Home/Preventive Care for Patients at Risk of Hereditary Conditions
Preventive Care for Patients at Risk of Hereditary Conditions 2020-09-29T10:03:36+00:00

Preventive Care for Patients at Risk of Hereditary Conditions

Coverage is provided for preventive care for patients with specific genetic mutations that put them at higher risk of developing metastatic disease as described below.

The following surgeries are covered when recommended by a Physician:

  • Mastectomy for patients with BRCA 1/2 mutation
  • Oophorectomy for patients with BRCA 1/2 mutation
  • Gastrectomy for patients with CDH1 mutation
  • Thyroidectomy for patients with MEN 2A and 2B mutation
  • Colectomy for patients with familial juvenile polyposis
  • Preventive ultrasound for ovarian cancer screening in BRCA 1/2 positive patients

Participants must obtain prior approval from the benefits administrator. If prior approval is not obtained, no benefits will be payable under the program.