If you are new to Blue Shield of California Promise Health Plan and are using a brand of durable medical equipment that is not on our list, we will continue to cover this brand for you for up to 90 days. 9900 . Anthem Blue Cross and Blue Shield BadgerCare Plus and Medicaid SSI Programs Durable Medical Equipment (Rent to Purchase) Page 2 of 3 particular item may be considered for direct purchase on a case-by-case basis. 0000003248 00000 n Medically necessary and authorized durable medical equipment (DME) and supplies needed to operate DME, oxygen and its administration, ostomy supplies, and medical supplies to support and maintain gastrointestinal, bladder, or respiratory function are covered. %%EOF I have Blue Cross Anthem and they do cover hearing aids as medical equipment, amazingly. *Delta Dental of Minnesota is independent from Blue Cross and Blue Shield of Minnesota and Blue Plus. If you have a question regarding coverage please call (855) 272-6335 and one of our customer service representatives will be happy to assist you.. Insurances We Accept An Independent Licensee of the Blue Cross and Blue Shield Association Patient Lifts See Other Services for Durable Medical Equipment. As with medication, your doctor can tell you what equipment you’ll need and write you a prescription for it. The appliances themselves are categorized by Medicare as durable medical equipment (DME) and are not dental devices. Durable Medical Equipment Which Require Pre-Authorization . MEDICARE HAS FOUR PARTS COVERING DIFFERENT HEALTHCARE SERVICES Part AHospital insurance Covers inpatient care, home healthcare and hospice Free for people who are 65+ and eligible for Social Security Part BMedical insurance Covers outpatient care, doctor’s visits, durable medical equipment and more You pay a monthly premium for this plan. Maybe you need a wheelchair to get around, an oxygen tank to help you breathe or supplies to help you manage diabetes. 0000005036 00000 n Important Legal and Privacy Information | Important Information About Medicare Plans | Privacy Practices Blue Cross Community Centennial covers your physical health care needs. Examples of life -sustaining equipment include oxy gen equipment such as concentrators, Revised Date: December 03, 2020. Unless the insurance company decides these improvements are medically necessary in your circumstances, they will not be covered as DME or through another part of your health insurance. Devices and equipment used for environmental accommodation such as, but not limited to, chair lifts, stair lifts, home elevators, standing frames, and ramps are specifically excluded under most health benefit plans. This document is provided as a supplement to the Blue Cross and Blue Shield of Illinois (BCBSIL) Contract Agreement with all Durable Medical Equipment (DME) Providers to familiarize you with BCBSIL policies concerning DME, particularly life sustaining and non-life sustaining equipment as specified in your contract. ... First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. SERVICE SERVICE DESCRIPTION . However, there are unique circumstances when claims filing directions will differ based on the type of provider and service. OXYGEN You Must Provide the Lab Results of the Blood Gas Study (PO Does CareFirst cover services by Certified Nurse Midwives and Direct Entry Midwives? DME Suppliers must meet eligibility and/or credentialing requirements as defined by the Plan in order to be eligible for reimbursement. colostomy bags, belts and irrigators; and. NU - New equipment . Just use the number on the back of your Blue Cross ID card. The durable medical equipment not covered by your insurer under your benefit plan include: Cleaning supplies such as Mask wipes and cleaning machines, like the SoClean 2 or Lumin CPAP Cleaner. Reimbursement Policy: Consumable Medical Supplies Effective Date: May 1, 2016 Last Revised Date: July 27, 2020 Purpose: Provide clarification of the standard Horizon benefit contract exclusions relative to consumable medical supplies using specific codes and examples. Durable medical equipment is also not meant for personal care and conveniece, so unfortunately home improvements like ramps and grab bars are excluded as well. should file claims for your Blue Cross and Blue Shield patients to the local Blue Plan. Information for new Blue Shield of California Promise Health Plan members. I see where they are covered and that a portion, the pump, falls under Durable Medical Equipment for initial set up and that the supplies such as tubing, reservoirs, etc. Anthem Blue Cross and Blue Shield recently updated its . Blue Cross & Blue Shield of Rhode Island Subscriber Agreement, HMC2C 2013 Centers for Medicare and Medicaid Claims Processing Manual. Effective Date: January 01, 2020. Anthem Blue Cross and Blue Shield Professional Reimbursement Policy IN, KY, MO, OH, WI 0022 Durable Medical Equipment Page 1 of 8 Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. DME is typically used to help you do things that you might be unable to do because of medical circumstances. Does the Patient’s condition require frequent changes in body ... An Independent Licensee of the Blue Cross and Blue Shield Association. “Deluxe” electrical or mechanical features, which enhance basic equipment usually serve a convenience x�b```f``z���������xX����� #Î�C���3V,H�:�S�4�]���2ߒ�OVn��r/���u�C�t���O���J�,�i6� �a������x�܊0͚�*BvPD���$H�C�@������[Jq���Zv����]�����nֆ2v���Zցlb[ �g`��d90 ��> endobj 34 0 obj <> endobj 35 0 obj <>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageB]/ExtGState<>>> endobj 36 0 obj <> endobj 37 0 obj <> endobj 38 0 obj <> endobj 39 0 obj [/ICCBased 48 0 R] endobj 40 0 obj <> endobj 41 0 obj <> endobj 42 0 obj <> endobj 43 0 obj <> endobj 44 0 obj <>stream Anthem Blue Cross and Blue Shield Durable Medical Equipment Policy and Ancillary Fee Schedule Updated . Once the limit Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Sections 40 - Payment for Maintenance and Service for Non-ESRD Equipment and 50 - Payment for Replacement of Equipment. ... a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. With NJ DIRECT, you have access to one of the largest doctor and hospital networks in New Jersey and 1.3 million providers nationwide through the BlueCard® PPO Network. 0000001167 00000 n That's durable medical equipment, or DME. The Following is a list of Health Insurance Companies that CSA Medical Supply accepts for both Durable Medical and Home Medical Equipment. 0000000956 00000 n It's really great that they do since they are so expensive. • Mainly used for a medical purpose rather than for comfort or convenience. 0000001794 00000 n ®† Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. The Dental Network and First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. However, each plan covers durable medical equipment a little differently. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. In addition to this policy, claims payments are subject to other plan requirements, including, but not limited to, requirements of medical necessity and reasonableness. I have been trying very hard to get an answer to a question that is very specific to insulin pumps. 32 0 obj <> endobj Anthem Blue Cross and Blue Shield Durable Medical Equipment Rental List Page 2 of 15 Procedure Procedure description E0840 TRACT FRAME ATTACH HEADBOARD E2394 DRIVE WHEEL EXCLUDES TIRE E2396 CASTER FORK E0974 W/CH ACCESS ANTI -ROLLBACK E2387 FOAM FILLED CASTER TIRE E1820 SOFT INTERFACE MATERIAL Therefore, you are about to leave the Blue Cross & Blue Shield of Mississippi website and enter another website not operated by Blue Cross & Blue Shield of Mississip pi. I started a business and got a Blue Shield personal gold plan and Durable Medical Equipment was covered at 90%. In 2010, a nasal expiratory resistance valve (PROVENT®, Ventus Medical) ... Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. Register Now. ). startxref Exchange coverage options: Individual & Family Qualified Health Plans First, you’ll need a prescription. should file claims for your Blue Cross and Blue Shield patients to the local Blue Plan. 0000002465 00000 n Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. Last Reviewed: November 19, 2020. Important Information About Medicare Plans. This site works better on newer browsers. Your medical insurance company or Medicare MAY cover all or part of your inversion equipment. This repersents a problem for the insured because the Durable Medical Equipment suppliers generally do not carry inversion tables. ©1996-document.write(new Date().getFullYear()); Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. 9900 . Maybe you need a wheelchair to get around, an oxygen tank to help you breathe or supplies to help you manage diabetes. Get access to your member portal. Though prescribed devices are typically covered by health insurance, over -the-counter dental devices may not be; Aetna , for example, won't cover … Some Blue Cross Blue Shield insurance plans not only cover a double electric breast pump, but they may also cover replacement parts for your breast pump as well. ... Medicare Parts A and B cover many of your healthcare services, but not all. This guide does not apply to life-sustaining equipment. subject: durable medical equipment (dme) this medical coverage guideline is not an authorization, certification, explanation of benefits, or a guarantee of payment, nor does it substitute for or constitute medical advice. <<8FD9AE4AB179EB4C8FFC165418D30721>]>> 0000001341 00000 n Anthem Blue Cross and Blue Shield Durable Medical Equipment Policy and Ancillary Fee Schedule Updated . DME is defined as equipment accepted by Blue Cross as required to diagnose or treat an illness or injury or to prevent a condition from becoming worse. The best way to get information about your plan is to log in to your account. Durable Medical Equipment (rent to purchase) policy and the associated fee schedule found at the links below. Anthem Blue Cross and Blue Shield recently updated its . The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Durable Medical Equipment (DME) DURABLE-1 Durable Medical Equipment (DME) Benefit Coverage . 0000002430 00000 n If you’re recovering from an operation or an illness, you may need extra help. Coverage is limited to physical, occupational and speech therapies. Durable Medical Equipment(DME) and disposable supplies: Yes: Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company* Southwest Texas HMO, Inc.* d/b/a HMO BlueÒ Texas * Independent Licensees of the Blue Cross and Blue Shield Association _____ Posted Jan. 7, 2003 Durable Medical Equipment (rent to purchase) policy and the associated fee schedule found at the links below. This guide does not apply to ... DME items with specific Blue Cross and Blue Shield of Alabama medical or DME policies are listed below. Durable Medical Equipment (DME) Actigraphy; Adjustable Cranial Orthoses for Positional Plagiocephaly and Craniosynostoses; Cardioverter Defibrillators: ... ©2021, Blue Cross Blue Shield of Alabama is an independent licensee of the Blue Cross Blue Shield Association. Does Blue Cross Blue Shield Cover Breast Pumps? 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As Medical equipment was covered at 90 % pay for your durable equipment... Is necessary to make the equipment usable and Direct Entry Midwives with.... A list of Health insurance Companies that CSA Medical Supply accepts for durable! A Mutual Legal Reserve company, an oxygen tank to help you manage diabetes a baby and need supplies! It in the other covered services category need and write you a prescription for it Supplier.... Of Minnesota is independent from Blue Cross and Blue Plus metabolic diseases:! Members under age 65 my coverage, select Medical and Home Medical equipment: Medical supplies that cost $ or!
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