Reconstructive Surgery. Benefits for reconstructive surgery are limited to surgical procedures that are Medically Necessary, as determined by CareFirst BlueChoice, and operative procedures performed on structures of the body to improve or restore bodily function or to correct a deformity resulting from disease, trauma, or previous therapeutic intervention.
Reconstructive Surgery. Reconstructive Surgery is surgery: • Which restores features damaged as a result of injury or illness • To correct a congenital deformity or anomaly. Service Area The service area for this plan is Washington State, excluding Xxxxx County.
Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be Covered if performed for the correction of functional disorders. Reconstructive Surgery must be prescribed by a Member’s Practitioner/Provider and requires Prior Authorization. For information regarding Reconstructive Surgery following a Mastectomy and Prophylactic Mastectomy, refer to the Women’s Healthcare Section.
Reconstructive Surgery. The insurer will cover the actual incurred medical cost of the reconstructive surgery required to restore natural function or appearance following an accident or following a surgical procedure for an eligible medical condition, which occurred after an insured person’s entry date or start date whichever is later. The maximum benefits should be mutually agreed between the policyholder and the insurer and stipulated in the insurance contract.
Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be provided if performed for the correction of functional disorders.
Reconstructive Surgery. Reconstructive Surgery is surgery: Which restores features damaged as a result of injury or illness To correct a congenital deformity or anomaly.
Reconstructive Surgery. This is limited to reconstructive surgery, incidental to or following surgery, resulting from injury or illness of the involved part, or to correct a congenital disease or anomaly resulting in functional defect in a dependent child, as determined by the attending physician.
Reconstructive Surgery. We cover reconstructive surgery. This shall include plastic, cosmetic and related procedures required to:
Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be Covered if performed for the correction of functional disorders. Reconstructive Surgery must be prescribed by a Member’s Practitioner/Provider and requires Prior Authorization. For information regarding Reconstructive Surgery following a Mastectomy and Prophylactic Mastectomy, refer to the Women’s Healthcare Section. Reconstructive surgery related to Gender Confirmatory Therapy and Gender Affirming Care are Covered. The Prior Authorization criteria of this Plan is applicable Rehabilitation and Therapy This benefit has one or more exclusions as specified in the Exclusions Section.
Reconstructive Surgery. We cover reconstructive surgery (1) to correct significant disfigurement resulting from an injury or Medically Necessary surgery, (2) to correct a congenital defect, disease, or anomaly in order to produce significant improvement in physical function, and (3) to treat congenital hemangioma known as port wine stains on the face for Members age 18 or younger. Breast augmentation is covered only if determined to be Medically Necessary. Following mastectomy, we cover reconstructive breast surgery and all stages of reconstruction of the other breast to produce a symmetrical appearance, and treatment of physical complications, including lymphedemas, in a manner determined in consultation with the attending physician and the patient. Mastectomy is the surgical removal of all or part of a breast. Reconstructive breast surgery is surgery performed as a result of a mastectomy to reestablish symmetry between the two breasts. Reconstructive breast surgery includes augmentation mammoplasty, reduction mammoplasty and mastopexy. Reconstructive Surgery Exclusions: Cosmetic surgery, plastic surgery or other services, supplies, dermatological preparations and ointments, other than those listed above, that are intended primarily to improve your appearance, or are not likely to result in significant improvement in physical function. Examples of excluded cosmetic dermatology services are: Removal of moles or other benign skin growths for appearance only; Chemical peels; and Xxxxxxx earlobe repairs, except for the repair of an acute bleeding laceration.
