Your Insurance: Other Blue Cross Blue Shield Plans
The Blue Cross Blue Shield Association is a national association of 36 independent, community-based, and locally operated Blue Cross Blue Shield companies. Because of this, different companies have different policies for lipedema surgery coverage.
As of November 24, 2020, Health Care Service Corporation, the second-largest Blue Cross Blue Shield licensee operating in Illinois, Texas, Montana, New Mexico, and Oklahoma, announced a new lipedema coverage policy. While this policy has many requirements for coverage, we believe that our Coverage Process™ is well suited to
Premera Blue Cross Blue Shield has a lipedema policy, but they can be picky about documentation and fight attempts to have surgery out-of-state.
Excellus, Highmark, CareFirst, Blue Cross Blue Shield of North Carolina, Arkansas and Massachusetts, and Regence have covered members and have done single case agreements with out-of-network surgeons. Hence, members only pay in-network coinsurance, copays and deductibles. Coverlipedema.com can help determine if you are missing any documentation and provide you with the contacts and information to avoid appeals and get fairly covered promptly.
Blue Cross Blue Shield of Michigan is currently reviewing its lipedema policies. In some cases, members have been covered after an internal review, and in others, an external review is required. These plans have been reasonable about doing single case agreements for members with out-of-network providers, so members pay in-network copays and deductibles.
Other smaller Blue Cross Blue Shield plans are likely to embrace covering lipedema as more members apply for coverage. If you have one of these plans, coverlipedema.com gives you the tools to argue that these smaller plans should follow the lead and cover lipedema quickly and fairly.
Most Blue Cross plans will cover skin excisions along with liposuction in most cases unless your plan policy has limitations on reconstructive surgery.
If it is necessary to appeal for coverage or fair payment, our Appeal Process is a step by step process designed to create successful appeals. It has template documents for members that are easy to use and are continually updated with the latest coverage and payment arguments. We also provide essential strategies and a database to ensure fair external reviews. We have even had “final” reviews reopened for poor quality and reversed.
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