We Accept Plans From the Following Carriers
Frequently Asked Questions
How can I check if my insurance will cover surgery and hospital stay?
Most group insurance plans that cover mastectomies are required to cover breast reconstruction surgery under the Women’s Health and Cancer Rights Act (WHCRA). To confirm your specific coverage:
- Contact your insurance provider directly and inquire about coverage for breast reconstruction surgery.
- Reach out to our office for assistance. We can help verify your insurance benefits and guide you through the process.
Where can I find information about my deductible?
Your deductible information is typically available:
- On your insurance provider’s website or mobile app under your plan details.
- In your insurance policy documents or benefits summary.
- By contacting your insurance provider’s customer service for clarification.
What’s the difference between out-of-pocket maximums, deductibles, and co-insurance?
- Deductible: The amount you pay for covered healthcare services before your insurance starts to pay.
- Co-insurance: The percentage of costs you share with your insurance after meeting your deductible.
- Out-of-pocket maximum: The most you’ll pay in a year for covered services, including deductibles, co-insurance, and co-pays. Once you reach this limit, your insurance covers 100% of covered services for the rest of the year.
If you have additional questions or need help understanding your insurance, feel free to contact our office or consult your insurance provider.
What should I do if my insurance provider isn’t listed?
We are participating providers with several major insurance companies, including Aetna, Blue Cross Blue Shield of South Carolina, Cigna, and UnitedHealthcare. If your provider isn’t listed, please contact our office. We can discuss your options and help determine if your insurance plan can still be used for your care.
Does insurance cover all types of breast reconstruction procedures?
Coverage may vary depending on your insurance plan and the type of procedure. Most insurance plans that cover mastectomies are required to cover breast reconstruction surgery, but it’s best to confirm with your provider. Our team can assist in verifying your benefits and explaining what’s covered.
How do I know if I’ve met my deductible or out-of-pocket maximum?
You can check your deductible and out-of-pocket maximum status by:
- Logging into your insurance provider’s online portal or app.
- Reviewing your most recent Explanation of Benefits (EOB) statement.
- Calling your insurance provider’s customer service for up-to-date information.
What documents do I need to provide for insurance verification?
To verify your insurance coverage, you’ll typically need:
- A copy of your insurance card (front and back).
- Your policy number and group number.
- Any pre-authorization forms or referrals required by your insurance plan.
Will I need pre-authorization for breast reconstruction surgery?
Many insurance plans require pre-authorization for surgical procedures. Our office can help you navigate this process by working with your insurance provider to obtain the necessary approvals before your surgery