Heart valve replacement or repair

Definition

Undergoing of surgery to replace any heart valve with either a natural or mechanical valve or to repair heart valve defects or abnormalities.

The surgery must be determined to be medically necessary and performed by a specialist.

Exclusions

• A 30-day survival period applies, except for the Life with CI Advance product.
• No benefit will be payable under the definition of "heart valve replacement or repair" for:
  • angioplasty;
  • intra-arterial procedures, percutaneous trans-catheter procedures; or
  • non-surgical procedures.