Common use of Reconstructive Surgery Clause in Contracts

Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be Covered if performed for the correction of functional disorders. Reconstructive Surgery must be prescribed by a Member’s Practitioner/Provider and requires Prior Authorization. For information regarding Reconstructive Surgery following a Mastectomy and Prophylactic Mastectomy, refer to the Women’s Healthcare Section. Reconstructive surgery related to Gender Confirmatory Therapy and Gender Affirming Care are Covered. The Prior Authorization criteria of this Plan is applicable This benefit has one or more exclusions as specified in the Exclusions Section.

Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be Covered if performed for the correction of functional disorders. Reconstructive Surgery must be prescribed by a Member’s Practitioner/Provider and requires Prior Authorization. For information regarding Reconstructive Surgery following a Mastectomy and Prophylactic Mastectomy, refer to the Women’s Healthcare Section. Reconstructive surgery related to Gender Confirmatory Therapy and Gender Affirming Care are Covered. The Prior Authorization criteria of this Plan is applicable applicable. This benefit has one or more exclusions as specified in the Exclusions Section.

Reconstructive Surgery. This benefit has one or more exclusions as specified in the Exclusions Section. Reconstructive Surgery from which an improvement in physiological function can reasonably be expected will be Covered if performed for the correction of functional disorders. Reconstructive Surgery must be prescribed by a Member’s Practitioner/Provider and requires Prior Authorization. For information regarding Reconstructive Surgery following a Mastectomy and Prophylactic Mastectomy, refer to the Women’s Healthcare Section. Reconstructive surgery related to Gender Confirmatory Therapy and Gender Affirming Care are Covered. The Prior Authorization criteria of this Plan is applicable applicable. This benefit has one or more exclusions as specified in the Exclusions Section.