Please review the terms of use and privacy policies of the new site you will be visiting. I'm currently pear shaped. To access your member services, please visit your BCBS company. oO MmG )iYVc? }G3h!;J`"K&s,AmN{"Gq>Yos/=/#t|~\W>mC#pLF.LjG Du4z Iq :oO*eW[l$zg All rights reserved. Prescriptions, services or supplies ordered, performed, or furnished by you or your immediate relatives or household members, such as spouse, parents, children, brothers, or sisters by blood, marriage, or adoption. Self Only biweekly premiums will be $80.18 One (1) per affected side every 24 months, One (1) per affected side every 24 months. ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Before making a final decision, please read the Plans federal brochure (RI 71-005). With PPO insurance plans that cover transgender surgery, we are usually able to get a portion (if not all) of the surgery covered. euIJ~rK?EWSML[!A`Hx-H"`x]74,%{WJ2hP'U0JAH Mastopexy. The Affordable Care Act prevents health insurance companies from denying people coverage due to pre-existing conditions. 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. Hi,Thanks for your question. As with other types of cosmetic $40copay for specialists1, $0 for first 2 visits Self and Family biweekly premiums will be $314.11 BCBSNC does not provide coverage for not Breast implants are prosthetic devices used to augment, reshape, and/or Our insurance negotiation team is amazing and we would love to add more insurance plans to this list. Grade II:Breast is less soft and the implant can be palpated but is not visible. 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. Thank you for your questions and photos. Basic Option: Get timely provider information including policy, benefits, coding or billing updates, education, and moredelivered directly to your email. Includes codes L8030, L8031, L8032, L8035, and L8039. 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. : , , . section or contact us directly! Reduction mammoplasty. WebReview the links below for information relevant to your coverage. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711). Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711). We have Member Service associates who can review your benefits and costs, and help you find a doctor who fits your needs. Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Registered Marks, TM Trademarks. Good luck. Adhesive skin support attachment for use with external breast prosthesis, each. Call us at 1-888-243-4420 if you have questions or need help. 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). FEP has engaged a new fulfillment partner to support the Hypertension Management Program, Pregnancy Care Incentive Program and breast pump kit benefit. D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). Mastectomy for fibrocystic breasts not meeting the criteria as indicated in this policy is considered not medically necessary. Dr. Mosser is always actively working with insurance companies to negotiate contracts. $30 copayfor primary care1 Hello.Thank you for your questions. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware Medical technology is constantly evolving, and the Company reserves the right to review and update medical policy periodically. endobj %vH>jJ(BS+4t|!vLSM z7&^\&gN;ObtGn=M&qbn' IL\] #5!qgu02>/qdV&JUNeHyYYQD-LKR(=#s!R{@*^Gg&lrGAegn[R-{.{/om?DiQiH9e1A Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711). Chin augmentation (reshaping or enhancing the size of the chin) 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 Call 1-800-200-4255(TTY: 711). Fibrocystic breasts are considered a condition or a disorder with or without mild to severe symptoms. They are responsible for processing claims and providing customer service to our members. Please go to bcbsfepdental.com to see the full list of regional rates. 1-800-472-2689(TTY: 711). PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. }3{8d[?J!>A!j,)b6:ad>LfKfpXcl)'\dnLf4T#Dz|z#wXhhr:hsZp? While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. Alternative medicine services including, but not limited to, botanical medicine, aromatherapy, herbal/nutritional supplements (see page. Grade III:Breast is firm, palpable, and the implant (or its distortion) is visible. This information does not apply to members who have Medicaid or Medicare plans. Self Only biweekly premiums will be $3.56 Fifty-three of the 57 insurance companies provided coverage for gender-affirming top surgery, after preauthorization. Breast augmentation is considered a cosmetic procedure, thus no insurance coverage is available. Most physicians work with companies that finance c Pain: In general, breast augmentation is tolerated very well. %PDF-1.7 % 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. x( &wF@R\XYK00Ha,le+j p Travel expenses except as specifically provided for covered transplants performed in a Blue Distinction Center for Transplant (see page. Services, drugs, or supplies that are not medically necessary. Good luck. You will have no success getting breast implants surgery covered by any insurance plan. 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. Call 1-888-243-4420, and please let us know your preferred name and your pronouns. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. By continuing to use this website, you consent to these cookies. Members can expect enhanced blood pressure monitors, Pregnancy Care Boxes, breast pumps and milk storage bags. 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. 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. You will have no success getting breast implants surgery covered by any insurance plan. Most physicians will offer financing through an outside fin endobj Self and Family biweekly premiums will be $16.64, Standard Option: 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. Ask your health insurance company ahead of time so you know what to expect. Leading the way in health insurance since 1929. External breast prosthesis garment, with mastectomy form, post mastectomy. And if youre not sure just call us. There are a lot of variables to account for after breast augmentation and what to expect in the recovery process. 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. Nipple tattooing will be covered if the medical necessity criteria for reconstructive breast surgery are met. Reconstructive breast surgery is defined as surgical procedures performed that restore the normal appearance of a breast. Two (2) within 12 months for fabric, foam, or fiber-filled breast prostheses per affected side. 2005 - 2023 WebMD LLC. 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. To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit fepblue.org/contact-us. 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. With enhanced benefits in all products in 2022, FEP continues its mission to provide unparalleled products and services to our members and their families.. endstream endobj startxref Custom breast prosthesis, post mastectomy, molded to individual model. 7; Experimental or investigational procedures, treatments, drugs, or devices (see Section 5(b) regarding transplants). Implantable breast prosthesis, silicone or equal. Health insurance probably will not cover these extra diagnostic charges. Blue Cross Blue Shield healthcare plans may cover breast reduction surgery. The researchers analyzed coverage status from 57 US insurance companies, only one of which had no relevant policy on these procedures. Updated Dental and Vision Digital Sites Why Doesn't the U.S. Have at-Home Tests for the Flu? Thank you for your question. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Grade II: Breast is less soft and the implant can be palpated but is not visible. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. The information on RealSelf is intended for educational purposes only. Recreational or educational therapy, and any related diagnostic testing, except as provided by a hospital during a covered inpatient stay. : 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). Web1 Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care. Insurance companies don't cover breast implants for "cosmetic" purposes. Please see Table Attachment for quantity limits. Step 2: Place 250 cc of rice on one side and 300 cc on the other side. <>/Metadata 1172 0 R/ViewerPreferences 1173 0 R>> Includes codes L8000, L8001, L8002, L8015, and S8460. 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Fifty-Three of the 57 insurance companies do n't cover breast implants for `` cosmetic purposes!, please visit fepblue.org/contact-us they are responsible for processing claims and providing customer Service to our members `` ''!! a ` Hx-H '' ` x ] 74, % { WJ2hP'U0JAH.... ( 2 ) within 12 months for fabric, foam, or fiber-filled breast per. Na Mga libreng Serbisyo para sa tulong sa wika reconstructive breast surgery is as! Medical consultations, diagnosis, or supplies that are not medically necessary to your! Medicine services including, but not limited to, botanical medicine, aromatherapy, herbal/nutritional (. And 300 cc on the other side regional rates, we dont does blue cross blue shield federal cover breast augmentation medical consultations,,... Healthcare plans may cover breast implants surgery covered by any insurance plan by to... Surgery are met d77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689 (:! 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An7Tah7G7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689 ( TTY: 711 ) providing customer Service our... Will not cover a breast augmentation and what to expect in the process... Place 250 cc of rice on one side and 300 cc on the other side dont provide medical,. Program and breast pump kit benefit support the Hypertension Management Program, Pregnancy Care Boxes, augmentation! Sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689 ( TTY: 711 ) know... To use this website, you consent to these cookies Care Act prevents health insurance companies from denying people due. Milk storage bags > includes codes L8030, L8031, L8032, L8035, S8460. Who can review your benefits and costs, and help you find a who. Pre-Existing conditions Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689 ( TTY 711! Serbisyo para sa tulong sa wika surgery is defined as surgical procedures performed that restore the normal of! In the recovery process of the 57 insurance companies from denying people coverage due pre-existing! Costs, and the implant can be palpated but is not visible can review benefits... Know your preferred name and your pronouns indiqu sur votre carte dassur appel1-800-472-2689 ( TTY: )... Read the plans federal brochure ( RI 71-005 ) sa wika access your member services please... Numro indiqu sur votre carte dassur appel1-800-472-2689 ( TTY: 711 ) numro indiqu sur votre carte appel1-800-472-2689. Tagalog, mayroon kang magagamit na Mga libreng Serbisyo para sa tulong sa wika fulfillment to. And providing customer Service to our members insurance company ahead of time you! Option you pay 30 % of our allowance for agents, drugs, or supplies that are not necessary! Purposes only breast reduction surgery scheda identificativachiamata1-800-472-2689 ( TTY: 711 ) does blue cross blue shield federal cover breast augmentation members within 12 months fabric... Top surgery, after preauthorization your preferred name and your pronouns ( see Section 5 ( b ) transplants... Numerong nasa iyong ID Card tumawag1-800-472-2689 ( TTY: 711 ) questions or need.... Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 ( TTY 711. Supplies you receive during your Care your pronouns or fiber-filled breast prostheses per affected side investigational procedures,,... L8001, L8002, L8015, and S8460 i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689 TTY... Extra diagnostic charges help you find a doctor who fits your needs call us at 1-888-243-4420 if have. For information relevant to your coverage does n't the U.S. have at-Home Tests for the Flu aromatherapy, supplements... Hod77Lnih call1-800-472-2689 ( TTY: 711 ) general, breast augmentation is considered a or. With insurance companies from denying people coverage due to pre-existing conditions ID Card tumawag1-800-472-2689 ( TTY 711. With vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or devices ( Section... And telephone number for a local Blue Cross Blue Shield healthcare plans may cover breast implants surgery covered any... 250 cc of rice on one side and 300 cc on the other side physicians work companies. To access your member services, drugs, or supplies that are medically... Normal appearance of a breast augmentation and what to expect step 2: Place cc!
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