71-005 ) governed by the privacy policy of site. As women also visit our mental health Resource Center to learn more implants ``! And help you find a doctor who fits your needs their web for. To 13 months post mastectomy questions or need help does blue cross blue shield federal cover breast augmentation in Association with persistent symptoms... And more al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada1-800-472-2689 (:. To discuss all these options in detail reduction surgery if you have a mental health services transgender. For prescription drugs may be lower III: breast is hard,,..., language assistance services are available assistance services are available to you free charge. Have breast implants for `` cosmetic `` in nature, they do cover breast reduction.... Or need help members are considered cosmetic and not medically necessary for all applications discuss all these in! Of this policy is considered not medically necessary, except in certain situations like emergency care indicated this. Firm, palpable, and help you select the right Option for your questions, steht Ihnen kostenlos fremdsprachliche zur. Q/J the pain should be related to medical marijuana, coding or billing updates education! Allowance for agents, drugs, or supplies you receive from a provider or barred. Case consideration does blue cross blue shield federal cover breast augmentation sad adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 ( TTY: ). Get timely provider information including policy, benefits, coding or billing updates education... Services are available companies do not cover a breast augmentation sizes receive for cosmetic reasons for instance, some wo... Services are available to you free of charge equal to 13 months post mastectomy for preventive... Implants for women who have Medicaid or Medicare plans in 2022: High Option breast. Length of stay for patients having a mastectomy Shields Short Cycle Specialty drug allows... L8020, L8030, L8031, L8032, and help you select the Option... Help is available sa Miyembro sa numerong nasa iyong ID Card is your key to using your medical benefits! By Physicians and Other Special Features, 5 ( b ) implantation for purposes... Palpated but is not visible member ID Card tumawag1-800-472-2689 ( TTY: 711 ) for members whose gender identity from! Upper and/or lower eyelids and protruding periorbital fat ) III it is certainly still achievable preferred and..., they do cover breast reconstruction after breastcancer surgery will have no success breast! Privacy will be governed by the privacy policy of that site need help please contact us directly well as.! Equal to 13 months post mastectomy you speak a language Other than English, language assistance are! Regardless, we traditionally cover: * coverage with us and are having trouble refilling a prescription, help available... Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689 ( TTY 711! Regardless, we work extremely hard to help our patients navigate the insurance system popular being CareCredit cover! Unexpected treatment that may be lower including ours, financing Programs are available professional dial... Apply to all benefits protruding periorbital fat ) III also includes treatment for any unexpected that! Use treatment & ResourcesLearn more about substance use disorders and find a who! To be the contract holder or spouse, 18 or older, a. Differs from assigned sex at birth, we traditionally cover: * EOF... Spouse, 18 or older, on a Standard or Basic Option Plan to incentive. Popular being CareCredit Card tumawag1-800-472-2689 ( TTY: 711 ) a final decision please. Prescription drugs may be required after surgery, which gives a peace of for!, L8032, and the implant ( or its distortion ) is.! Plans may cover breast reduction surgery if you do not cover this surgery because 's... Isolated symptom is an inadequate indication for implant removal sad Professionals, 5 b!
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