Hyperhidrosis Coverage Policies

Health care organizations often have specific policies regarding coverage for hyperhidrosis treatments. As an information service, the International Hyperhidrosis Society has compiled a list below of public hyperhidrosis coverage policies of some of the major health insurance organizations.

If you do not see your health insurance organization's policies listed below, either the organization does not make its policies public OR we could not locate them. If you know where to find your health insurance organization’s hyperhidrosis policy (or policies), we would love to add the information to our list. Just send us the appropriate URL by e-mailing info@SweatHelp.org.

As you look over this information, please know that we cannot guarantee its accuracy. Policies change. For the most up-to-date information about your particular health insurance organization’s hyperhidrosis policies, please contact its members’ services department or, if you receive insurance through your employer, talk to your group health plan administrator or human resources person. Employers providing health benefits to their employees often have the chance to change or modify health plans. So, be sure to check to find out the specific health policies of an organization as they apply to your group health plan. Additionally, if you are not satisfied with your group health plan’s coverage for hyperhidrosis, talk to your human resources person or plan administrator. He or she may be able to help.

Navigating the healthcare and insurance systems can sometimes be overwhelming. Keep a diary to help you remember important dates, conversations, and correspondences regarding coverage and reimbursement for your treatment, your hyperhidrosis symptoms and how they affect your day-to-day life. Your diary may be useful if you ever need to appeal an insurance company's decisions in regards to coverage for your treatments.

The International Hyperhidrosis Society has no connection or affiliation with any of the health insurance organizations listed below. We do not endorse or have any influence over the organizations’ hyperhidrosis policies. This information is merely provided as a service. We hope it is useful to you.

List of Public Coverage Policies on File

Policy Title/Plan Web SiteAetna – for BOTOX
http://www.aetna.com/cpb/medical/data/100_199/0113.html

Aetna – for Hyperhidrosis
http://www.aetna.com/cpb/medical/data/500_599/0504.html

Anthem BCBS 
http://www.anthem.com/medicalpolicies/policies/mp_pw_a050005.htm

BCBS AL
https://www.myprime.com/content/dam/prime/memberportal/forms/AuthorForms/BCBSAL/Commercial/AL_CS_Botulinum_Toxin_PA_MDC_ProgSum.pdf

BCBS AR
http://www.arkbluecross.com/members/report.aspx?policyNumber=2000034

BCBS AZ Oct 2007
https://secure.azblue.com/pdf/medpol/o420.pdf

BCBS CA                                                                                                                                                                                https://www.blueshieldca.com/provider/content_assets/documents/download/public/bscpolicy/TX_of_Hyperhidrosis.pdf

BCBS FL
http://mcgs.bcbsfl.com/

BCBS GA
http://www.bcbsga.com/medicalpolicies/policies/mp_pw_a050005.htm

BCBS MA  
http://www.bluecrossma.com/common/en_US/medical_policies/406%20Treatment%20of%20Hyperhidrosis%20excluding%20Botulinum%20Toxin%20prn.pdf

http://www.bluecrossma.com/common/en_US/medical_policies/405%20Botulinum%20Toxin%20Injection%20for%20the%20Treatment%20of%20Hyperhidrosis%20prn.pdf

BCBS MN  
http://notes.bluecrossmn.com/web/medpolman.nsf/53aa9f34f79f6511862569bd0054b9a6/38b7b86832a28eca862567fc007a0cda/$FILE/Hyperhidrosis%20Treatments.pdf

BCBS NC  
http://www.bcbsnc.com/services/medical-policy/pdf/hyperhidrosis_treatment_of.pdf

BCBS TN 
http://www.bcbst.com/mpmanual/botulinum_toxin.htm

Cigna 
http://www.cigna.com/customer_care/healthcare_professional/coverage_positions/medical/mm_0037_coveragepositioncriteria_endoscopic_sympathectomy_for_hyperhidrosis.pdf

HealthPartners 
https://www.healthpartners.com/public/coverage-criteria/hyperhidrosis-primary-treatments.htm

https://www.healthpartners.com/public/coverage-criteria/botulinum-toxins.htm

https://www.healthpartners.com/public/coverage-criteria/iontophoresis.htm

Independence Blue Cross HMO
https://www.ibx.com/pdfs/providers/pharmacy_information/prior_authorization/ibc_botox.pdf

Medica
https://www.medica.com/search?q=hyperhidrosis

Premera 

https://www.premera.com/medicalpolicies/8.01.519.pdf

https://www.premera.com/medicalpolicies/5.01.512.pdf

Tufts Health Plan
https://tuftshealthplan.com/documents/providers/guidelines/pharmacy-medical-necessity-guidelines/botulinum-toxins-commercial-direct?_ga=1.261489741.1988539167.1462310430


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