Benefits Handbook

MMC Benefits Handbook

Breast reduction surgery that is determined to be a Cosmetic procedure, except as required by the Women's Health and Cancer Rights Act of 1998.
Cosmetic procedures. Examples include:
Hair removal or replacement by any means, except as part of a genital reconstruction procedure by a physician for the treatment of gender dysphoria.
Liposuction or removal of fat deposits considered undesirable, including fat accumulation under the male breast and nipple. This exclusion does not apply to liposuction for which Benefits are provided.
Pharmacological regimens, nutritional procedures, or treatments.
Scar or tattoo removal or revision procedures (such as salabrasion, chemosurgery, and other such skin abrasion procedures).
Skin abrasion procedures performed as a treatment for acne.
Treatments for hair loss.
Treatments for skin wrinkles or any treatment to improve the appearance of the skin.
Treatment for spider veins of the lower extremities when it is considered Cosmetic.
Varicose vein treatment of the lower extremities when it is considered Cosmetic.
Excision or removal of hanging skin on any part of the body, unless Medically Necessary. Examples include plastic surgery procedures called abdominoplasty, brachioplasty, and panniculectomy.
Replacement of an existing breast implant if the earlier breast implant was performed as a cosmetic procedure. Note: Replacement of an existing breast implant is considered reconstructive if the initial breast implant followed mastectomy.
Physical conditioning programs such as athletic training, bodybuilding, diversion or general motivation, exercise, fitness, flexibility, health club memberships and programs, and spa treatments.
Reconstructive surgery where there is another more appropriate covered surgical procedure or when the proposed Reconstructive surgery offers minimal improvement in your appearance. This exclusion shall not apply to breast reconstruction when performed subsequent to a mastectomy, including surgery on either breast to achieve or restore symmetry.
Treatment of benign gynecomastia (abnormal breast enlargement in males).
Weight loss programs whether or not they are under medical supervision. Weight loss programs for medical reasons are also excluded.
Wigs (scalp/cranial hair prostheses) except for Participants with scalp/head wound, burns, injuries, alopecia areata, and cancer who are undergoing chemotherapy, radiation therapy, or gender dysphoria.
Treatments for skin wrinkles or any treatment to improve the appearance of the skin.
Treatment for spider veins.
Skin abrasion procedures performed as a treatment for acne.
Treatments for hair loss.
Varicose vein treatment of the lower extremities, when it is considered cosmetic.
Sclerotherapy treatment of veins.