Top Answer
User Avatar
Wiki User
Answered 2015-07-16 18:06:33

They would start with the defintion

Medically Necessary Services or supplies provided by a licensed health facility or health professional, which are determined by the health plan company and its contracting or employed Physician Group to be: Not Experimental or Investigational. Appropriate and necessary for the symptoms, diagnosis, or treatment of a condition, illness or injury. Provided for the diagnosis or care and treatment of the condition, illness, or injury. Not primarily for the convenience of the Member the Member's Physician, or anyone. The most appropriate supply or level of service that can safely be provided. For example, outpatient rather than inpatient surgery may be authorized when the setting is safe and adequate.

for more info visit www.steveshorr.com

My Blue Cross plan required documentation of medical condition requiring breast reduction, i.e., neck pain,Back pain, etc. I had to prove that I had sought help from MD's for a period of time and that the reduction was recommended by them.


User Avatar

Your Answer

Still Have Questions?

Related Questions

Will medicare cover breast lift?

No. If a breast reduction is medically necessary it can be covered by Medicare.

Is there any kind of cosmetic surgery insurance at all?

There are cosmetic surgeries that insurance will cover as long as it is medically necessary. Examples would include breast reduction, eye lifts and nose jobs as long as a doctor can prove to the insurance company that the surgery is medically necessary.

Are chloroplast necessary for reduction of DCPIP?

Yes, chloroplasts are necessary for the reduction of DCPIP.

Do any insurance companies cover plastic surgery?

Cosmetic Surgery and InsuranceTypically, Cosmetic surgery and all other "elective" surgery is NOT covered under Medical Insurance policies unless the procedure is of a medical necessity. Corrective Cosmetic SurgeryIn general, for an insurance company to cover a plastic surgery, the surgery needs to be deemed medically necessary. Reconstructive surgery is considered medically necessary by many insurance companies if you are receiving reconstructive surgery after an accident or an additional medically necessary surgery (for example, breast reconstruction after a mastectomy). Nasal surgery performed with a diagnosis of deviated septum are considered medically necessary and normally some cosmetic repair is performed at the same time.Breast reduction can be medically necessary in certain circumstances.What is typically not medically necessary is breast implants (no previous mastectomy), face lifts, liposuction, abdominoplasty to remove excess skin around the abdomen, etc.Plan provisions vary widely. Even one insurance carrier can have 20 different plans available, each with variances regarding covered/non covered services. It is always best to contact your insurance company directly.

Will insurance cover it if I get her brest reducition?

Most of the times yes, insurance does cover breast reduction because breast reduction is considered medically necessary. Being the case that it is your daughter (who I can only assume is young) it will be an even bigger medical need because of the future medical problems that could result otherwise. Yes, you are covered (though, this is all depending on your insurance, of course).

What is an indicator used for oxidation-reduction?

they are used to, determine the pH of a solution. ~natalia !

How do you determine the size of a reduction gear box?

You can determine the circumference of a reduction gear box by multiplying its diameter by pi. This is because its outer portion is a circle.

Can you receive short term disability for plastic surgery?

Yes, as long as your doctor certifies it is medically necessary. Such as breast reduction for back pain, skin removal after massive weight loss, etc. Simply getting breast implants or a face lift for cosmetic reasons are not covered.

How do you determine the discount percentage?

It is = (reduction in price)/(original price) * 100.

Why are dental records and X-rays necessary before mentoplasty is done?

The dental history and x ray studies of the head and jaw are necessary in order to determine whether the facial disproportion can be corrected by an implant or simple reduction, or whether orthognathic surgery is required.

What reaction is reduction?

In chemistry, reduction is considered the gaining of electrons. Oxidation is the lose of electrons. They go together in reactions called redox (reduction/oxidation). You cannot have a reduction without also having an oxidation.

Does anthem blue cross blue shield pay for breast reduction?

Anthem Blue cross will pay for a breast reduction ONLY if it is medically nessacary and is not pre-exisiting. It is good to get a DR. to note that it is needed in order for your quality of life to be better.

Is a gastric reduction always necessary?

It depends on whether or not your obesity is genetic. Look at your family history to determine if obesity is becoming enough of a problem to require a gastric bypass. There are other options too, like the HCG diet.

How do you calculate reduction in yield?

The first step in calculating the reduction in yield is to determine the year ten surrender value. You will then need to determine a new surrender value. The final step is to subtract the new surrender value from the unreduced yield.

Should you insulate between first and second floor?

Though it is not necessary it does help with noise reduction.

How can one determine if a redox reaction will be nonspontaneous?

The reduction potential plus oxidation potential is negative.

When is a breast reduction medically necessary?

If your breasts are extremely large to the point you have grooves from your bra in your shoulders, you have back and/or neck pain, and you are generally uncomfortable or, you can't even get dressed and wear normal clothing your size, you should think about getting a breast reduction. It would help make things better overall. If you were, say, an E cup or larger, getting them reduced to a C would make it easier to find bras, clothes, and eliminate any pain.

Will tricare pay for breast reduction?

Tricare MAY cover a breast reduction if they deem it medically necessary due to medical conditions such as neck and back pain, rashes, shoulder grooves, numbness, etc. You must first get an approval for a referral to a plastic surgeon covered by tricare. Then, the plastic surgeon must submit photos and a recommendation report to Tricare. They will then review it and either approve or deny the procedure or request additional information before making a decision.

What changes are necessary to reduce stress?

Reduction of stress may require changes in both activities and attitudes.

How can one determine that a redox reaction will be non spontaneous?

The reduction potential plus oxidation potential is negative

What is business attrition?

Business attrition is the reduction of the work force through natural means. For example, if someone retires, the reduction of the work force would be considered a normal occurrence.

So-so security number reduction plan how often?

Which of the following need to be considered

Accounting treatment of trade discount and cash discount?

Trade Discount are considered cost of sales/reduction in sales dependant upon who the customer is. Cash Discount is always considered Increasing Interest Expense/Reduction of Interest Expense, dependant upon who the recipient is.

Are chloroplast necessary for reduction of DCPIP and why?

Chloroplasts release electrons when stimulated by light the DCPIP accepts the electrons and becomes colourless

Still have questions?

Trending Questions
Do potatoes have genders? Asked By Wiki User
Why is Vanna White so skinny? Asked By Wiki User
How many 20 go into 200? Asked By Wiki User
What times what equals 6? Asked By Wiki User
Unanswered Questions
Does arsenio hall have ms? Asked By Wiki User