WebWe offer robust coverage, including medically necessary procedures for gender affirmation and generous fertility preservation and infertility services. Insurance companies do not cover this surgery because it's "cosmetic " in nature, they do cover breast reconstruction after breastcancer surgery. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware of. The following is an outline based on some of these variables:1. Services or supplies for which no charge would be made if the covered individual had no health insurance coverage. Please review the terms of use and privacy policies of the new site you will be visiting. I'm currently pear shaped. Is there a Dr. that has a monthly payment plan or any kind of special offer or assistance with the price of breast implants? Most surgeons do offer financing through outside companies such as Care credit for example. WebReview the links below for information relevant to your coverage. endstream endobj startxref Self Plus One biweekly premiums will be $18.44 External breast prosthesis garment, with mastectomy form, post mastectomy. 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. Leading the way in health insurance since 1929. If additional surgery is required for either breast for treatment of physical complications of the implant or reconstruction, surgery on the other breast to produce a symmetrical appearance is reconstructive at that point as well. Self and Family biweekly premiums will be $54.16, Standard Option: Self Only biweekly premiums will be $3.56 hbbd```b``3A$dll{0&S*`@RfKk@d7 Dm`:$5s2012 e bh This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. 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. Other insurance types such as disability insurance, motor vehicle insurance, prescription card plans and workers' compensation. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. 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 **Conservative treatment for fibrocystic breasts consists of, but is not limited to: support bras, avoiding trauma, avoiding caffeine, medication for pain, anti-inflammatory drugs, hormonal manipulation, use of vitamin E, use of diuretics, and salt restrictions. 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. Quantity Level Limits For Breast Prosthetics. Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral. ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. 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. I. Mental Health and Substance Use Disorder Benefits, 5(h). Self and Family biweekly premiums will be $27.67. Reconstructive breast surgery not meeting the criteria as indicated in this policy is considered not medically necessary. $40copay for specialists1, $0 for first 2 visits ART-20203231. 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Springfield Named President of Blue Cross and Blue Shield of Texas. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele1-800-472-2689 TTY: 711). The rates presented here are for BCBS FEP Dentals most populous region, Region 1. Description Services, drugs, or supplies related to medical marijuana. Transverse rectus abdominis myocutaneous flap (TRAM), latissimus dorsi flap or free flap. Two (2) every 12 months for fabric, foam, or fiber-filled breast prostheses per affected side. Incontinence products such as incontinence garments (including adult or infant diapers, briefs, and underwear), incontinence pads/liners, bed pads, or disposable washcloths. Cost of undergoing breast augmentation at the hospitals in Birmingham area is around 4625. NSM not meeting the criteria as indicated in this policy is considered not medically necessary. Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc. Some have been more receptive than others. Nipple prosthesis, reusable, any type, each. Learn how were working to make health care more equitable. Please see your subscriber certificate for details about your plan coverage. No-indicates the removal would be considered not medically necessary. Self and Family biweekly premiums will be $314.11 Hello.Thank you for your questions. WebSection V-Surgical Management of Breast Implants. -L The Affordable Care Act prevents health insurance companies from denying people coverage due to pre-existing conditions. Membership or concierge service fees charged by a healthcare provider. Webthe Blue Shield contracted rate up to $100 copayment maximum / prescription N / A Not covered Covers up to a 30-day supply. Includes codes L8000, L8002, L8010, L8015, and S8460. of breast tissue removed from each breast and who meet the following criteria: Presence of one or more of the following : A cervical or thoracic pain syndrome (upper back and shoulder pain), in which interference with daily activities or work has been documented. At present, we have gotten successful insurance approval for FTM/N top surgery from the following insurers: Anthem BC For members whose gender identity differs from assigned sex at birth, we traditionally cover:*. Services, drugs, or supplies you receive from noncovered providers. Call 1-800-200-4255(TTY: 711). For members whose gender Abdominoplasty and Lipectomy are considered cosmetic and not medically necessary for all applications. BCBS FEP Vision plans will offer a second eye exam, frame and second pair of lenses when a prescription changes for children aged 13 and under. Do you have any questions? Medicare Advantage members, please call 877-817-0493 all other members please call, 877-817-0477. This document addresses gender affirming surgery (also known as sex affirmation surgery, gender or sex reassignment surgery, gender or sex confirmation 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. Self Only biweekly premiums will be $9.22 Generally, you must exhibit physical, objective symptoms to qualify. Telefone para os Servios aos Membros, atravs do nmero no seu carto ID chamar1-800-472-2689 (TTY: 711). BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. Recreational or educational therapy, and any related diagnostic testing, except as provided by a hospital during a covered inpatient stay. 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. 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. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). Ask your health insurance company ahead of time so you know what to expect. 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. This information does not apply to members who have Medicaid or Medicare plans. The mandate applies to men, as well as women. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. The exclusions in this Section apply to all benefits. Implantable breast prosthesis, silicone or equal. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Grade IV: Breast is hard, painful, cold, tender, and distorted. The protection of your privacy will be governed by the privacy policy of that site. Web1 Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care. For more information, view our privacy policy. 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. Additional information about 2022 benefits is available online or by calling the National Information Center. Services, drugs, or supplies you receive while you are not enrolled in this Plan. <> Individuals, regardless of BSA, who are anticipated to have at least 1 kg. *Your benefits and coverage may vary. Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). . 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. Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral. 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. 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