Search

Food products modified to be low protein that are medically necessary to treat inherited diseases of amino acids and organic acids. The member may buy these food products directly from a distributor.

Brand-Name Drugs Purchased When Generic Equivalent Available - When the member buys a covered drug, the pharmacist will provide a generic equivalent of the prescribed drug whenever it is allowed. If the member chooses to buy the brand-name drug instead of the generic drug equivalent, the member pays the brand-name copayment plus the difference between the cost of the brand-name drug and the generic drug equivalent.

Gender reassignment surgery, including hormone therapy, breast augmentation surgery (mammoplasty), mastectomy, and reduction of thyroid cartilage for treatment of gender identity disorders.

Gender reassignment surgery, including hormone therapy, breast augmentation surgery (mammoplasty), mastectomy, and reduction of thyroid cartilage for treatment of gender identity disorders.

Some examples of covered durable medical equipment include (but are not limited to): knee and back braces; hospital beds; wheelchairs; crutches; walkers; orthopedic and corrective shoes; arch supports, shoe (foot) inserts and foot orthotics; and glucometers that are medically necessary due to the patient's type of diabetic condition.

This health plan covers a routine vision exam furnished by a Physician (who is an ophthalmologist) or an Optometrist and frames and/or prescription lenses up to the dollar amount described in the benefit limit.

Inpatient admissions in a covered hospital. This includes mental health care services that require a hospital stay. (Private room charges are not covered unless the room is medically necessary for the member's condition.)

Outpatient services furnished by a covered hospital or other mental health provider.

Treatment to repair and/or replace sound, natural teeth damaged due to accidental injury. These benefits include accident care, treatment to repair or replace damaged teeth, dental prosthetics (such as implants, dentures, and bridges), necessary x-rays, and follow-up medical care. No benefits are provided for orthodontic services and dental care following an injury caused by biting or chewing.

Weight Loss Program Benefit - All members may take part of the weight loss program benefit. This health plan will reimburse up to $100 for each member but no more than a total of $300 for a family in each calendar year for fees paid for hospital-based weight loss programs or for non-hospital-based weight loss programs that are designated by Blue Cross Blue Shield. The member can claim this maximum benefit for any combination of fees incurred by the subscriber and/or other members enrolled under the same family membership.