AZ Blue Best Life Classic (HMO): Prosthetic Devices and Related Supplies

Prosthetics replace or restore lost functionality and include everything from orthotic shoes to implants to artificial limbs.

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Cost
20% coinsurance
Prior Authorization Required
Yes, for orthotics and prosthetics but not medical supplies
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain an order from a primary care provider or other specialist for a prosthetic device.

    • This may take place in the course of existing treatment, such as with a cardiologist for heart arrhythmia.

  2. Contact the AZ Blue Best Life Classic Team at 1-800-446-8331 (TTY 711) for prior authorization.

    • The ordering provider may help with authorization.

    • The prosthetic supplier may also help with authorization.

  3. Schedule a fitting appointment with the prosthetic supplier.

  4. Attend the fitting appointment.

  5. Receive the prosthetic when completed and available.

    • This may involve an implantation procedure, such as with a pacemaker.

  6. Ensure proper education and demonstration of prosthetic use and care, including following all manufacturer guidelines.

Availability
Ongoing, and as needed for repair or replacement
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Prosthetic devices are devices (other than dental) that replace all or part of a body part or its function. For example, a pacemaker replaces the electrical signals in the heart, orthotic shoes replace structures in the feet that are missing or damaged, and a colostomy replaces part of the bowel.

Prosthetics and Orthotics

Also included are certain supplies related to prosthetic devices and repair and/or replacement of prosthetic devices. There may also be some coverage following cataract removal or cataract surgery (see Vision Care benefit). 

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