Look into all of your surgery options before choosing a provider. Services or supplies primarily for weight reduction or treatment of obesity, unless they are determined to be medically necessary covered health services and authorized by a, surgical treatment of morbid obesity is necessary to treat another life-threatening condition involving morbid obesity, and, it has been documented that non-surgical treatments of the morbid obesity have failed, and. Learn more about HAP Empowered Duals (HMO SNP) for Genesee, Macomb, Oakland and Wayne county residents. The waiving of lab test cost-sharing applies to HAP’s Medicare, Medicaid and individual members, as well as fully insured employer group customers. The following are not considered to be cosmetic surgery: Surgery to treat a condition, including a birth defect, that impairs the function of a body organ; or. Since cataracts are common and cause serious vision loss, most health insurance policies (most vision insurance won’t actually help here) cover surgery to remove them and implant a monofocal lens. Find HAP (Health Alliance Plan) Eye Doctors & Providers with verified reviews. Haze - Severe hazing occurs in less than 1% of the patients causes everything to look blurred. Any services or supplies for learning disabilities, mental retardation, or hospitalization for environmental change except for Applied Behavioral Analysis (ABA) or speech/occupational/physical therapy rendered in association with autistic spectrum disorder. Intraocular lens (IOL) implants are artificial lenses that help clear up your vision after cataract surgery. However, it is important to weigh the expense of traveling to appointments with the amount you may save. Many LASIK providers offer payment options to help people afford the cost of surgery. Heating pads and thermometers, and other over-the-counter products. The fact that a covered person may suffer psychological consequences or socially avoidant behavior as a result of an injury, illness or congenital anomaly does not classify surgery or other procedures done to relieve such consequences or behavior as a reconstructive procedure. Lines and paragraphs break automatically. The HAP claims administrator will provide services and supplies in connection with such injury or disease but will be entitled to reimbursement for them in accordance with rules set out in The Pacific Gas and Electric Company Health Care Plan for Active Employees Plan Document. One such need is Laser-Assisted Stromal In-situ Keratomileusis (LASIK). Services or supplies furnished in connection with cosmetic surgery or surgery performed mainly to change appearance. Services or supplies that are not covered health services, which include all services that are not, For Anthem HAP members, charges in excess of the reasonable and customary charges (R&C), as determined by Anthem Blue Cross (see ", For KPIC HAP members, charges in excess of eligible charges, as determined by KPIC (see ". Always read the fine print before agreeing to financing to ensure that you aren’t paying extra for the procedure in exchange for receiving financing. Services or supplies received from a provider or supplier who is not licensed, registered or certified under state law to the extent required to provide such service or supply, or if the service or supply provided is not within the scope of the provider's license, certificate or registration. Devices and computers to assist in communication and speech. Laser assisted in-situ keratomileusis (LASIK), is a procedure that uses a highly specialised laser (excimer laser) to correct myopia, hyperopia and astigmatism. Air purifiers, air conditioners and humidifiers. Because it is an elective procedure, it’s generally not covered by original Medicare. They can recommend other financing options for the portion of costs VSP does not cover. Just like other 0% offers, you just need to make your minimum monthly payments and paying the full amount by the end of the promotional period. HAP also offers employer-sponsored Medicare plans. Self-insured employer group customers control their own health benefits and HAP is working with its self-insured customers to determine how they will cover COVID-19 testing. Speech therapy that is not determined to be a medically necessary covered health service, as determined solely by Anthem Blue Cross or KPIC. Treatment for conditions caused by war or aggression, declared or undeclared, or international armed conflict. Many even offer interest free financing to qualified patients. More than one pair of glasses or set of contact lenses after cataract surgery. LASIK surgery can help patients reduce or, in some cases, eliminate their … Does LASIK Have Any Negative Side Effects? Physical and/or occupational therapy that is not determined to be a medically necessary covered health service, as determined solely by Anthem Blue Cross or KPIC. Hospitalization that continues after coverage has ended and after you have recovered sufficiently to be discharged, unless you are certified as totally disabled as explained in ". Care credit is a health care credit card with a credit line for treatments and procedures. Benefits provided under the extension of a benefits provision of other insurance policies, benefit plans, or health plan contracts. In general LASIK is more affordable in larger cities than in smaller communities. Services and supplies in connection with mental, behavioral, psychoneurotic, and personality disorders, and for abuse of or addiction to alcohol and drugs, are not covered by Anthem as medical services but are covered elsewhere by the Plan under the Mental Health and Substance Abuse treatment provisions administered by ValueOptions. After the laser treatment is finished, the epithelial tissue is repositioned on the surface of the eye to cover the lasered stroma, and a bandage contact lens is placed on the eye to keep the epithelium in place as it heals. While your insurance may not cover the cost of the initial procedure, they may be willing to cover expenses associated with complications should they occur. Custodial care is defined as care provided primarily to assist an individual in meeting the activities of daily living including, but not limited to, walking, bathing, dressing, eating, preparation of special diets, changing catheters, and supervision over self-administration of medications not requiring constant attention of trained medical personnel. Services and supplies for which coverage is available under any other Company-sponsored health plan or benefit program. Supplies for comfort, hygiene or beautification. Does My Eyeglass Prescription Qualify For LASIK? If the answer is “yes”, then they will cover it if you spend 10 hours on the phone with them over five different phone calls. As of July 7, 2016, a new Medicare rule prohibits such add-ons of cosmetic upper eyelid procedures. Each pulse of the laser removes 39-millionths of an inch of tissue, enabling surgeons to achieve remarkable accuracy while maintaining excellent control throughout the LASIK procedure . Can I have laser eye surgery? Usually the world of insurance has very clear boundaries. Show your HAP member ID card and save 20% on massage therapy, reiki and acupuncture treatments at locations throughout metro Detroit. Prior to the application of laser, a thin cornea flap is created using a specialised blade (microkeratome) or by using another specialised laser (femtosecond laser). One of the main concerns people have when considering LASIK surgery is the cost of the procedure. Henry Ford Ophthalmology: Considering LASIK? Dental and orthodontia services, including braces, bridges, and guards, or X-ray exams involving one or more teeth, the tissue or structure around them, the alveolar process, or the gums. In most cases, LASIK is performed on both eyes and completed within minutes. LASIK is considered a cosmetic procedure and insurance any coverage will vary depending on whether monthly premiums are set aside to cover the procedure. Henry Ford Ophthalmology offers preferred rates on LASIK services. Working with laser surgery centers, VSP vets surgeons and ophthalmologists to ensure you get the best care so you can have great vision after LASIK. Some providers offer discounts to those working for certain employers or in certain industries. Massage therapy, if performed by a massage therapist, or any services performed by a massage therapist who is not also a. New technologies and techniques can shorter recovery time, led to better results and increase the overall cost of the procedure. LASIK benefit details Your LASIK discount Your benefit group has […] This applies even if a condition requiring any of these services involves a part of the body other than the mouth, such as the treatment of Temporomandibular Joint Disorders (TMJD) or malocclusion involving joints or muscles by methods including, but not limited to, crowning, wiring or repositioning teeth. These plans may be provided by your employer, giving you Medicare benefits in retirement. Your employer will be able to tell you of any LASIK providers offering a discount to company employees. Providers may also offer special seasonal deals or discounts; waiting until you can get the best price may help you to be able to afford the procedure. Even if you don’t have a flexible spending account, you may be able to set one up and start using the account to save for the procedure. What the HAP Doesn't Cover Unless exceptions to the following are specifically noted elsewhere in this Handbook, no benefits are provided for the following: For KPIC HAP members, any non-emergency service received from a non-network provider or facility, unless such services are Authorized Referrals, emergencies or out-of-area urgent care . Surgery to be medically necessary learn more about HAP Empowered Duals ( HMO ). 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