2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5. FEP Blue Focus Benefits
Page 32
Section 5. FEP Blue Focus Benefits
Page 32
Section 5. FEP Blue Focus Benefits
Section 5. FEP Blue Focus Overview - 34
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals - 38
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals - 38
Diagnostic and Treatment Services - 39
Lab, X-ray and Other Diagnostic Tests - 40
Preventive Care, Adult - 41
Preventive Care, Child - 44
Maternity Care - 45
Family Planning - 47
Reproductive Services - 47
Allergy Care - 48
Treatment Therapies - 49
Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy - 50
Hearing Services - 50
Vision Services (Testing, Treatment, and Supplies) - 51
Foot Care - 52
Orthopedic and Prosthetic Devices - 52
Durable Medical Equipment (DME) - 53
Medical Supplies - 54
Home Health Services - 54
Alternative/Manipulative Treatment - 55
Educational Classes and Programs - 55
Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals - 56Lab, X-ray and Other Diagnostic Tests - 40
Preventive Care, Adult - 41
Preventive Care, Child - 44
Maternity Care - 45
Family Planning - 47
Reproductive Services - 47
Allergy Care - 48
Treatment Therapies - 49
Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy - 50
Hearing Services - 50
Vision Services (Testing, Treatment, and Supplies) - 51
Foot Care - 52
Orthopedic and Prosthetic Devices - 52
Durable Medical Equipment (DME) - 53
Medical Supplies - 54
Home Health Services - 54
Alternative/Manipulative Treatment - 55
Educational Classes and Programs - 55
Surgical Procedures - 57
Reconstructive Surgery - 59
Oral and Maxillofacial Surgery - 61
Organ/Tissue Transplants - 66
Anesthesia - 68
Section 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services - 69Reconstructive Surgery - 59
Oral and Maxillofacial Surgery - 61
Organ/Tissue Transplants - 66
Anesthesia - 68
Inpatient Hospital - 70
Maternity – Facility - 71
Outpatient Hospital or Ambulatory Surgical Center - 73
Residential Treatment Center - 76
Extended Care Benefits/Skilled Nursing Care Facility Benefits - 77
Hospice Care - 77
Ambulance - 80
Section 5(d). Emergency Services/Accidents - 81Section 5(e). Mental Health and Substance Use Disorder Benefits - 85Maternity – Facility - 71
Outpatient Hospital or Ambulatory Surgical Center - 73
Residential Treatment Center - 76
Extended Care Benefits/Skilled Nursing Care Facility Benefits - 77
Hospice Care - 77
Ambulance - 80
Professional Services - 85
Inpatient Hospital or Other Covered Facility - 87
Residential Treatment Center - 87
Outpatient Hospital or Other Covered Facility - 88
Section 5(f). Prescription Drug Benefits - 89
Inpatient Hospital or Other Covered Facility - 87
Residential Treatment Center - 87
Outpatient Hospital or Other Covered Facility - 88