Services That Need Preapproval

Blue Cross Blue Shield of Michigan and Blue Care Network need to review and approve some health care services before you receive them. 

Blue Cross Blue Shield of Michigan PPO plans

These services are only eligible for coverage when your provider gets our approval before giving them.

When we review your health care services, that doesn't guarantee payment of your claims. You'll need to be sure that your plan covers those services and that your coverage is active at the time you receive treatment. Here are the services that need approval.

  • Some radiology services: 
    • CT
    • CTA
    • Echocardiology
    • MRI
    • MRA
    • MRS
    • nuclear cardiology
    • PET
    • QCT bone densitometry
  • Inpatient care:
    • Acute
    • Mental health care including residential psychicatric admissions
    • Substance abuse treament
  • In-lab sleep studies
  • Skilled nursing care
  • Human organ transplant services
  • Rehabilitation therapy
  • Applied behavioral analysis

Blue Care Network HMO plans

  • Procedures that may be cosmetic, such as removing scars or excess tissue from your eyes or abdomen
  • Physical therapy, speech therapy and occupational therapy
  • Weight-reduction procedures
  • Bone marrow transplants
  • Infertility services
  • Breast reduction
  • Durable medical equipment
  • Services from out-of-network physicians or health care professionals
  • Procedures that may be experimental or investigational



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