International Hyperhidrosis Society
 

Hyperhidrosis Coverage Policies

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

If you are interested in a particular health insurance organization’s hyperhidrosis policies but don’t see it listed here, either the organization does not make its policies public OR we could not locate them. If you know where to find the 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 a particular health insurance organization’s hyperhidrosis policies, please contact its members’ services department. 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 patients' group health plan. Additionally, if your patients are not satisfied with their group health plan’s coverage for hyperhidrosis, encourage them to talk to their human resources person or plan administrator. He or she may be able to help.

Navigating the healthcare and insurance systems can sometimes be overwhelming. Patients should keep a diary to help them remember important dates, conversations, and correspondences regarding coverage and reimbursement for their treatment, as well as their hyperhidrosis symptoms and how they affect their day-to-day life. Their diary may be useful if they (or you) ever need to appeal an insurance company's decisions in regards to reimbursement for their 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

Aetna – for BOTOX (last review 3/30/18) 
http://www.aetna.com/cpb/medical/data/100_199/0113.html

Aetna – for Hyperhidrosis (last review 7/19/18) 
http://www.aetna.com/cpb/medical/data/500_599/0504.html

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

BCBS AR (last review 5/2018)
http://www.arkbluecross.com/members/report.aspx?policyNumber=2000034

BCBS AZ (last review 5/15/18) 
https://www.azblue.com/~/media/azblue/files/healthcare/resources/medical-coverage-guidelines/medicine/o420.pdf

BCBS CA (last review 7/1/18)                                                                                                                                                                     https://www.blueshieldca.com/provider/content_assets/documents/download/public/bscpolicy/TX_of_Hyperhidrosis.pdf

BCBS FL (last review 7/15/18) 
http://mcgs.bcbsfl.com/ 

BCBS GA (last review 8/3/17)
https://www.bcbsga.com/medicalpolicies/policies/mp_pw_a049843.htm 

BCBS MA  
https://www.bluecrossma.com/common/en_US/medical_policies/406%20Treatment%20of%20Hyperhidrosis%20prn.pdf    

BCBS MN (last review 9/2017)
https://www.bluecrossmnonline.com/minnesota-medical-policy/external-medical-policy/minnesota-medical-policy/II-55-005.html 

BCBS NC (last review 11/2017)
http://www.bcbsnc.com/services/medical-policy/pdf/hyperhidrosis_treatment_of.pdf

BCBS TN (last review 4/10/18) 
http://www.bcbst.com/mpmanual/botulinum_toxin.htm

Cigna (last review 1/15/18)
https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0037_coveragepositioncriteria_endoscopic_sympathectomy_for_hyperhidrosis.pdf   

Dean Health System (effective 7/1/18)
https://www.deancare.com/DHP/media/Documents/Medical-Policies/Dean-Hyperhidrosis-Treatment-9224.pdf?ext=.pdf 

Excellus (2/22/18)
https://www.excellusbcbs.com/wps/wcm/connect/7ed2d2d3-186d-40ff-b5e8-d8379f9e1ba5/cosmetic+mpc3+18.pdf?MOD=AJPERES&CACHEID=7ed2d2d3-186d-40ff-b5e8-d8379f9e1ba5

HealthPartners 
https://www.healthpartners.com/public/coverage-criteria/policy.html?contentid=AENTRY_045822 

Highmark West Virginia, BCBS (last review 6/25/18)
https://www.highmarkbcbswv.com/west-virginia-commercial-medical-policy/I-11-031.html

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

Keystone Blue Cross HMO (last review 1/18/17)
https://www.keystonefirstpa.com/pdf/provider/resources/clinical/policies/160201-hyperhidrosis-treatment.pdf 

Medica (last reivew 2/1/17)
https://www.medica.com/-/media/documents/provider/coverage-policies/botox_treatment_for_non-cosmetic_indications_cp.pdf

Premera (last review 7/1/18)
https://www.premera.com/medicalpolicies/8.01.519.pdf

Tufts Health Plan (effective 8/13/18)
https://tuftshealthplan.com/documents/providers/guidelines/pharmacy-medical-necessity-guidelines/bot-toxins

United Kingdom National Health System
https://www.nhs.uk/conditions/excessive-sweating-hyperhidrosis/

 

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