Sunday, March 3, 2024

Does Blue Cross Blue Shield Cover Radiation Treatment

Does Medicare Cover Cancer Treatments

Memorial Hermann, Blue Cross Blue Shield in standoff that could affect your insurance coverage

Medicare does cover cancer treatments. Your cancer coverage will work differently depending on if youre in the hospital or an outpatient facility. Also, depending on your policy, you may need prior authorization for treatment.

In most cases, preventive services are available for people at risk for cancer.

Part A Cancer Coverage

Part A hospitalization coverage covers cancer Testing and treatment administered during a hospital stay. Before Part A begins to pay, however, you must meet a deductible.

If you have multiple hospital stays, you may end up paying the deductible more than once. Part A also pays the full cost of the first 20 days in a skilled nursing facility after cancer surgery, and it covers hospice care at a certified hospice facility.

A Medigap plan can reduce your costs by paying your Part A deductible. It also provides expanded benefits for hospital stays and hospice care.

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Part B Cancer Coverage

Part B covers cancer screenings and treatments at a doctors office or clinic. These preventive care benefits pay the full cost of some cancer screenings. Also, Part B pays 80% of the price of chemotherapy, radiation, and tests done on an outpatient basis or at a doctors office.

What Is Couples Counseling

Couples counseling is a type of psychotherapy that can aid in the improvement of your relationship with your partner. Suppose youre experiencing marital or relationship issues or want to enhance your bond. In that case, couples counseling may be able to help rebuild your connection and strengthen the relationship.1

There are many different types of couples counseling, including marriage therapy and the following therapy treatment and techniques:2

  • Reflective Listening
  • Imago relationship therapy

Does Couples Counseling Work

While couples counseling may not be helpful for every couple in every situation, it is highly effective for many of them. According to the American Association for Marriage and Family Therapy, 97.1% of clients questioned thought they received the assistance they required. In addition, upwards of 80% of respondents rated couples counseling as having a positive influence.5

According to the American Psychological Association, couples counseling as it is currently practicedusing Emotionally-Focused Therapy is now around 75% effective.6

On the other hand, success can only be achieved if both parties put in the work. Your relationship will have a much better foundation to grow on if you work through the challenges together with a counselors help.

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How To Find In

With Athena Care, gaining access to a counseling clinic in Tennessee has never been easier.

Open Monday through Friday, 7:00 a.m. to 6:00 p.m., Athena Care has multiple locations throughout Tennessee, and a care coordinator is just a call away. Our caring team can assist you with any questions or concerns, including Blue Cross couples counseling information.

When searching for psychologists or clinicians for couples counseling, its important to keep the following in mind:

  • Education, training, license, and years of experience
  • Specialties and services offered
  • Insurance companies they work with
  • Ask lots of questions

Here, youll find a list of practitioners organized by city and information about their backgrounds and specialties.

How Much Does Tms Cost Without Insurance

The following are average costs for TMS therapy without insurance, though these costs may vary by location and other factors. Furthermore, they may not reflect the actual cost of treatment or what you may pay in Tennessee.

TMS therapy sessions typically cost between $400 and $500 per session.2 Because most people require multiple TMS therapy sessions to achieve optimal outcomes, the total cost of TMS therapy could be about $15,000.

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Bailey V Blue Cross/blue Shield

No. 2:94cv897.

Timothy G. Clancy, Cummings, Hatchett, Moschel Patric, Hampton, VA, Robert E. Hoskins, Foster Foster, Greenville, SC, for plaintiff.

Richard J. Cromwell, Thomas E. Spahn, Robert W. McFarland, McGuire, Woods, Battle Boothe, Norfolk, VA, Jeanette D. Rogers, Blue Cross/Blue Shield of Va., Legal Dept., Richmond, VA, for defendant.

> > > 1 Bedtime Hack To Pee Like A Bull

An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.

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Does Blue Cross Blue Shield Cover Intensive Outpatient Rehab

Blue Cross Blue Shield health does usually cover outpatient programs for substance abuse treatment. Outpatient treatment can prove highly effective for the treatment of substance use disorders and other co-occurring mental illnesses. However, outpatient treatment programs are also often best fit for those who are not suffering any medical issues due to their drug use or withdrawal, who feel comfortable in their living environment, and who may have responsibilities to tend to while receiving addiction treatment.

People may being their substance abuse treatment journey in an outpatient program. However, many people also transition to outpatient treatment from a more intensive level of care, such as residential inpatient treatment or a drug detoxification center.

Does Anthem Blue Cross And Blue Shield Cover Online Therapy

Blue Cross RI wont cover new Alzheimers drug Aduhelm

Yes, Anthem Blue Cross and Blue Shield offers coverage for online therapy. This opens the doors for many clients who arent able to physically attend therapy sessions each week. Anthem Blue Cross and Blue Shield even created their own online teletherapy resource center, LiveHealth Online, back in 2016, which is available in certain geographies.

Your coverage for therapy costs will remain the same, whether you visit your therapy in-person or online.

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Does Medicare Cover Radiation Treatments

Part B. covers radiation administered at a doctors office or clinic. This is because Part B covers outpatient services.

If you receive radiation treatment during a hospital stay, its covered under Part A. Inpatient services have coverage through Part A.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

How To Verify Tms Therapy Blue Cross Blue Shield Coverage

Athena Care, a TMS clinic in Tennessee, is in-network with most major insurance plans. Filling out our free and confidential online insurance verification form is the best method to determine if your Blue Cross Blue Shield insurance covers TMS.

Let our highly experienced, expert care coordinators handle the challenges of contacting your insurance carrier for more information about Blue Cross Blue Shield transcranial magnetic stimulation coverage. A care coordinator will review your policy and clearly explain your options after youve completed the form. Rest assured, all submitted or discussed information is kept confidential.

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What Are Some Perks Available To Members

Members receive a variety of perks and discounts with their Blue Cross Blue Shield insurance many of these benefits could prove useful in leading a healthy life free of drug and alcohol abuse. The list of perks may include:

  • Savings on pet-related items, like toys and food
  • Discounts on healthy food options
  • Reduced rates for gym memberships and well-being apps
  • Deals on in-home fitness equipment
  • Free memberships to travel clubs
  • Lower prices on eyewear and vision services

Eating nutritious meals and exercising is good for everyone, not just those in recovery. But someone working to curb cravings for a substance or manage the unpleasant symptoms of a mental health condition might have even more to gain from pursuing a healthy lifestyle.

Does Blue Cross Blue Shield Insurance Cover Rehab

Blue Cross Blue Shield health insurance does cover rehab for drug and alcohol addiction. BCBS is a large and well known insurance provider that is accepted at many addiction treatment facilities, including American Addiction Centers. Coverage varies from state to state and plan to plan, and it is best to contact BCBS directly with any questions about your coverage.

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What Is Blue Cross Blue Shield

The Blue Cross and Blue Shield Association owns 36 health insurance companies, independent and locally operated, nationwide which comprise the Blue System.1

Commonly referred to as The Blues or BCBS, Blue Cross and Blue Shield have over half of all federal employees enrolled in their network, as part of the Federal Employee Program.

Blue Cross Blue Shields individual and family plans fall into 3 or 4 categories, depending on your state: bronze plans, silver plans, gold plans, and platinum plans. Bronze plans will have the lowest costs, while platinum plans will have the highest monthly costs. Some states will not offer the platinum category. Blue Cross and Blue Shield recommends the bronze-level plan for those who do not go to the doctor often, as it will have a low monthly payment and a high deductible.

Does Medicare Cover Chemotherapy

Yes, Medicare covers chemotherapy cancer treatment for patients in a hospital setting, outpatient setting, or doctors office. If its administered during a hospital stay, you may have to pay the Part A deductible. If done at a doctors office or clinic, youll be responsible for 20% of the cost under Part B.

Find Medicare Plans in 3 Easy Steps

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You can avoid having to pay either of these by signing up for a Medigap plan. The Medicare-approved amount for chemotherapy is dependent on what type of treatment youre undergoing. Your physician will be able to look up the amount.

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What Types Of Therapy Does Anthem Blue Cross And Blue Shield Not Cover

Anthem Blue Cross and Blue Shield does not cover life coaching, career counseling, or holistic treatment modalities like aromatherapy, massage therapy, or non-medically required acupuncture. It also does not cover energy work such as reiki healing.

Anthem Blue Cross and Blue Shield requires therapists to be professionally credentialed and offering evidence-based treatment appropriate for the diagnosis.

Blue Cross Blue Shield Drug Rehab Coverage Levels And Plans

UMMC could be removed from Blue Cross/Blue Shield Insurance Network

While BCBS drug and alcohol rehabilitation plans can vary based on which state you are in, most plans are broken into 3 metal tiers: bronze, silver and gold. The general breakdown for each plan is as follows:7

  • Bronze plans have lower premiums, but higher out-of-pocket costs. BCBS pays about 60% of the costs of your medical care once your deductible is met.
  • Silver plans have higher premiums, but out-of-pocket costs are less than with a bronze plan. BCBS pays about 70% of your medical care after your deductible is met.
  • Gold plans have the highest premiums and lowest out-of-pocket costs. BCBS pays about 80% of your medical care once your deductible is met.

Deductibles may vary for each plan. Make sure to contact the BCBS representatives for your state as their plan offerings may be different from those above.

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Do I Need To See My Primary Doctor Before Starting Therapy

If your Anthem Blue Cross and Blue Shield health insurance plan is an HMO plan, you will need to get a referral from your primary care physician before you start seeing a therapist. This means that youll likely need to first schedule a visit with your primary care physician to get this referral.

However, some people have Anthem Blue Cross and Blue Shield PPO plans instead. If you have a PPO plan, you do not need a referral from your primary care physician before seeing a therapist. This means you can begin your search and mental health journey when youre ready!

Find vetted therapists who are in-network with Anthem Blue Cross and Blue Shield

Blue Cross Blue Shield Tiers

In summary, the tiered plans of Blue Cross Blue Shield are as follows:2

  • Bronze: This level covers around 60% of medical costs, with a low monthly payment and a high deductible.
  • Silver: This level covers around 70% of medical costs, with a slightly higher monthly payment and lower deductible.
  • Gold: This level covers around 80% of medical costs, with a higher monthly payment and low deductible.
  • Platinum: This level covers around 90 of medical costs, with the highest monthly payment and the lowest deductible.

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Does Medicare Cover Breast Cancer

Medicare pays 100% of the cost of an annual breast cancer screening. Part A pays for inpatient breast cancer surgery or breast implant surgery after a mastectomy. Breast surgeries done at a doctors office or outpatient center are covered by Part B.

Part B also covers breast prostheses after a mastectomy.

How Can I Pay The Costs Not Covered By My Insurance Plan

You dont have to break the bank to get started on the path toward recovery. Using Blue Cross Blue Shield insurance for addiction treatment may cover some or all of your treatment costs. Additional private costs may incur so it is important to speak to your insurance provider and the rehab facility to gain a full understanding of all costs included. Treatment providers can talk to you about treatment options available.

For help verifying your insurance plan and finding treatment solutions, contact a treatment provider today.

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Reviewed by Certified Addiction Professional: January 14, 2019

David Hampton

  • David embarked on his journey into sobriety in June of 2005, which led him to his current career path as a Certified Professional Addiction Recovery Coach in private practice in Greater Nashville. David is also a public speaker and the author of two books. David is cohost of the weekly Positive Sobriety Podcast, as well as being a frequent contributor to various articles and recovery based materials. As a member of the National Association of Alcohol and Drug Abuse Counselors , David works closely with area treatment centers, recovery orientated nonprofit organizations, as well as being a keynote speaker for various recovery-focused events.

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What Types Of Mental Health Conditions Does Anthem Blue Cross And Blue Shield Cover

Anthem Blue Cross and Blue Shield covers many mental health conditions. To reimburse therapists or clients, Anthem Blue Cross and Blue Shield requires that the client receive a diagnosis from their therapist. This diagnosis guides treatment and insurance coverage.

Examples of eligible mental health conditions include:

Blue Cross Blue Shield Denial Of Proton Beam Radiation Therapy Class Action

Insurance companies have the power to decide what kinds of tests and treatments patients receive. The complaint for this class action claims that Proton Beam Radiation Therapy was delayed or denied for cancer patients by Blue Cross Blue Shield of Florida, Inc. .

Plaintiffs David Simpkins and George Cawthorn both are insured through BCBS. For Simpkins, the insurance came through an employer-provided plan which is governed by the Employee Retirement Income Security Act , which the complaint says makes BCBS a fiduciary of the plan. Cawthorn had his coverage as a Medicare Advantage plan, governed by the Centers for Medicare and Medicaid Services national coverage determinations. The complaint says that the contracts require that BCBS cover all treatments that are medically necessary.

PBRT provides radiation to a tumor while reducing the amount provided to healthy tissues. This results in fewer side effects and complications than the earlier Intensity Modulated Radiotherapy treatments, the complaint says: With PBRT, protons deposit their energy over a very small area called the Bragg peak. The Bragg peak can be used to target high doses of proton beams to a tumor, while doing less damage to normal tissues in front of and behind the tumor. Proton beams enable patients to tolerate higher total doses of radiation therapy

BCBS initially denied both plaintiffs coverage for PBRT.

Two classes have been defined for this action.

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How To Verify Blue Cross Blue Shield Couples Therapy Coverage

Athena Care is in-network with most major insurance plans. Filling out our free and confidential online insurance verification form is the easiest and quickest method to determine if BCBS couples therapy is covered.

Find a doctor and get the help your relationship needs without all of the difficulties of contacting your insurance carrier. Let our highly experienced, expert care coordinators handle getting more information about couples therapy Blue Cross Blue Shield may cover. After completing the form, a care coordinator will review your policy and thoroughly explain your options. Rest assured, all submitted or discussed information will remain confidential.

Does Blue Cross Blue Shield Cover Drug And Alcohol Rehab Programs


You may be wondering, does Blue Cross Blue Shield cover drug rehab? or what are some drug treatment centers that accept Blue Cross Blue Shield insurance? Perhaps you are wondering whether Blue Cross Blue Shield covers alcohol detox. While coverage may vary depending on your plan, BCBS plans typically cover some level of treatment for drug or alcohol addiction. You may be responsible for copayments or partial reimbursement of services rendered, so contact your states BCBS representative to learn about specific rehabilitation coverage and costs. The cost of rehab will also depend on factors such as program length.

Since BCBS offers plans on the Health Insurance Marketplace as part of the Affordable Care Act , many plans cover mental health and substance abuse services, which are considered an essential health benefit per the ACA.10 However, coverage for certain types of treatment programs may vary depending on the plan you have and on factors like geographic location.

There are varying levels of care for addiction treatment, which can include medical detoxification, inpatient/residential treatment and outpatient treatment. Coverage for these different levels of care may depend on your plan, the state you live in and the facility you choose.

Learn more about our treatment facilties

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Bcbs Tms Coverage Eligibility Policy

Blue Cross Blue Shield TMS coverage is considered medically necessary when the patient meets ALL of the following medically appropriate conditions:

  • 18 years of age or older
  • Confirmed diagnosis of severe major depressive disorder as determined by a standardized-rating scale that accurately evaluates depressive symptoms.
  • Failure of a psychotherapy trial


  • Four trials of psychopharmacologic drugs for depression failed, involving two different agent classes. At least one of the treatment trials had to be provided as an adequate mono- or poly-drug therapy course.
  • Four trials of psychopharmacologic drugs with documented adverse effects show an inability to tolerate a significant therapy dose.
  • Response to TMS in the past during a depressive episode
  • Individual qualifies for electroconvulsive treatment not clinically superior to TMS.


Furthermore, any device used in this treatment must be FDA approved for the specific indication.

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