does blue cross blue shield federal cover breast augmentation

1 0 obj 3You must be the contract holder or spouse, 18 or older, on a Standard or Basic Option Plan to earn incentive rewards. 1-800-472-2689(TTY: 711). FEP Blue Focus: The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Furniture (other than medically necessary durable medical equipment) such as commercial beds, mattresses, chairs. 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. x( &wF@R\XYK00Ha,le+j p 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. Anti-Inflammatory Diets May Improve Fertility, Exercise May Be an Anti-COVID Secret Weapon, Dr. Whyte's Book: Take Control of Your Diabetes Risk, Street Medicine Reaches People Where They Live, Health News and Information, Delivered to Your Inbox, Breast Implants (Breast Augmentation) Home, 5 Questions to Ask Your Health Insurance Company, Additional Costs of Breast Implant Surgery, Insurance Eligibility and Breast Implants, Breast Implants: Types, Cost, Problems, and Recovery, Facts About Breast Implants and Health Insurance. Is there a rule of thumb or tips for choosing breast augmentation sizes? 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. Self and Family biweekly premiums will be $212.29. Reconstructive breast surgery is defined as surgical procedures performed that restore the normal appearance of a breast. 500 One (1) per affected side every three (3) months. Please go to bcbsfepdental.com to see the full list of regional rates. 1114 0 obj <>stream FEP has engaged a new fulfillment partner to support the Hypertension Management Program, Pregnancy Care Incentive Program and breast pump kit benefit. Before you get breast implants, ask your insurance company these five questions: Get the answers in writing and check back with your insurance company every couple of years, since it may change its policy. Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral. Orthodontic care for malposition of the bones of the jaw or for temporomandibular joint (TMJ) syndrome. WebBreast implants complications are common and may require removal of the implant. D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). American Society for Aesthetic Plastic Surgery. The pain should be related to the Baker classification or a diagnosis of rupture. 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. Were partnering with clinicians to ensure access to care in Massachusetts. 3 0 obj Lumpectomy is the removal of the breast tumor and surrounding tissue. 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. Quantity Level Limits For Breast Prosthetics. Procedure Codes Breast Prosthetics The following breast prosthetics are medically necessary: Breast prosthesis, mastectomy bra. Description ID 1-800-472-2689TTY 711). $40copay for specialists1, $0 for first 2 visits 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. Your member ID card is your key to using your medical plan benefits. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711). 1089 0 obj <>/Filter/FlateDecode/ID[<50450C2B75DCDF4CB37C20535D129F89><28C61A8B7ECC9640B72333AA8FDFF1D6>]/Index[1067 48]/Info 1066 0 R/Length 109/Prev 449243/Root 1068 0 R/Size 1115/Type/XRef/W[1 3 1]>>stream BCBSNC does not provide coverage for not Blue Cross Blue Shield FEP Vision Premiums in 2022: High Option: Personal comfort items such as beauty and barber services, radio, television, or phone. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. Having breast implants may also affect your insurance rates later on. Services you receive from a provider that are outside the scope of the providers licensure or certification. Self Plus One biweekly premiums will be $196.13 Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Reduction mammoplasty. : , . 1Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care. 1067 0 obj <> endobj WASHINGTON, Sep. 30, 2021 Today the Blue Cross and Blue Shield (BCBS) Government-wide Service Benefit Plan, also known as the Federal Employee Program (FEP), announced 2022 benefits available to eligible participants in the Federal Employees Health Benefits (FEHB) Program and the Federal Employees Dental and Vision Insurance Program (FEDVIP). This information does not apply to members who have Medicaid or Medicare plans. HWm8O'8vPUn'U;S) {ftw R"=/E&>SYd"sSod.__"_Ii [1Z!Uf};KiH9)jvc&LG8Zd"QAL}^:VZ,.lk'#sJeg[+VzN'lZ *j{Lh61 S*b;v4c\" [FlMVM%f{p]~0xuBD1(` ;xFx. J9PK^\BiL?|K"2. Stay in-network for care. At present, we have gotten successful insurance approval for FTM/N top surgery from the following insurers: Anthem BC You will have no success getting breast implants surgery covered by any insurance plan. Some have been more receptive than others. )jiH9A ,-&_[7`!PWg GUb971IXsH"$I= $QDG! Services, drugs, or supplies you receive from a provider or facility barred or suspended from the FEHB Program. I. Call 1-888-243-4420, and please let us know your preferred name and your pronouns. By continuing to use this website, you consent to these cookies. 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. ; 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. hb```@(1atZ Qr)aFKyi]8>I_13 huv1v.<4zz"@lfYXl}qjRX*:;+:;:;:LQ f 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. Insurance usually will not cover breast enlargement surgery. All Rights Reserved. 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. ID 1-800-472-2689TTY: 711. In the U.S., breast augmentation surgery -- getting breast implants for cosmetic reasons -- cost an average of $6550 (including surgeon's fees, operating room costs and anesthesia)in 2022. Self Only biweekly premiums will be $3.56 HZjz:|QkM]h]\ }3{8d[?J!>A!j,)b6:ad>LfKfpXcl)'\dnLf4T#Dz|z#wXhhr:hsZp? Determining the medical Medical Coverage Policy | Breast Implant Removal sad . %%EOF Preparation of moulage for custom breast implant. To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit fepblue.org/contact-us. WebMD does not provide medical advice, diagnosis or treatment. WebAlthough we may list a specific service as a benefit, we will not cover it unless we determine it is medically necessary to prevent, diagnose, or treat your illness, disease, injury, or condition. Last review: July 2003. Medicare. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. 1zGzdQp26W&YJHO2pF(ug.`Fh$5XP>C!^DmSkp_J)^)6"Y/!r7s!J/\] }} f((x Most physicians will offer financing through an outside financing company. All rights reserved. Recreational or educational therapy, and any related diagnostic testing, except as provided by a hospital during a covered inpatient stay. While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. Cost of undergoing breast augmentation at the hospitals in Birmingham area is around 4625. Topical Hyperbaric Oxygen Therapy (THBO). Greater than or equal to 13 months post mastectomy. Transverse rectus abdominis myocutaneous flap (TRAM), latissimus dorsi flap or free flap. hbbd``b`~ H ,f@]bXu $UW4 bV+X ``0 \] 1152 0 obj <> endobj If you do not see your insurer on this list, please contact us. Visitwww.fepblue.org/whatsnew or call 1-800-411-BLUE (2583). Our AskBlueSMFEP Medical Plan Finder tool can help you select the right option for your needs. 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. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware of. Self Only biweekly premiums will be $5.55 We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. Fibrocystic breasts are considered a condition or a disorder with or without mild to severe symptoms. Calf implants IV. 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 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. The following is an outline based on some of these variables:1. Registered Marks of the Blue Cross and Blue Shield Association. For more information, view our privacy policy. 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. As with other types of cosmetic I don't know if silicone or saline is best & not sure on either a C or D cup. Eligible participants will have an opportunity to make their coverage decisions during Open Season, which runs from Nov. 8 through Dec. 13, 2021. When the implant was originally placed for reconstructive purposes in an individual with a history of mastectomy, lumpectomy or treatment of breast cancer. Applied behavior analysis (ABA) and related services for any condition other than an autism spectrum disorder. Grade II:Breast is less soft and the implant can be palpated but is not visible. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. and SM Service Marks are the property of their respective owners. Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). Surgery on the contralateral breast to produce symmetry not meeting the criteria as indicated in this policy is considered not medically necessary. Reconstructive breast surgery not meeting the criteria as indicated in this policy is considered not medically necessary. Self Only biweekly premiums will be $9.22 endstream endobj 1071 0 obj <>stream Health insurance probably will not cover these extra diagnostic charges. BCBS FEP Dental Standard Option will cover Class A (Basic), B (Intermediate), and C (Major) services for children at 100% when these services are provided by in-network providers. 4 0 obj Custom breast prosthesis, post mastectomy, molded to individual model. However many plastic surgeons offer payment options and outside financing, the most popular being CareCredit. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. 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. How Long is Breast Implants Recovery Time? UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. 2005 - 2023 WebMD LLC. Self and Family biweekly premiums will be $125.67 Why Doesn't the U.S. Have at-Home Tests for the Flu? WebAdditional Costs of Breast Implant Surgery. 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. One (1) within 24 months for silicone prostheses per affected side. 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. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Ask your health insurance company ahead of time so you know what to expect. Includes codes L8000, L8001, L8010, L8015, and S8460. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Mayo Clinic: "Breast Augmentation: Breast Implants Reshape Self-Image." To access your member services, please visit your BCBS company. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c).
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