Insurers and Health Plans Covering Bronchial Thermoplasty

One of the most common questions people have when they are considering Bronchial Thermoplasty (BT) is, "Will my insurance cover it?".  More health plans approve BT treatment for appropriate patients than ever before, and Boston Scientific can help work with doctors and health plans to help manage pre-authorization and appeals.

Check the table below to see if your plan covers BT, and remember, even if not listed here, BT may be covered on a case-by-case basis.

Government Health Insurance  
Medicare(1) National
Medicaid(2) AR, CA, CT, DE, HI, ID, IL, LA, ME, MD, MA, MI, MS, MT, NE, NV, NH, NJ, NM, ND, OH, OR, PA, RI, SC, SD, TX, VA, WI, WY
Commercial Health Insurance Plans
Plan Name
AmeriHealth(3)
AvMed
Avera Health Plans
Blue Cross Blue Shield of Illinois-HCSC(4)
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Montana-HCSC(4)
Blue Cross Blue Shield of New Mexico-HCSC(4)
Blue Cross Blue Shield of Oklahoma-HCSC(4)
Blue Cross Blue Shield of Texas-HCSC(4)
Boston Medical Center Healthnet
CareFirst Blue Cross Blue Shield
Capital Blue Cross
Community Health Options
Fallon Health
Gateway Health Plan
Geisinger Health Plan
Harvard Pilgrim
Hawaii Medical Service Association
Health Alliance Plan
HealthChoice
Healthfirst
Health First Health Plan
HealthPartners
Health New England
Highmark Blue Cross Blue Shield
Independence Blue Cross(3)
Inland Empire Health Plan
Johns Hopkins Healthcare
Keystone Health Plan East HMO(3)
LehighValley Health Plan
Ohio State University Health Plan
Optima Health
Oscar Health Plan
Piedmont Community Health Plan
Priority Health
SelectHealth
Tufts Health Plan
Unity Health
University of Cincinnati Health
West Virginia Family Health Plan
Large Employer Groups
Houston Methodist Health System
Loma Linda University Health Plan
Wellstar Health System
Jupiter Medical Center
 
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Write a letter to your insurance company and state legislators to explain what BT means to you.

(1) Medicare includes Bronchial Thermoplasty as part of a covered benefit category and has approved the procedure for qualified patients nationwide, but does not have a formal written coverage policy for the procedure. Healthcare facilities and physicians treating patients who have Medicare coverage will need to submit a claim to their local Medicare contractor.

(2) Medicaid includes traditional Medicare and Primary Care Case Management (PCCM) Medicare.

(3) Independence Health Group, selected plans: Independence Blue Cross, AmeriHealth PA, AmeriHealth NJ, and Keystone Health Plan East HMO

(4) Health Care Service Corporation operating through BlueCross BlueShield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

Brief Statement of Relevant Indications for Use, Contraindications, Warnings, and Adverse Events: The Alair™ Bronchial Thermoplasty System is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Alair System is not for use in patients with an active implantable electronic device or known sensitivity to medications used in bronchoscopy. Previously treated airways of the lung should not be retreated with the Alair System. Patients should be stable and suitable to undergo bronchoscopy. The most common side effect of BT is an expected transient increase in the frequency and worsening of respiratory-related symptoms. ENDO-551804-AA

As with any procedure, there are risks, and individual results may vary. The most common adverse event of BT is a temporary worsening of respiratory-related symptoms. These events typically occur within one day of the BT procedure and usually resolve within a week with standard care. There is a small risk (3.4% per procedure) that symptoms may require hospitalization.1

Reference

  1. Castro M, et al, for the AIR2 Trial Study Group. Am J Respir Crit Care Med. 2010;181:116-124.
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