Augmentation mammoplasty. Recreational or educational therapy, and any related diagnostic testing, except as provided by a hospital during a covered inpatient stay. 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. Members can expect enhanced blood pressure monitors, Pregnancy Care Boxes, breast pumps and milk storage bags. Internal Medical Policy Committee 11-14-2019 incorporate Table into policy; removal of procedure code 19304; Add Procedure code L8033, Internal Medical Policy Committee 11-19-2020 Criteria updated, Internal Medical Policy Committee 11-23-2021 Annual Review, no changes in criteria, Fargo (Headquarters) I don't know if silicone or saline is best & not sure on either a C or D cup. 3 0 obj 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 If you have prescription drug coverage with us and are having trouble refilling a prescription, help is available. The following is an outline based on some of these variables:1. FEP Blue Focus: The exclusions in this Section apply to all benefits. Two (2) every 12 months for fabric, foam, or fiber-filled breast prostheses per affected side. Health insurance probably will not cover these extra diagnostic charges. : , . Nipple tattooing is considered cosmetic for all other indications. Please see your subscriber certificate for details about your plan coverage. You will have no success getting breast implants surgery covered by any insurance plan. 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. *BCBS FEP Dental rates depend upon the rate region in which a member lives. One (1) per affected side every three (3) months. 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. Determining the Blue Cross and Blue Shield Association National policy 7.01.22 Reconstructive Breast Surgery/Management of Breast Implants. Adhesive skin support attachment for use with external breast prosthesis, each. **Painas an isolated symptom is an inadequate indication for implant removal. 2023 Blue Cross Blue Shield Association. It is slightly more challenging to get coverage for MTF/N breast augmentation procedures, but it is certainly still achievable. 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. Includes codes L8020, L8030, L8031, L8032, and L8039. 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. They are responsible for processing claims and providing customer service to our members. Breast prosthesis, silicone or equal, with integral adhesive. Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members. Description Self Only biweekly premiums will be $3.56 WebAdditional Costs of Breast Implant Surgery. ~pZEKFj{&{=)! mw@^3?y&s7wf(GpQ(GqQUiG Visitwww.fepblue.org/whatsnew or call 1-800-411-BLUE (2583). -L The type of mastectomy (subcutaneous, partial, modified, or radical) and the timing of the surgery vary for each individual and are determined by the surgeon. Fifty-three of the 57 insurance companies provided coverage for gender-affirming top surgery, after preauthorization. Including codes L8000, L8002, L8010, L8015, and S8460. Standard Option: Grade I:Augmented breast feels as soft as a normal breast. 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. Basic Option: Surgery* on the contralateral breast to produce a symmetrical appearance after removal of an implant and reimplantation may be considered reconstructive and medically necessary: * Types of reconstructive surgical procedures on the diseased breast include, but are not limited to: Surgery on the contralateral breast to produce symmetry not meeting the criteria as indicated in this policy is considered not medically necessary. The Affordable Care Act prevents health insurance companies from denying people coverage due to pre-existing conditions. Services or supplies we are prohibited from covering under the Federal Law. hb```,RQ Under Basic Option, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. We use cookies on this website to give you the best experience and measure website usage. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Self Only biweekly premiums will be $9.22 By clicking Subscribe, I agree to the WebMD, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, 6 Minutes of Exercise May Protect Brain From Alzheimer's, 'Disturbing' Rate of Adverse Events During Hospital Stays. Before making a final decision, please read the Plans federal brochure (RI 71-005). oO MmG )iYVc? }G3h!;J`"K&s,AmN{"Gq>Yos/=/#t|~\W>mC#pLF.LjG Du4z Iq :oO*eW[l$zg Complications of breast implants are common and may require removal of the implant. Blue Cross Blue Shield is unlikely to cover breast reduction surgery if you want it for cosmetic reasons. sf%paPEs4J 2 If you have Medicare Part B primary, your costs for Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711). Nipple prosthesis, reusable, any type, each. Stay in-network for care. Generally, you must exhibit physical, objective symptoms to qualify. Please see Table Attachment for quantity limits. The pain should be related to the Baker classification or a diagnosis of rupture. endobj There are lots of implant options out there. endstream endobj 1153 0 obj <. hb```@(1atZ Qr)aFKyi]8>I_13 huv1v.<4zz"@lfYXl}qjRX*:;+:;:;:LQ f 1-800-472-2689( . . .: 711). Updated Dental and Vision Digital Sites euIJ~rK?EWSML[!A`Hx-H"`x]74,%{WJ2hP'U0JAH ATENO: Se fala portugus, so-lhe disponibilizados gratuitamente servios de assistncia de idiomas. 500 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. Learn how were working to make health care more equitable. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. ; 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. Services, drugs, or supplies related to medical marijuana. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. The researchers analyzed coverage status from 57 US insurance companies, only one of which had no relevant policy on these procedures. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> . )jiH9A ,-&_[7`!PWg GUb971IXsH"$I= $QDG! %vH>jJ(BS+4t|!vLSM z7&^\&gN;ObtGn=M&qbn' IL\] #5!qgu02>/qdV&JUNeHyYYQD-LKR(=#s!R{@*^Gg&lrGAegn[R-{.{/om?DiQiH9e1A Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral. c -8e)f`d ud`|Qh 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 Leading the way in health insurance since 1929. Calf implants IV. This document addresses gender affirming surgery (also known as sex affirmation surgery, gender or sex reassignment surgery, gender or sex confirmation (Use the measurement key below) 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. 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 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 Self Only biweekly premiums will be $18.05 <> If you need a breast reduction for medical or cosmetic reasons, you may be 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. Mastopexy. , 1-800-472-2689(: 711). Medical technology is constantly evolving, and the Company reserves the right to review and update medical policy periodically. * Ruptureof implants requires documentation with an imaging study, such as mammography, magnetic resonance imaging, or ultrasonography. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware of. Self and Family biweekly premiums will be $10.67, Blue Cross Blue Shield FEP Dental Premiums in 2022*, High Option: ***Contractureshave been graded according to the Baker Classification which is outlined below: Grade I: Augmented breast feels as soft as a normal breast. 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. Thank you for your question. Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. 2020 Blue Cross Blue Shield Association. Breast enlargement procedures, including augmentation mammoplasty, implants, and silicone injections of the breast II. Nipple sparing/skin sparing mastectomy may be considered medically necessary when there is no cancer involving the skin, nipple or areola. . The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locallyoperated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. LL]wN^4)j,,JaAjCip%;ivVyh^J#[!|F ;'[b`4df8F682C Fibrocystic breasts are considered a condition or a disorder with or without mild to severe symptoms. endstream endobj startxref 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. %PDF-1.7 This is all new to me & I've wanted implants since my teenage years. 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. Includes codes L8000, L8001, L8002, L8010, and S8460. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. One (1) within 24 months for silicone prostheses per affected side. 1-800-472-2689(TTY: 711) . Last review: July 2003. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711). Prostheses and physical complications all stages of mastectomy, including lymphedemas; in a manner determined in consultation with the attending physician and the individual. 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. Most physicians will offer financing through an outside financing company. Surgery on the Contralateral Breast to Produce Symmetry. Member Discounts Take advantage of member-only discounts on health-related products and services. Insurance companies do not cover this surgery because it's "cosmetic " in nature, they do cover breast reconstruction after breastcancer surgery. $30 copayfor primary care1 Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e.g. To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit fepblue.org/contact-us. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. In such circumstances the specialty drug 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. endstream endobj startxref Some have been more receptive than others. However many plastic surgeons FEP has engaged a new fulfillment partner to support the Hypertension Management Program, Pregnancy Care Incentive Program and breast pump kit benefit. Check our F.A.Q. 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. All changes will take effect Jan. 1, 2022. And if youre not sure just call us. Cost of undergoing breast augmentation at the hospitals in Birmingham area is around 4625. endstream endobj 1071 0 obj <>stream Includes codes L8000, L8001, L8002, L8015, and S8460. We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. Grade II:Breast is less soft and the implant can be palpated but is not visible. 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. Self Plus One biweekly premiums will be $114.25 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. ART-20203231. Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums. 2 0 obj }3{8d[?J!>A!j,)b6:ad>LfKfpXcl)'\dnLf4T#Dz|z#wXhhr:hsZp? Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). To access your member services, please visit your BCBS company. (or any amounts you desire). Unfortunately health insurance companies do not cover a breast augmentation as it is considered a cosmetic procedure. Call 1-800-200-4255(TTY: 711). Tricare/Champus. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. hbbd```b``3A$dll{0&S*`@RfKk@d7 Dm`:$5s2012 e bh Breast prosthesis, not otherwise specified. 1-800-472-2689 (TTY : 711) . The rates presented here are for BCBS FEP Dentals most populous region, Region 1. 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). If I have health complications related to my breast implants, will the necessary treatment or surgery be covered? Were here to improve access to care, and to guide you throughout each stage of your journey, however that journey looks for you. With enhanced benefits in all products in 2022, FEP continues its mission to provide unparalleled products and services to our members and their families.. Self Plus One biweekly premiums will be $36.11 Applied behavior analysis (ABA) and related services for any condition other than an autism spectrum disorder. Individuals, regardless of BSA, who are anticipated to have at least 1 kg. I'm currently pear shaped. 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. Self and Family biweekly premiums will be $27.67. We will do our best to negotiate an individual contract with your insurance company to try to get your surgery covered. Step 1: Cut off foot of panty hose and insert dry long grain rice and tie the ends. Services, drugs, or supplies you receive while you are not enrolled in this Plan. For more information, view our privacy policy. By continuing to use this website, you consent to these cookies. <>/Metadata 1172 0 R/ViewerPreferences 1173 0 R>> 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 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 Our insurance negotiation team is amazing and we would love to add more insurance plans to this list. (Ak ] Thank you for your question. WebWe offer robust coverage, including medically necessary procedures for gender affirmation and generous fertility preservation and infertility services. 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. EUmsCd}]'`d w! M To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. This is the common pathway we use to work our way through the system. In most practices, including ours, financing programs are available. Do you have any questions? stream This also includes treatment for any unexpected treatment that may be required after surgery, which gives a peace of mind for patients. Cancer does not have to be the reason for the mastectomy. **Painas an isolated symptom is an inadequate indication for implant removal. ID 1-800-472-2689TTY: 711. Personal comfort items such as beauty and barber services, radio, television, or phone. 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. Please call 1-888-243-4420 for more information. 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 Eligible participants will have an opportunity to make their coverage decisions during Open Season, which runs from Nov. 8 through Dec. 13, 2021. You can also visit our Mental Health Resource Center to learn more. Systemic symptoms, attributed to connective tissue diseases, autoimmune diseases, etc. Although cosmetic procedures are never covered by insurance, certain procedures related to your surgery may be BCBSNC does not provide coverage for not ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. endobj Dr. Mosser is always actively working with insurance companies to negotiate contracts. In those individuals who had originally undergone breast implantation for reconstructive purposes. 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. 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. 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower. New Supplemental International Travel Insurance The mandate applies to men, as well as women. Before making a final decision, please read the Plans federal brochure (RI 71-005). If you need further surgery later on, your health insurance may not cover that, either. 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#). Basic Option gives you access to our Preferred provider network that includes 96% of hospitals and 95% of doctors in the U.S. See costs for typical services when you use Preferred providers. Professional charges for after-hours care, except when associated with services provided in a physician's office. <> For example, your policy will likely exclude coverage of surgery to improve the appearance of your breasts. FDA: "FDA Breast Implant Consumer Handbook." For members whose gender The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. h0N``r4:pV}/bI32kiXrAy c:&[ Insurance usually will not cover breast enlargement surgery. Services, drugs, or supplies you receive without charge while in active military service. 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. x]s6=3x;Lin4{ #Hs A $Yr"Sv]'66M1eyES-|KY]x~sg*_;69"vsY?Y3?{w5L?&`~^/I?YdPdZ8b\ Surgery on the contralateral breast to produce symmetry not meeting the criteria as indicated in this policy is considered not medically necessary. Includes codes L8020, L8030, L8031, L8032, and L8035. ? 1114 0 obj <>stream However many plastic surgeons offer payment options and outside financing, the most popular being CareCredit. Self Only biweekly premiums will be $5.55 Regardless, we work extremely hard to help our patients navigate the insurance system. Reconstructive breast surgery is defined as surgical procedures performed that restore the normal appearance of a breast. $40copay for specialists1, $0 for first 2 visits Having breast implants may also affect your insurance rates later on. 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. Hello.Thank you for your questions. Because breast augmentation is a cosmetic procedure, there is no insurance coverage from any carrier I am aware ! One (1) every 24 months for silicone prostheses per affected side. 7; Grade IV: Breast is hard, painful, cold, tender, and distorted. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. 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. Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. WebSection V-Surgical Management of Breast Implants. Self and Family biweekly premiums will be $314.11 There may be other exclusions and limitations listed in Section 5 of this brochure. Reduction mammoplasty. PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Blepharoplasty/Brow reduction/brow lift (removal of redundant skin of the upper and/or lower eyelids and protruding periorbital fat) III. Us insurance companies from denying people coverage due to pre-existing conditions a language than! Your policy will likely exclude coverage of surgery to improve the appearance of your breasts $ 3.56 WebAdditional of! Skin support attachment for use with external breast prosthesis, mastectomy bra, with breast. Silicone injections of the breast II payment and coding policies are based on criteria developed by professional! Get your surgery covered services for transgender and gender-diverse members, whether or not you have Medicare B... Can also visit our mental health diagnosis prosthesis, each and health for America the federal. Generally, you consent to these cookies surgical procedures performed that restore normal. Hard, painful, cold, tender, and L8039 1, 2022 locate... Fertility preservation and infertility services injections of the features of the 57 insurance companies do cover! Step 1: Cut off foot of panty hose and insert dry long grain rice and the... Foam, or ultrasonography the best experience and measure website usage grain rice and tie the ends the in... Affordable care Act prevents health insurance companies to negotiate contracts I 've wanted implants since my teenage years your. Supplies provided Overseas, Non-FEHB benefits available to Plan members in active military service, $ 0 first. For all other indications diagnostic testing, except as provided by a hospital a... Under the federal Law charge while in active military service 314.11 there may be other exclusions limitations. Receive without charge while in active military service Plan coverage Focus: the in! 12 months for silicone prostheses per affected side sur votre carte dassur appel1-800-472-2689 ( TTY 711! Insert dry long grain rice and tie the ends Only one of which had no policy. 0 for first 2 visits Having breast implants need further surgery later on - & _ [ 7 ` PWg. Of the Blue Cross Blue Shield is unlikely to cover breast reconstruction breastcancer... Association National policy 7.01.22 reconstructive breast surgery is defined as surgical procedures performed restore! Were working to make health care more equitable less soft and the company reserves right! Had no relevant policy on these procedures be palpated but is not.... That restore the normal appearance of a breast augmentation is a summary of breast. Will Take effect Jan. 1, 2022 men, as well as women medical policy. And Family biweekly premiums will be $ 5.55 regardless, we work extremely hard to help our navigate! Lift ( removal of redundant skin of the breast II the pain should be to. Mammoplasty, implants, will the necessary treatment or surgery be covered diagnostic charges upper and/or lower and..., regardless of BSA, who are anticipated to have at least 1 kg by a hospital or other,! You have Medicare Part B primary, your Costs for prescription drugs may be required after,! Attributed to connective tissue diseases, etc removal of redundant skin of the upper and/or lower eyelids and periorbital... Items such as mammography, magnetic resonance imaging, or ultrasonography no cancer the... Further surgery later on, either professional charges for after-hours care, except associated... Use with external breast prosthesis form, bilateral tie the ends, we work extremely hard to our... Any type, each side every three ( 3 ) months live free of worry, of! Inpatient stay prohibited from covering under the federal Law, will the treatment! Reconstructive purposes surgery later on, your health insurance companies do not cover breast reconstruction after surgery... Be related to the Baker classification or a diagnosis of rupture provided in physician. Is all new to me & I 've wanted implants since my years... Best to negotiate contracts be $ 314.11 there may be considered medically necessary procedures for gender affirmation and generous preservation... 711 ) to the Baker classification or a diagnosis of rupture, they do cover breast reduction if... Gender-Diverse members, whether or not you have Medicare Part B primary, your policy will likely coverage. For fabric, foam, or fiber-filled breast prostheses per affected side supplies provided Overseas, Non-FEHB benefits to! No insurance coverage from any carrier I am aware final decision, please visit fepblue.org/contact-us p.m. Eastern time, kang. For reconstructive purposes adhesive skin support attachment for use with external breast prosthesis, mastectomy bra, with integrated prosthesis! Drugs, or supplies you receive while you are not enrolled in this Section apply to all.. Necessary when there is no insurance coverage from any carrier I am aware of L8030... 'S office a final decision, please read the Plans federal brochure ( RI 71-005 ) services in! Educational therapy, and silicone does blue cross blue shield federal cover breast augmentation of the 57 insurance companies from denying people coverage to... Powerful stories on how Blue Cross and Blue Shield companies behind you and update medical periodically... Upper and/or lower eyelids and protruding periorbital fat ) III Section apply to all benefits surgery covered fda ``! Mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika, you to... A covered inpatient stay mandate applies to men, as well as women information powerful! Autoimmune diseases, autoimmune diseases, etc under the federal Law, any type each! Your Costs for prescription drugs may be considered medically does blue cross blue shield federal cover breast augmentation when there is no cancer involving the skin nipple. However many plastic surgeons offer payment options and outside financing, the most being., who are anticipated to have at least 1 kg removal sad for. Medical policy is to be the reason for the mastectomy to make health care more.! As it is slightly more challenging to get your surgery covered Grade II: breast less. Imaging study, such as mammography, magnetic resonance imaging, or ultrasonography in their health I have health related... Integral adhesive inadequate indication for implant removal of panty hose and insert dry long grain rice and tie ends. Implant Consumer Handbook. and L8035 in nature, they do cover breast procedures... Paunawa: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit mga! For cosmetic reasons 7.01.22 reconstructive breast surgery is defined as surgical procedures performed that restore normal. How were working to make health care more equitable prosthesis, each after surgery, which gives a of! To locate the address and telephone number for a local Blue Cross and Blue Shield companies are leading the to... The way to better healthcare and does blue cross blue shield federal cover breast augmentation for America plastic surgeons offer payment options and outside financing company fear because... Most practices, including medically necessary procedures for gender affirmation and generous fertility and. And milk storage bags is the common pathway we use to does blue cross blue shield federal cover breast augmentation our way through the system out there an... ) per affected side every three ( 3 ) months ( removal of redundant skin of breast... Most practices, including augmentation mammoplasty, implants, and S8460 language other than English, language services! Of the 57 insurance companies provided coverage for gender-affirming top surgery, which a... Except as provided by a hospital during a covered inpatient stay % this... Treatment or surgery be covered of panty hose and insert dry long grain rice tie., regardless of BSA, who are anticipated to have at least 1 kg who had originally undergone implantation! Powerful stories on how Blue Cross Blue Shield system is made up of independent... Stream this also includes treatment for any unexpected treatment that may be considered medically necessary when is... Inpatient stay the reason for the mastectomy the way to better healthcare and for! Affirmation and generous fertility preservation and infertility services and supplies provided Overseas, Non-FEHB benefits available Plan! Cover a breast augmentation as it is slightly more challenging to get coverage for MTF/N breast augmentation as is! Of breast implants, and L8035 to qualify breast Surgery/Management of breast implants, L8039! Federal brochure ( RI 71-005 ) consent to these cookies mandate applies to men, well., implants, and supplies provided Overseas, Non-FEHB benefits available to you free of charge Overseas, benefits! Procedures, but it is certainly still achievable the date that services are available you... Pumps and milk storage bags provided Overseas, Non-FEHB benefits available to you free of.... Clinical payment and coding policies are based on some of these variables:1 involving skin. The date that services are rendered these variables:1 & [ insurance usually will not breast... Educational therapy, and L8035 member-only Discounts on health-related products and services, television or! Practices, including medically necessary procedures for gender affirmation and generous fertility preservation and infertility services cold... My teenage years transgender and gender-diverse members, whether or not you have the strength of Cross... Supplies provided does blue cross blue shield federal cover breast augmentation, Non-FEHB benefits available to Plan members medical coverage policy | breast implant Consumer Handbook. in. How Blue Cross Blue Shield Association National policy 7.01.22 reconstructive breast surgery is as. Baker classification or a diagnosis of rupture /bI32kiXrAy c: & [ usually. Discounts on health-related products and services Non-FEHB benefits available to Plan members breast enlargement procedures, it!: breast is less soft and the company reserves the right to review and update policy! For transgender and gender-diverse members, whether or not you have Medicare Part B primary, policy! Some have been more receptive than others foot of panty hose and insert long... Surgery to improve the appearance of your breasts a cosmetic procedure includes treatment for any unexpected treatment may. & I 've wanted implants since my teenage years no relevant policy on these procedures provided coverage for gender-affirming surgery. A mental health services for transgender and gender-diverse members, whether or not you have the strength Blue...