Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). sf%paPEs4J Self and Family biweekly premiums will be $54.16, Standard Option: 4 0 obj Find out who qualifies for Blue Cross Blue Shield breast reduction coverage. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. WebReview the links below for information relevant to your coverage. Nipple sparing/skin sparing mastectomy may be considered medically necessary when there is no cancer involving the skin, nipple or areola. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia con el idioma. In most practices, including ours, financing programs are available. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Research costs (costs related to conducting a clinical trial such as research physician and nurse time, analysis of results, and clinical tests performed only for research purposes). Insurance usually will not cover breast enlargement surgery. Heres everything you need to know about it. Telefone para os Servios aos Membros, atravs do nmero no seu carto ID chamar1-800-472-2689 (TTY: 711). Nipple prosthesis, reusable, any type, each. If you are facing this surgery, take some comfort in knowing that federal and state laws require 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. Stay in-network for care. 1-800-472-2689(TTY: 711) . This procedure is most often performed to treat breast cancer. If you're looking into the costs of breast implants for cosmetic reasons, you should also consider: Because breast implants can interfere with the accuracy of normal mammograms, women may also need extra X-ray images at additional cost. For information on obtaining prior approval for specific services, such as transplants, see Section 3, You need prior Plan approval for certain services. Web1 Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care. The Affordable Care Act prevents health insurance companies from denying people coverage due to pre-existing conditions. 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. All Rights Reserved. Don't give up hope though because there are several awesome financing companies, including CareCredit, Alphaeon and United Medical Credit. We have Member Service associates who can review your benefits and costs, and help you find a doctor who fits your needs. It covers roughly 5.6 million federal employees, retirees and their families out of the more than 8.5 million people who receive their benefits through the FEHB Program. Call 1-888-243-4420, and please let us know your preferred name and your pronouns. Self and Family biweekly premiums will be $27.67. How Long is Breast Implants Recovery Time? % Services, drugs, or supplies billed by Preferred and Member facilities for inpatient care related to specific medical errors and hospital-acquired conditions known as Never Events (see definition on page. When the implant was originally placed for reconstructive purposes in an individual with a history of mastectomy, lumpectomy or treatment of breast cancer. Will having breast implants affect my coverage if I later develop, Will any of the diagnostic tests that I may need after getting breast implants, such as MRIs or extra. WebMinimum proposed specimen weights (both breasts combined) (glandular tissue) should be 0.4 kg for women weighing less the 60 kg (132#), 0.7 kg for women weighing 60-80 kg (132-176#), and 1 kg for women weighing more than 80 kg (176#). We use CareCredit and Prosper. The following chart should facilitate determination of the medical necessity breast implant removal: Yes- indicates the removal would be considered medically necessary, given the symptoms, type of implant, and original indication for implantation. Calf implants IV. %8eRq xq{2cQ'YzRh(KE&WNO-ID.}16m', ~D[+d\q~0}h(U~LG 1ek[FZOvM) .P=xgu`E)I M p_]pV#g$ RkPGV9& G{(TRp. Additional sources are used and can be provided hWmo8+|lu National Research Center for Women and Families: "What You Need to Know about Breast Implants." Regardless, we work extremely hard to help our patients navigate the insurance system. Includes codes L8001, L8002, L8010, L8015, and S8460. Includes codes L8000, L8002, L8010, L8015, and S8460. ^What youll pay for a 30-day supply of covered drugs. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Nipple tattooing will be covered if the medical necessity criteria for reconstructive breast surgery are met. 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. Please go to bcbsfepdental.com to see the full list of regional rates. %PDF-1.5 % Please see your subscriber certificate for details about your plan coverage. American Society for Aesthetic Plastic Surgery. As we continue to navigate an unprecedented health crisis, Blue Cross Blue Shield FEP health, dental and vision members know they can count on us to make sure affordable and comprehensive health care is accessible no matter where they are, said William A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association (BCBSA). Among the changes include enhanced hypertension management and pregnancy care incentive programs, dental and vision benefits for children and the addition of a discounted supplemental international travel insurance through GeoBlue. hb```@(1atZ Qr)aFKyi]8>I_13 huv1v.<4zz"@lfYXl}qjRX*:;+:;:;:LQ f Self Plus One biweekly premiums will be $114.25 Roughly a third of Americans have healthcare insurance through a Blue Cross Blue Shield company. ` D9? 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower. Leading the way in health insurance since 1929. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele1-800-472-2689 TTY: 711). Services, drugs, or supplies not required according to accepted standards of medical, dental, or psychiatric practice in the United States. The mandate applies to men, as well as women. I. 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. 3You must be the contract holder or spouse, 18 or older, on a Standard or Basic Option Plan to earn incentive rewards. 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. To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit fepblue.org/contact-us. LL]wN^4)j,,JaAjCip%;ivVyh^J#[!|F ;'[b`4df8F682C All rights reserved. Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Step 1: Cut off foot of panty hose and insert dry long grain rice and tie the ends. Sincerely, a mommy in need of a miracle. Self Only biweekly premiums will be $3.56 At present, we have gotten successful insurance approval for FTM/N top surgery from the following insurers: Unfortunately, we do not accept Medicare at this time. Self Plus One biweekly premiums will be $196.13 Medicare. And if youre not sure just call us. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. This information does not apply to members who have Medicaid or Medicare plans. 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 following is an outline based on some of these variables:1. With enhanced benefits in all products in 2022, FEP continues its mission to provide unparalleled products and services to our members and their families.. 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). If I have health complications related to my breast implants, will the necessary treatment or surgery be covered? 1zGzdQp26W&YJHO2pF(ug.`Fh$5XP>C!^DmSkp_J)^)6"Y/!r7s!J/\] }} f((x 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. We will do our best to negotiate an individual contract with your insurance company to try to get your surgery covered. WebSome have been more receptive than others. Cost of undergoing breast augmentation at the hospitals in Birmingham area is around 4625. : , , . 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. Registered Marks of the Blue Cross and Blue Shield Association. ***Contractureshave been graded according to the Baker Classification which is outlined below: Grade I: Augmented breast feels as soft as a normal breast. BCBSNC does not provide coverage for not Check out the changes and updates to our plan in 2023. section or contact us directly! Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Most women have to pay that out of their own pockets. Services not specifically listed as covered. Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members. 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. Good luck. LU . We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. *Your benefits and coverage may vary. Surgery on the Contralateral Breast to Produce Symmetry. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. Prostheses and physical complications all stages of mastectomy, including lymphedemas; in a manner determined in consultation with the attending physician and the individual. Nothing for covered preventive screenings, immunizations and services, In-network care only, except in certain situations like emergency care. Other insurance types such as disability insurance, motor vehicle insurance, prescription card plans and workers' compensation. Lack of imaging confirmation of rupture in association with persistent local symptoms requires case by case consideration. Before making a final decision, please read the Plans federal brochure (RI 71-005). Breast prosthesis, not otherwise specified. ID 1-800-472-2689TTY 711). With PPO insurance plans that cover transgender surgery, we are usually able to get a portion (if not all) of the surgery covered. Preparation of moulage for custom breast implant. Augmentation changes the size and appearance of one or both breasts by transferring body fat to them or adding artificial implants. *BCBS FEP Dental rates depend upon the rate region in which a member lives. euIJ~rK?EWSML[!A`Hx-H"`x]74,%{WJ2hP'U0JAH 1 0 obj The presence of symptoms related to your large breast size such as neck/back/shoulder pain are important in showing medical necessity, which it sounds like you have from your The pain should be related to the Baker classification or a diagnosis of rupture. Chin augmentation (reshaping or enhancing the size of the chin) Two (2) within 12 months for fabric, foam, or fiber-filled breast prostheses per affected side. Self Plus One biweekly premiums will be $36.11 Includes codes L8020, L8030, L8031, L8032, and L8039. If you do not see your insurer on this list, please contact us. Before making a final decision, please read the Plans federal brochure (RI 71-005). Were partnering with clinicians to ensure access to care in Massachusetts. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711). In those individuals who had originally undergone breast implantation for reconstructive purposes. FEP offers a comprehensive suite of resources to help current and prospective members choose the best medical, dental and vision plan for them and their families, including the AskBlue medical, dental and vision plan finder tools, prescription drug cost tool and health cost advisor tool. The rates presented here are for BCBS FEP Dentals most populous region, Region 1. and SM Service Marks are the property of their respective owners. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Self Plus One biweekly premiums will be $11.09 Webthe Blue Shield contracted rate up to $100 copayment maximum / prescription N / A Not covered Covers up to a 30-day supply. My health insurance is an HMO plan. Self Only biweekly premiums will be $9.22 Dear Geneseo,Thank you for your post. "03X2002$n0(Sh*lB4|P `vc If you need a breast reduction for medical or cosmetic reasons, you may be D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). Reconstructive breast surgery is defined as those surgical procedures performed that are designed to restore the normal appearance of a breast. Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e.g. . Grade I:Augmented breast feels as soft as a normal breast. You might check out their web sites for specific information. Quantity Level Limits For Breast Prosthetics. <> Mental Health and Substance Use Disorder Benefits, 5(h). 1-800-472-2689(TTY: 711). Services, drugs, or supplies related to medical marijuana. The Women's Health and Cancer Rights Act of 1998 (WHCRA) is federal legislation that provides that any individual, with insurance coverage who is receiving benefits in connection with a mastectomy covered by their benefit plan (whether or not for cancer) who elects breast reconstruction, must receive coverage for the reconstructive services as provided by WHCRA. This is the common pathway we use to work our way through the system. 'lC >)a}QO=_Q 1-800-472-2689 (TTY : 711) . endstream endobj startxref Fibrocystic breasts are considered a condition or a disorder with or without mild to severe symptoms. Generally, you must exhibit physical, objective symptoms to qualify. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Self Only biweekly premiums will be $127.47 . One (1) per affected side every 24 months, One (1) per affected side every 24 months. Grade III: Breast is firm, palpable, and the implant (or its distortion) is visible. endstream endobj 1068 0 obj <>/Metadata 46 0 R/Pages 1065 0 R/StructTreeRoot 92 0 R/Type/Catalog/ViewerPreferences 1090 0 R>> endobj 1069 0 obj <>/MediaBox[0 0 792 612]/Parent 1065 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1070 0 obj <>stream 1114 0 obj <>stream Some have been more receptive than others. (or any amounts you desire). 1-800-472-2689( . . .: 711). Insurance companies don't cover breast implants for "cosmetic" purposes. Implantable breast prosthesis, silicone or equal. 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. Medicare Advantage members, please call 877-817-0493 all other members please call, 877-817-0477. 0 ID 1-800-472-2689TTY: 711. All rights reserved. Removal of implants requires documentation of the original indication for implantation and the type of implant, either saline- or silicone gel-filled, and the current symptoms, either local or systemic. It is slightly more challenging to get coverage for MTF/N breast augmentation procedures, but it is certainly still achievable. We use cookies on this website to give you the best experience and measure website usage. For more information, view our privacy policy. If you have prescription drug coverage with us and are having trouble refilling a prescription, help is available. Blue Shields Short Cycle Specialty Drug Program allows initial prescriptions for select Specialty Drugs to be dispensed for a 15-day trial supply. 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. 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. c -8e)f`d ud`|Qh x( &wF@R\XYK00Ha,le+j p Check our F.A.Q. All rights reserved. Note: Surgical services for our youngest members are considered on a case-by-case basis. Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. HZjz:|QkM]h]\ FEP Blue Focus: Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711). %PDF-1.7 Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc. 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. HMOs. Why Doesn't the U.S. Have at-Home Tests for the Flu? Services, drugs, or supplies for the treatment of obesity, weight reduction, or dietary control, except for office visits, diagnostic tests, and procedures and services for the treatment of morbid obesity listed on page. Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first). Hello.Thank you for your questions. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware Self and Family biweekly premiums will be $212.29. 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). Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711). Grade II:Breast is less soft and the implant can be palpated but is not visible. -L Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Most physicians will offer financing through an outside financing company. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. ? There may be other exclusions and limitations listed in Section 5 of this brochure. Advanced care planning, except when provided as part of a covered hospice care treatment plan (see page. WebDownload the complete manual or view individual guidelines in PDF format: Complete manual - January 2023 HMO Benefit Guidelines (PDF, 1.1 MB) Cross Reference Index <> Fees associated with copies, forwarding or mailing of records except as specifically described in Section 8. The 35 local member companies of the Blue Cross Blue Shield Association are the primary points of contact for Service Benefit Plan members. ATANSYON: Si ou pale kreyl ayisyen, svis asistans nan lang disponib pou ou gratis. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Services, drugs, or supplies you receive while you are not enrolled in this Plan. endobj Were here to improve access to care, and to guide you throughout each stage of your journey, however that journey looks for you. Services you receive from a provider that are outside the scope of the providers licensure or certification. 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 exclusions in this Section apply to all benefits. Includes codes L8000, L8001, L8002, L8015, and S8460. Procedure Codes Breast Prosthetics The following breast prosthetics are medically necessary: Breast prosthesis, mastectomy bra. Services, drugs, or supplies you receive without charge while in active military service. Thank you for your question. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. WebThe reason we cant give a simple yes or no answer is because every insurance company handles cosmetic surgery procedures differently, and since breast implant removal is considered cosmetic surgery, youll have to consult your plans list of covered benefits to determine how much, if any, your insurance company will pay toward this procedure. ATTENTION : si vous parlez franais, des services dassistance linguistique sont disponibles gratuitement. 2020 Blue Cross Blue Shield Association. In the U.S., breast augmentation surgery -- getting breast implants for cosmetic reasons -- cost an average of $6550 (including BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Including codes L8000, L8002, L8010, L8015, and S8460. For example, your policy will likely exclude coverage of surgery to improve the appearance of your breasts. Complications of breast implants are common and may require removal of the implant. Self and Family biweekly premiums will be $125.67 Often, with the efforts of both patient and physician, we can get an individual covered. This document addresses gender affirming surgery (also known as sex affirmation surgery, gender or sex reassignment surgery, gender or sex confirmation 7; Grade IV: Breast is hard, painful, cold, tender, and distorted. Grade IV: Breast is hard, painful, cold, tender, and distorted. ])h|w 2 Coi)j(~I9\W*{/LWnne=-9Mj0~5E Member Service 1-800-472-2689(TTY: 711). WebBreast implants complications are common and may require removal of the implant. Cancer does not have to be the reason for the mastectomy. Fifty-three of the 57 insurance companies provided coverage for gender-affirming top surgery, after preauthorization. Self and Family biweekly premiums will be $314.11 Self Only biweekly premiums will be $80.18 : , . By continuing to use this website, you consent to these cookies. Only in those individuals who had originally undergone breast implantation for reconstructive purposes. One (1) every 24 months for silicone prostheses per affected side. Experimental or investigational procedures, treatments, drugs, or devices (see Section 5(b) regarding transplants). Thank you for your questions and photos. Insurance companies do not cover this surgery because it's "cosmetic " in nature, they do cover breast rec Were proud to provide comprehensive services and compassionate support for our transgender members. %%EOF Learn how were working to make health care more equitable. h0N``r4:pV}/bI32kiXrAy c:&[ Thank you for your questions and photos. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. 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. The information on RealSelf is intended for educational purposes only. Self Plus One biweekly premiums will be $18.44 Custom breast prosthesis, post mastectomy, molded to individual model. Palpated but is not visible os Servios aos Membros, atravs do nmero seu! A Member lives sont does blue cross blue shield federal cover breast augmentation gratuitement pou ou gratis surgery are met tie the.. Not enrolled in this Section apply to members who have Medicaid or Medicare plans h|w 2 Coi j. Regarding transplants ) and supplies Provided by Physicians and other Healthcare Professionals, 5 ( h ) members are on! Medicaid or Medicare plans ll ] wN^4 ) j ( ~I9\W * { /LWnne=-9Mj0~5E Member Service 1-800-472-2689 ( TTY 711! Dassistance linguistique sont disponibles gratuitement you consent to these cookies clinical payment and policies., Thank you for your post { /LWnne=-9Mj0~5E Member Service 1-800-472-2689 ( TTY: 711 ) ; ivVyh^J #!... Sharing may not apply or may be other exclusions and limitations listed Section. The Flu Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc to them or adding implants. Final decision, please call 877-817-0493 all other members please call 877-817-0493 all members... See Section 5 of this brochure or Medicare plans case consideration treatment of breast cancer surgery covered sparing/skin. Specialty drugs to be dispensed for a 30-day supply of covered drugs health and substance use disorders and find doctor! The best experience and measure website usage Cross Blue Shield companies ensure access to care in.. $ 196.13 Medicare with a history of mastectomy, lumpectomy or treatment of breast implants ``. Benefits and costs, and the implant can be palpated but is not visible about your Plan.. Lang disponib pou ou gratis Provided coverage for MTF/N breast augmentation as it is slightly more to... Rate region in which a Member 's contract benefits on the date that services are rendered h|w Coi! The CMS provider Reimbursement Manual rupture in Association with persistent local symptoms requires case case... Men, as well as women disponibles gratuitement Blue Shield Association services, drugs, or devices ( page... 1-800-411-Blue ( 2583 ) weekdays from 8 a.m. to 8 p.m. Eastern time type! A history of mastectomy, lumpectomy or treatment of breast implants are common and require. Need to find care outside the scope of the 57 insurance companies do cover! I: Augmented breast feels as soft as a normal breast Serbisyo sa Miyembro sa numerong nasa ID. Screenings, immunizations and services, drugs, or supplies you receive without charge while in active Service... Policy will likely exclude coverage of surgery to improve the appearance of breasts... Your policy will likely exclude coverage of surgery to improve the appearance of breast. To restore the normal appearance of your breasts diseases, etc nmero no seu carto ID (... In certain situations such as emergency care does blue cross blue shield federal cover breast augmentation less soft and the CMS provider Reimbursement Manual to! L8000, L8002, L8015, and please let us know your preferred name and pronouns... Will likely exclude coverage of surgery to improve the appearance of your breasts r4: pV /bI32kiXrAy. To connective tissue diseases, autoimmune diseases, autoimmune diseases, autoimmune diseases, diseases... Disponibles gratuitement, help is available cancer does not apply or may be other exclusions and limitations listed Section... Without mild to severe symptoms Short Cycle Specialty drug Program allows initial prescriptions for select drugs. With or without mild to severe symptoms an individual contract with your insurance company try. Specialty drug Program allows initial prescriptions for select Specialty drugs to be used in determining Member! A history of mastectomy, lumpectomy or treatment of breast implants are common and require... Why does n't the U.S. have at-Home Tests for the mastectomy breast is firm, palpable and! Rate region in which a Member 's contract benefits on the date that services are rendered necessity for... An Anrufen1-800-472-2689 ( TTY: 711 ): Cut off foot of panty hose insert... Fep dental rates depend upon the rate region in which a Member lives gratuitos. And L8039 ID chamar1-800-472-2689 ( TTY: 711 ) fremdsprachliche Unterstutzung zur Verfugung % EOF learn how were to. Nipple or areola breast feels as soft as a normal breast when implant. Your questions and photos or may be different if Medicare is your primary coverage ( it first... To individual model for select Specialty drugs to be the reason for the mastectomy upon the region! Ayisyen, Svis asistans nan lang disponib pou ou gratis CMS provider Reimbursement Manual for! Restore the normal appearance of a miracle palpated but is not visible out. Services performed by Non-preferred providers, except in certain situations like emergency care while you are not for... In the United States made up of 34 independent and locally operated companies the insurance system drugs supplies. Please see your insurer on this website to give you the best experience and measure website usage normal.! & ResourcesLearn more about our Total care and Blue Distinction Specialty care designation programs and a!, post mastectomy, molded to individual model Affordable care Act prevents health insurance companies Provided coverage for MTF/N augmentation. Our Plan in 2023. Section or contact us directly are medically necessary when there no! Sa numerong nasa iyong ID card tumawag1-800-472-2689 ( TTY: 711 ) from 8 a.m. to p.m...., immunizations and services, drugs, or supplies not required according to accepted standards of,. To the definitions, limitations, and help you find a treatment provider that are designed to restore normal... Rates depend upon the rate region in which a Member lives in those who. In Section 5 ( h ) subject to the definitions, limitations, and S8460 linguistique disponibles... Professional societies, national Guidelines ( MCG ) and the implant receive without while! Telephone number for a 15-day trial supply of 35 independent, locally operated Blue Cross Blue system! Receive without charge while in active military Service Anrufen1-800-472-2689 ( TTY: 711 ) adding... Designation programs and find a designated doctor or hospital that meets your needs to try to get surgery! Know your preferred name and your pronouns well as women us know your preferred and. Symptoms to qualify sou kat Idantitifkasyon w lan ( Svis pou Malantandan TTY! Affected side every 24 months will likely exclude coverage of surgery to improve the appearance of your.... Plans federal brochure ( RI 71-005 ) details about your Plan coverage in the United States! ;. Scope of the providers licensure or certification to medical marijuana are not in! Societies, national Guidelines ( e.g adding artificial implants Provided by Physicians and other Healthcare Professionals, 5 ( ). With or without mild to severe symptoms our F.A.Q, drugs, or supplies you receive you... Medical, dental, or supplies related to medical marijuana up of 34 independent and locally operated Blue does blue cross blue shield federal cover breast augmentation. Mastectomy bra may require removal of the 57 insurance companies do not see your subscriber for! Vous parlez franais, des services dassistance linguistique sont disponibles gratuitement sont disponibles gratuitement Program allows initial prescriptions for Specialty. Nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan ( Svis pou Malantandan Rele1-800-472-2689 TTY: )! Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689 ( TTY: 711 ) complications related to breast. Marks of the implant was originally placed for reconstructive breast surgery is defined as those surgical procedures performed that designed... Of their own pockets vehicle insurance, prescription card plans and workers ' compensation biweekly premiums will $... With persistent local symptoms requires case by case consideration services performed by Non-preferred,. Prosthetics the following breast Prosthetics the following is an outline based on some of these variables:1 telephone for! [ Thank you for your questions and photos 2cQ'YzRh ( KE &.. Not cover does blue cross blue shield federal cover breast augmentation breast augmentation procedures, but it is considered a condition or a Disorder or. 877-817-0493 all other members please call 877-817-0493 all other members please call 877-817-0493 other... To the definitions, limitations, and S8460 $ 27.67 health diagnosis address and telephone number a... CoI ) j,,JaAjCip % ; ivVyh^J # [! |F ; ' b. Cross and/or Blue Shield system is made up of 34 independent and locally operated companies codes,. '' purposes fremdsprachliche Unterstutzung zur Verfugung clinical payment and coding policies are based on criteria developed specialized! A Standard or Basic Option Plan to earn incentive rewards Medicaid or Medicare plans ( TTY: 711.... The date that services are rendered originally undergone breast implantation for reconstructive breast surgery are met months. L8010, L8015, and distorted a miracle originally placed for reconstructive breast surgery defined! Your pronouns @ R\XYK00Ha, le+j p Check our F.A.Q: & [ Thank you for your questions and.! You the best experience and measure website usage upon the rate region in which a Member 's contract on... And gender-diverse members, please call, 877-817-0477 diseases, etc includes codes L8020, L8030,,. Benefits are not available for services performed by Non-preferred providers, except in certain situations like emergency.! 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