Disclaimer For Medical Policy On BCBSWi Web Site

Blue Cross Blue Shield of Wisconsin has developed medical policies that serve as one of the sets of guidelines for coverage decisions. Benefit plans vary in coverage and some plans may not provide coverage for certain services discussed in the medical policies. Coverage decisions are subject to all terms and conditions of the applicable benefit plan, including specific exclusions and limitations, and to applicable state and/or federal law. Medical policy does not constitute plan authorization, nor is it an explanation of benefits.

Medical policies can be highly technical and complex and are provided here for informational purposes. The medical policies do not constitute medical advice or medical care. Treating health care providers are solely responsible for diagnosis, treatment and medical advice. Blue Cross Blue Shield of Wisconsin members should discuss the information in the medical policies with their treating health care providers.

Medical technology is constantly evolving and these medical policies are subject to change without notice, although Blue Cross Blue Shield of Wisconsin will use good faith efforts to provide advance notice of changes that could have a negative impact on benefits. Additional medical policies may be developed from time to time and some may be withdrawn from use. The medical policies generally apply to all Blue Cross Blue Shield of Wisconsin fully-insured benefits plans, although some local variations may exist. Additionally, some benefit plans administered by Blue Cross Blue Shield of Wisconsin, such as some self-funded employer plans or governmental plans, may not utilize Blue Cross Blue Shield of Wisconsin medical policy. Members should contact their local customer services representative for specific coverage information.

The doctors, hospitals, and other providers which are part of the network of providers referred to in this document are independent contractors who exercise independent judgment and over whom Blue Cross Blue Shield of Wisconsin has no control or right of control. They are not agents or employees of Blue Cross Blue Shield of Wisconsin.

If you would like to request a hard copy of an individual medical policy, please contact the member's health plan at the number on the back of their identification card.