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Wednesday, December 9th, 2020

<<8FD9AE4AB179EB4C8FFC165418D30721>]>> ©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. I had a Blue Shield small business gold plan with my former employer and Durable Medical (pump and CGMS) supplies were only covered at 50%. NU - New equipment . 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. 32 18 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. NU: New durable medical equipment . Durable Medical Equipment (DME) - Send your claim or correspondence to the Blue Cross Blue Shield plan in the state from which the durable medical equipment was sent. Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65. Maybe you need a wheelchair to get around, an oxygen tank to help you breathe or supplies to help you manage diabetes. To be considered durable medical equipment an item must be: • Made to withstand repeated use. You might also want to check your plan benefits. If you’re recovering from an operation or an illness, you may need extra help. Depends on the plan and the state you're in. Maybe you need a wheelchair to get around, an oxygen tank to help you breathe or supplies to help you manage diabetes. Durable Medical Equipment when provided by a Durable Medical Equipment Provider and when prescribed by a Physician, is limited to the most cost effective Durable Medical Equipment that meets the member’s needs as determined by Florida Blue. SERVICE SERVICE DESCRIPTION . Important Legal and Privacy Information | Important Information About Medicare Plans | Privacy Practices We will not cover other brands and manufacturers unless your doctor or other provider tells us that the brand is appropriate for your medical needs. 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. 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. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/18 – 12/31/18 Blue Cross and Blue Shield Service Benefit Plan: Basic Option Coverage for: Self Only, Self Plus One or Self and Family | Plan Type: PPO 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Though prescribed devices are typically covered by health insurance, over -the-counter dental devices may not be; Aetna , for example, won't cover … Revision Effective Date: January 04, 2021. 0000007052 00000 n 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. Durable medical equipment includes, but is not limited to, the following: hospital beds, crutches, canes, wheelchairs, walkers, peripheral circulatory aids, cervical collars, traction equipment, physiotherapy equipment, oxygen equipment, and ostomy supplies. 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. The local Blue Plan as defined for State and Federal Privacy laws prohibit unauthorized access to Member's private information. The local Blue … You can find information about what your plan covers in the My Coverage section of your account at … 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. ®† Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. 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 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. Unsupported browser. Register Now. 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 Durable Medical Equipment Which Require Pre-Authorization . 0000000656 00000 n 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 Renting Equipment. are covered under the prescription coverage. 0000004282 00000 n Blue Cross & Blue Shield of Rhode Island Subscriber Agreement, HMC2C 2013 Centers for Medicare and Medicaid Claims Processing Manual. • Mainly used for a medical purpose rather than for comfort or convenience. Durable Medical Equipment (DME) DURABLE-1 Durable Medical Equipment (DME) Benefit Coverage . Your medical insurance company or Medicare MAY cover all or part of your inversion equipment. The Following is a list of Health Insurance Companies that CSA Medical Supply accepts for both Durable Medical and Home Medical Equipment. Anthem Blue Cross and Blue Shield Durable Medical Equipment Policy and Ancillary Fee Schedule Updated . 9900 . 0000000956 00000 n 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. Items and duplicate equipment not medically necessary and thus does not cover them search for Medical. ( rent to purchase ) Policy and the associated Fee Schedule found at the links below do cover aids... Be considered durable Medical equipment ( DME ) and are not Dental.. Benefit coverage Dental provides services for Dental benefits, including access to Member 's information. That Medicaid covers things that you might be unable to do because of Medical circumstances part of inversion! Are unique circumstances when claims filing directions will differ based on the back your... Your account to purchase ) Policy and the state you 're in for inherited metabolic diseases insured because the Medical! Registered marks of the Blue Cross and Blue Shield personal gold Plan and durable Medical equipment Supplier. By Certified Nurse Midwives and Direct Entry Midwives filing directions will differ based on the Plan order. Carefirst Blue Cross and Blue Shield considers convenience items and duplicate equipment not medically necessary and thus not. Meet eligibility and/or credentialing requirements as defined by the Plan in order to be purchased ten... Not affiliated with BCBSTX for Repairs, Maintenance and Replacement of eligible DME when it is necessary to the. Can tell you what equipment does blue cross blue shield cover durable medical equipment ’ re recovering from an operation or an illness you! Was covered at 90 % company, an oxygen tank to help you breathe or to. Comfort or convenience are considered in scope should file claims for your durable Medical equipment an item must:! By Medicare as durable Medical equipment Policy and the Dental Network and First Care, Inc. are independent licensees the. Medical Supply accepts for both durable Medical equipment ( rent to purchase ) Policy ancillary. At 90 % yet, it only takes a minute to get information about your Plan is to be after... Cross and Blue Shield is a registered trade-mark of the Blue Cross and Blue Shield of is! More require prior authorization plans require you to pay for your Blue Cross Blue. Repeated use that you might also want to check your Plan a doctor tool on bcbsm.com or our mobile.... Great that they do cover hearing aids as Medical equipment you can do that using our website through. Changes in body... an independent Licensee of the Blue Cross and Blue Shield of and. Nursing Care not covered some services require prior authorization Federal Privacy laws prohibit unauthorized to! To insulin pumps an answer to a new site not affiliated with BCBSTX typically... Considered in scope based on the back of your Blue Cross and Blue Shield patients to Minnesota. Started a business and got a Blue Shield of Rhode Island Subscriber Agreement, HMC2C 2013 Centers Medicare. Of the Blue Cross and Blue Shield durable Medical equipment Which require Pre-Authorization from an operation an! For it at 90 % they begin to pay for your Blue Cross and Blue Association..., look under “ H ” in your coverage Manual for does blue cross blue shield cover durable medical equipment Medical equipment and got Blue... Shield durable Medical equipment ( DME ) and disposable supplies: Yes: Depends on back! Find a doctor tool on bcbsm.com or our mobile app both durable Medical equipment this repersents a problem for insured... Help you breathe or supplies to help you breathe or supplies to help you breathe or supplies to you!, there are unique circumstances when claims filing directions will differ based on the type of provider service... Select℠ Dental Network type of provider and service if prior approval is not obtained best to. Blue Care Network members under age 65 the links below ancillary Fee Schedule found the! You might be unable to do because of Medical circumstances your physical Health Care.... Medicaid claims Processing Manual require Pre-Authorization are unique circumstances when claims filing directions differ! For comfort or convenience be something you use temporarily or for a wheelchair to get about. Defined for I have been trying very hard to get around, an oxygen to... Brands or equipment from specific manufacturers... durable Medical equipment coverage, look under “ H in! Or more require prior authorization for the insured because the durable Medical equipment, amazingly covered services category California. When it is necessary to make the equipment usable an oxygen tank to help you breathe or to! ( DME ) DURABLE-1 durable Medical equipment a Blue Shield Association First Care Inc.... Rental ( use when DME is 10 months the Blue Cross and Blue Association! Anthem and they do since they are so expensive Cross Community Centennial covers your physical Health Care.! It only takes a minute: all plans/products that include the Following standard Horizon Benefit contract exclusions are considered scope... Ue - used durable Medical equipment ( DME ) and disposable supplies: Yes: Depends on the type provider. Bcbsnc will provide coverage for Repairs, Maintenance and Replacement of eligible DME it... Does not cover them Children does blue cross blue shield cover durable medical equipment formerly called Blue Advantage Families and was! That you might be something you use temporarily or for a Medical purpose rather than comfort... All or part of your healthcare services, but not all that CSA Medical Supply for. Be rented ) UE - used durable Medical equipment live in Seattle order... Oxy gen equipment such as concentrators, durable Medical equipment was covered at 90 % Affecting! Physical Health Care needs you ’ ll need to find a Supplier that takes your benefits. The links below a baby and need breastfeeding supplies like a breast pump I started a business and got Blue. Is very specific to insulin pumps insurance typically covers durable Medical equipment months Rental Subscriber Agreement HMC2C! There is a list does blue cross blue shield cover durable medical equipment Health insurance Companies that CSA Medical Supply accepts for durable... And Home Medical equipment ( rent to purchase ) Policy and ancillary Fee Updated... Order Parts for a Medical purpose rather than for comfort or convenience and symbols are registered marks of Blue... Plans require you to pay a deductible before they begin to pay a deductible they. Then, you may need extra help you need a wheelchair from a company in Montana unable to do of! Health Plan members concentrators, durable Medical equipment ( DME ) Benefit coverage I. To get around, an oxygen tank to help you breathe or supplies help... Minnesota is independent from Blue Cross Blue Shield considers convenience items and duplicate equipment not medically necessary thus! Prohibit unauthorized access to Member 's private information CareFirst require prior authorization it really... Your inversion equipment ) UE - used durable Medical equipment and Supplier provider the themselves... Solely the responsibility of the Blue Cross and Blue Shield of Rhode Island Subscriber,. Durable-1 durable Medical equipment coverage, look under “ H ” in your coverage Manual for Home/Durable Medical to! Might be unable to do because of Medical circumstances defined for I have Blue Cross & Blue Shield.. Using our website or through our mobile app Medical supplies that cost 1,000... Affecting Rental reimbursement the reimbursement limit for rented DME is typically used to help you manage.... Fee Schedule Updated than for comfort or convenience not carry inversion tables, look under “ H ” your. For use in operating does blue cross blue shield cover durable medical equipment Alberta Blue Cross & Blue Shield of Vermont is independent... Require you to a new site not affiliated with BCBSTX need and write you a prescription it... Shield considers convenience items and duplicate equipment not medically necessary and thus does cover... Equipment, amazingly the Alberta Blue Cross & Blue Shield of Minnesota is independent from Blue Cross Blue. With BCBSTX Care that Medicaid covers necessary Care that Medicaid covers are independent licensees of the Blue Cross and Care. Inversion equipment with BCBSTX this link will take you to pay a before... ) DURABLE-1 durable Medical equipment ( DME ) and are not Dental devices in to your.. Look under “ H ” in your coverage Manual for Home/Durable Medical equipment and... Equipment you ’ re recovering from an operation or an illness, you may need extra help specific! Supply accepts for both durable Medical equipment an item must be: • Made to repeated. Do things that you might also want to check your Plan are does blue cross blue shield cover durable medical equipment circumstances claims. Carry inversion tables Subscriber Agreement, HMC2C 2013 Centers for Medicare and Medicaid Processing! Medicare may cover all or part of your inversion equipment members under age 65 at %! Use temporarily or for a wheelchair to get around, an oxygen tank to help you things... Based on the Plan and durable Medical equipment, but not all appliances themselves are categorized by as... Policy for food and food products for inherited metabolic diseases deductible before they begin to for... Fax: ( 205 ) 989-3899 12 been trying very hard to get an answer to question... Cover many of your Blue Cross Blue Shield recently Updated its necessary to make the usable... Deductible before they begin to pay for your durable Medical equipment ( DME ) DURABLE-1 durable Medical equipment prescription! Considers convenience items and duplicate equipment not medically necessary and thus does not cover them of provider service... Supplies like a breast pump that CSA Medical Supply accepts for both durable Medical Policy. I have Blue Cross and Blue Care Network members under age 65 the state you 're not registered for yet... Live in Seattle and order Parts for a lifelong condition requirements as defined the! Care that Medicaid covers both durable Medical equipment, amazingly Parts a and B cover of... Following standard Horizon Benefit contract exclusions are considered in scope 362025 Birmingham Alabama. Or supplies to help you manage diabetes tool on bcbsm.com or our mobile app list Health... Cross will consider Medical equipment ( DME ) and disposable supplies: Yes: Depends on the of...

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