Mastectomy Services Inpatient
Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.
Anesthesia Services This plan covers general and local anesthesia services received from an anesthesiologist when the surgical procedure is a covered healthcare service. This plan covers office visits or office consultations with an anesthesiologist when provided prior to a scheduled covered surgical procedure.
Security Services CONTRACTOR shall provide security services designed for preventing escapes, maintaining order, providing care, custody, control, supervision and management of the inmate population. A successful security program depends heavily on staff training, effective administration, and the establishment of inmate programs. The organization, staffing, and administration of the security program are vital to the Facility. The direction provided by a well-organized and clearly articulated operations manual, and emergency planning provides a solid base for successful administration. The final operations manual shall be submitted to the Bureau prior to the Service Commencement Date and shall be reviewed annually and updated as needed. Documentation of the review shall be provided annually to the On- Site Contract Monitor. Changes to the plan require written permission by the Contract Manager. The Department reserves the right to require changes to plans submitted to the Bureau.
Maternity Services Your benefits for maternity services are the same as your benefits for any other condition and are available whether you have Individual Coverage or Family Coverage. Benefits will be provided for delivery charges and for any of the pre viously described Covered Services when rendered in connection with pregnancy. Benefits will be provided for any treatment of an illness, injury, congenital defect, birth abnormality or a premature birth from the moment of the birth up to the first 31 days, thereafter, you must add the newborn child to your Family Coverage. Premiums will be adjusted accordingly. Coverage will be provided for the mother and the newborn for a minimum of: