2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(e). Mental Health and Substance Use Disorder Benefits
Inpatient Hospital or Other Covered Facility
Section 5(e). Mental Health and Substance Use Disorder Benefits
Inpatient Hospital or Other Covered Facility
Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.
Benefit Description
Inpatient Hospital or Other Covered Facility
Inpatient services to treat mental health and/or substance use disorders provided and billed by a hospital or other covered facility (see below for residential treatment center care) includes:
Notes:
You Pay
Preferred facilities: 30% of the Plan allowance (deductible applies)
Non-preferred (Member/Non-member) facilities: You pay all charges
Benefit Description
Inpatient Hospital or Other Covered Facility
Inpatient services to treat mental health and/or substance use disorders provided and billed by a hospital or other covered facility (see below for residential treatment center care) includes:
- Room and board, such as semiprivate or intensive accommodations, general nursing care, meals and special diets, and other hospital services
- Diagnostic tests
Notes:
- Inpatient care to treat substance use disorders includes room and board and ancillary charges for confinements in a hospital/treatment facility for rehabilitative treatment of alcoholism or substance use disorder.
- You must get precertification of inpatient hospital stays; failure to do so will result in a $500 penalty.
You Pay
Preferred facilities: 30% of the Plan allowance (deductible applies)
Non-preferred (Member/Non-member) facilities: You pay all charges