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Table of Contents
Introduction/Plain Language/Advisory
FEHB Facts
Section 1
Section 2
Section 3
Section 4
Section 5
5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals
5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services
5(d). Emergency Services/Accidents
5(e). Mental Health and Substance Use Disorder Benefits
5(f). Prescription Drug Benefits
5(g). Dental Benefits
5(h). Wellness and Other Special Features
5(i). Services, Drugs, and Supplies Provided Overseas
Non-FEHB Benefits Available to Plan Members
Section 6
Section 7
Section 8
Section 9
Section 10
Index
Summary of Benefits – FEP Blue Focus
2024 Rate Information
Entire brochure in page-number order
 
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This brochure version is for internal use only.
 

 

2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals

Educational Classes and Programs

 

Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.

Benefit Description

Educational Classes and Programs
  • Smoking and tobacco cessation treatment including:
     
    • Counseling for smoking and tobacco use cessation
       
    • Smoking and tobacco cessation classes
      Note: See Section 5(f) for our coverage of smoking and tobacco cessation drugs.


You Pay
Preferred: Nothing (no deductible)

Non-preferred (Participating/Non-participating): You pay all charges

 

Benefit Description
  • Diabetic education

    Note: See pages 39, 41 and 44 for our coverage of nutritional counseling services that are not part of a diabetic education program.

You Pay
Preferred: 30% of the Plan allowance (deductible applies)

Non-preferred (Participating/Non-participating): You pay all charges

 

Benefit Description
Not covered:

 
  • Marital, family, educational, or other counseling or training services, or applied behavior analysis (ABA), when performed as part of an educational class or program
     
  • Premenstrual syndrome (PMS), lactation (except as described on page 46), headache, eating disorder (except as described on page 39), and other educational clinics
  • Recreational or educational therapy, and any related diagnostic testing except as provided by a hospital as part of a covered inpatient stay
     
  • Services performed or billed by a school or halfway house or a member of its staff


You Pay
All charges
 

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