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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 2. Changes for 2023
Section 2. Changes for 2023
Do not rely only on these change descriptions; this Section is not an official statement of benefits. For that, go to Section 5 (Benefits). Also, we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.
Changes to our FEP Blue Focus
  • We now cover preventive low-dose CT screenings for lung cancer for members aged 50 to 80. Previously, preventive benefits did not start until age 55.
  • We now require prior approval for certain high-cost drugs obtained outside of a pharmacy setting. Previously, prior approval was not required. (See page 20.)
  • We now require prior approval for proton beam therapy. Previously, prior approval was not required. (See page 20.)
  • We now require prior approval for stereotactic radiosurgery and stereotactic body radiation therapy. Previously, prior approval was not required. (See page 20.)
  • We now cover one year of sperm and egg storage for those individuals facing iatrogenic infertility. Previously, there was no benefit for this service. (See pages 21,  48 and 130.)
  • We now cover computed tomography (CT) colonography under the adult preventive benefit for colorectal cancer tests. Previously, this was not covered under the preventive benefit. (See page 42.)
  • We will make changes as soon as possible and provide you preventive benefits for the USPSTF A and B, ACIP, HRSA, and Bright Futures recommendations as they occur through the year. Previously, updates were made annually. (See pages 42 and 44.)
  • We now provide 8 visits per calendar year to treat depression associated with pregnancy with no member cost-share when a Preferred provider is used. Previously, we provided coverage for only 4 visits per calendar year. (See page 45.)
  • We now provide individuals who are pregnant with a free blood pressure monitor when ordered through our vendor. (See page 46.)
  • We now provide benefits for medically necessary bariatric surgery beginning at the age of 16. Previously, this benefit was limited to individuals aged 18 and older. (See page 57.)
  • We no longer limit the number of non-full sibling donor screening tests for transplants. Previously, we limited non-full sibling donor test screenings to three. (See page 67.)
  • We now cover medical foods for the treatment of inborn errors of amino acid metabolism regardless of age. Previously, we limited this to individuals under the age of 22. (See page 94.)
  • We now cover the generic naloxone nasal spray with zero cost-share for the first purchase of up to a 90-day supply per calendar year. Previously, we covered the Narcan nasal spray under this benefit. (See page 97.)
  • We now provide coverage for weight loss medications to treat obesity when obtained through one of our pharmacy drug programs. Previously, these drugs were not covered for treatment of obesity.
  • The calendar year deductible is now waived for all overseas services. (See page 107.)
  • We now cover over-the-counter (OTC) condoms for all members with zero member cost-share when you have a prescription from your physician and they are purchased in a Preferred retail pharmacy. Previously, benefits were available only for female condoms. (See page 95.)