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Blue Cross and Blue Shield Service Benefit Plan - 2023

FEP Blue Focus

 

Document list

Document Number Document Name Version Date Published
FBF23.00.1.1 Cover Page v1.0 01/01/2023
FBF23.00.1.2 Inside cover v1.0 01/01/2023
FBF23.00.1.3 Table of Contents v1.0 01/01/2023
FBF23.00.2.1 Introduction v1.0 01/01/2023
FBF23.00.2.2 Plain Language v1.0 01/01/2023
FBF23.00.2.3 Stop Healthcare Fraud v1.0 01/01/2023
FBF23.00.2.4 Discrimination is Against the Law v1.0 01/01/2023
FBF23.00.2.5 Preventing Medical Mistakes v1.0 01/01/2023
FBF23.00.3.1.1 No pre-existing condition limitation v1.0 01/01/2023
FBF23.00.3.1.2 Minimum essential coverage (MEC) v1.0 01/01/2023
FBF23.00.3.1.3 Minimum value standard v1.0 01/01/2023
FBF23.00.3.1.4 Where you can get information about enrolling in the FEHB Program v1.0 01/01/2023
FBF23.00.3.1.5 Types of coverage available for you and your family v1.0 01/01/2023
FBF23.00.3.1.6 Family member coverage v1.0 01/01/2023
FBF23.00.3.1.7 Children's Equity Act v1.0 01/01/2023
FBF23.00.3.1.8 When benefits and premiums start v1.0 01/01/2023
FBF23.00.3.1.9 When you retire v1.0 01/01/2023
FBF23.00.3.2.1 When FEHB coverage ends v1.0 01/01/2023
FBF23.00.3.2.2 Upon divorce v1.0 01/01/2023
FBF23.00.3.2.3 Temporary Continuation of Coverage (TCC) v1.0 01/01/2023
FBF23.00.3.2.4 Finding replacement coverage v1.0 01/01/2023
FBF23.00.3.2.5 Health Insurance Marketplace v1.0 01/01/2023
FBF23.01.0 Section 1. How This Plan Works v1.0 01/01/2023
FBF23.01.1 General features of FEP Blue Focus/We have a Preferred Provider Organization (PPO) v1.0 01/01/2023
FBF23.01.2 How we pay professional and facility providers v1.0 01/01/2023
FBF23.01.3 Your rights and responsibilities v1.0 01/01/2023
FBF23.01.4 Your medical and claims records are confidential v1.0 01/01/2023
FBF23.02 Section 2. Changes for 2023 v1.0 01/01/2023
FBF23.03.1 Identification cards v1.0 01/01/2023
FBF23.03.2.0 Where you get covered care v1.0 01/01/2023
FBF23.03.2.01 Balance Billing Protection v1.0 01/01/2023
FBF23.03.2.1 Covered professional providers v1.0 01/01/2023
FBF23.03.2.2 Covered facility providers v1.0 01/01/2023
FBF23.03.3.0 What you must do to get covered care v1.0 01/01/2023
FBF23.03.3.1 Transitional care v1.0 01/01/2023
FBF23.03.3.2 If you are hospitalized when your enrollment begins v1.0 01/01/2023
FBF23.03.4.00 You need prior Plan approval for certain services v1.0 01/01/2023
FBF23.03.4.01 Inpatient hospital admission, inpatient residential treatment center admission v1.0 01/01/2023
FBF23.03.4.02 Other services v1.0 01/01/2023
FBF23.03.4.03 Special prior authorization situations related to coordination of benefits (COB) v1.0 01/01/2023
FBF23.03.4.04 Prior notification - Maternity care v1.0 01/01/2023
FBF23.03.4.05 How to request precertification for an admission or get approval for Other services v1.0 01/01/2023
FBF23.03.4.06 Non-urgent care claims v1.0 01/01/2023
FBF23.03.4.07 Urgent care claims v1.0 01/01/2023
FBF23.03.4.08 Concurrent care claims v1.0 01/01/2023
FBF23.03.4.09 Emergency inpatient admission v1.0 01/01/2023
FBF23.03.4.10 Maternity care v1.0 01/01/2023
FBF23.03.4.11 If your facility stay needs to be extended v1.0 01/01/2023
FBF23.03.4.12 If your treatment needs to be extended v1.0 01/01/2023
FBF23.03.5.0 If you disagree with our pre-service claim decision v1.0 01/01/2023
FBF23.03.5.1 To reconsider a non-urgent care claim v1.0 01/01/2023
FBF23.03.5.2 To reconsider an urgent care claim v1.0 01/01/2023
FBF23.03.5.3 To file an appeal with OPM v1.0 01/01/2023
FBF23.04.01 Cost-share/Cost-sharing v1.0 01/01/2023
FBF23.04.02 Copayment v1.0 01/01/2023
FBF23.04.03 Deductible v1.0 01/01/2023
FBF23.04.04 Coinsurance v1.0 01/01/2023
FBF23.04.05 If your provider routinely waives your cost v1.0 01/01/2023
FBF23.04.06 Waivers v1.0 01/01/2023
FBF23.04.07 Differences between our allowance and the bill v1.0 01/01/2023
FBF23.04.08 Important Notice About Surprise Billing – Know Your Rights v1.0 01/01/2023
FBF23.04.09 Your costs for other care v1.0 01/01/2023
FBF23.04.10 Your catastrophic protection out-of-pocket maximum for deductibles, coinsurance, and copayments v1.0 01/01/2023
FBF23.04.11 Carryover v1.0 01/01/2023
FBF23.04.12 If we overpay you v1.0 01/01/2023
FBF23.04.13 When Government facilities bill us v1.0 01/01/2023
FBF23.04.14 The Federal Flexible Spending Account Program – FSAFEDS v1.0 01/01/2023
FBF23.05.01 Section 5. Benefits - Table of Contents v1.0 01/01/2023
FBF23.05.02 Section 5. FEP Blue Focus Overview v1.0 01/01/2023
FBF23.05a.0 Section 5(a). Overview v1.0 01/01/2023
FBF23.05a.01 Diagnostic and Treatment Services v1.0 01/01/2023
FBF23.05a.02 Lab, X-ray and Other Diagnostic Tests v1.1 01/01/2023
FBF23.05a.03 Preventive Care, Adult v1.0 01/01/2023
FBF23.05a.04 Preventive Care, Child v1.0 01/01/2023
FBF23.05a.05 Maternity Care v1.0 01/01/2023
FBF23.05a.06 Family Planning v1.0 01/01/2023
FBF23.05a.07 Reproductive Services v1.0 01/01/2023
FBF23.05a.08 Allergy Care v1.0 01/01/2023
FBF23.05a.09 Treatment Therapies v1.0 01/01/2023
FBF23.05a.10 Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy v1.0 01/01/2023
FBF23.05a.11 Hearing Services v1.0 01/01/2023
FBF23.05a.12 Vision Services (Testing, Treatment, and Supplies) v1.0 01/01/2023
FBF23.05a.13 Foot Care v1.0 01/01/2023
FBF23.05a.14 Orthopedic and Prosthetic Devices v1.0 01/01/2023
FBF23.05a.15 Durable Medical Equipment (DME) v1.0 01/01/2023
FBF23.05a.16 Medical Supplies v1.0 01/01/2023
FBF23.05a.17 Home Health Services v1.0 01/01/2023
FBF23.05a.18 Alternative/Manipulative Treatment v1.0 01/01/2023
FBF23.05a.19 Educational Classes and Programs v1.0 01/01/2023
FBF23.05b.0 Section 5(b). Overview v1.0 01/01/2023
FBF23.05b.1 Surgical Procedures v1.0 01/01/2023
FBF23.05b.2 Reconstructive Surgery v1.0 01/01/2023
FBF23.05b.3 Oral and Maxillofacial Surgery v1.0 01/01/2023
FBF23.05b.4 Organ/Tissue Transplants v1.1 01/01/2023
FBF23.05b.5 Anesthesia v1.0 01/01/2023
FBF23.05c.0 Section 5(c). Overview v1.0 01/01/2023
FBF23.05c.1 Inpatient Hospital v1.0 01/01/2023
FBF23.05c.2 Maternity - Facility v1.0 01/01/2023
FBF23.05c.3 Outpatient Hospital or Ambulatory Surgical Center v1.0 01/01/2023
FBF23.05c.4 Residential Treatment Center v1.0 01/01/2023
FBF23.05c.5 Extended Care Benefits/Skilled Nursing Care Facility Benefits v1.0 01/01/2023
FBF23.05c.6 Hospice Care v1.0 01/01/2023
FBF23.05c.7 Ambulance v1.0 01/01/2023
FBF23.05d.0 Section 5(d). Overview v1.0 01/01/2023
FBF23.05d.1 Accidental Injury v1.0 01/01/2023
FBF23.05d.2 Medical Emergency v1.0 01/01/2023
FBF23.05d.3 Ambulance v1.0 01/01/2023
FBF23.05e.0 Section 5(e). Overview v1.0 01/01/2023
FBF23.05e.1 Professional Services v1.0 01/01/2023
FBF23.05e.2 Inpatient Hospital or Other Covered Facility v1.0 01/01/2023
FBF23.05e.3 Residential Treatment Center v1.0 01/01/2023
FBF23.05e.4 Outpatient Hospital or Other Covered Facility v1.0 01/01/2023
FBF23.05f.0 Section 5(f). Overview v1.0 01/01/2023
FBF23.05f.01 There are important features you should be aware of v1.0 01/01/2023
FBF23.05f.02 Who can write your prescriptions v1.0 01/01/2023
FBF23.05f.03 Where you can obtain them v1.0 01/01/2023
FBF23.05f.04 What is covered v1.0 01/01/2023
FBF23.05f.05 Generic equivalents v1.0 01/01/2023
FBF23.05f.06 Disclosure of information v1.0 01/01/2023
FBF23.05f.07 There are dispensing limitations v1.0 01/01/2023
FBF23.05f.08 Important contact information v1.0 01/01/2023
FBF23.05f.09 Patient Safety and Quality Monitoring (PSQM) v1.0 01/01/2023
FBF23.05f.10 Prior Approval v1.0 01/01/2023
FBF23.05f.11 Preferred retail pharmacies v1.0 01/01/2023
FBF23.05f.12 Over-the-counter (OTC) contraceptive drugs and devices v1.1 01/01/2023
FBF23.05f.13 Immunizations when provided by a Preferred retail pharmacy that participates in our vaccine network v1.0 01/01/2023
FBF23.05f.14 Diabetic Meter Program v1.0 01/01/2023
FBF23.05f.15 Medications to promote better health as recommended under the ACA v1.0 01/01/2023
FBF23.05f.16 Generic medications to reduce breast cancer risk for women v1.0 01/01/2023
FBF23.05f.17 Bowel preparation medications and antiretroviral therapy medications for HIV v1.0 01/01/2023
FBF23.05f.18 Opioid Reversal Agents: Tier 1 medications limited to Narcan nasal spray and naloxone v1.0 01/01/2023
FBF23.05f.19 How to obtain your prescription drugs and supplies v1.0 01/01/2023
FBF23.05f.20 Smoking and Tobacco Cessation Medications v1.0 01/01/2023
FBF23.05f.21 Specialty Drug Pharmacy Program v1.0 01/01/2023
FBF23.05f.22 Not Covered v1.0 01/01/2023
FBF23.05f.23 Drugs From Other Sources v1.0 01/01/2023
FBF23.05g.0 Section 5(g). Overview v1.0 01/01/2023
FBF23.05g.1 Accidental Injury Benefit v1.0 01/01/2023
FBF23.05g.2 Inpatient and Outpatient Facility Care v1.0 01/01/2023
FBF23.05h.01 Health Tools v1.0 01/01/2023
FBF23.05h.02 Services for the Deaf and Hearing Impaired v1.0 01/01/2023
FBF23.05h.03 Web Accessibility for the Visually Impaired v1.0 01/01/2023
FBF23.05h.04 Travel Benefit/Services Overseas v1.0 01/01/2023
FBF23.05h.05 Healthy Families v1.0 01/01/2023
FBF23.05h.06 Blue Health Assessment v1.0 01/01/2023
FBF23.05h.07 Hypertension Management Program v1.0 01/01/2023
FBF23.05h.08 MyBlue Customer eService v1.0 01/01/2023
FBF23.05h.09 National Doctor & Hospital Finder v1.0 01/01/2023
FBF23.05h.10 Care Management Programs v1.0 01/01/2023
FBF23.05h.11 Flexible Benefits Option v1.0 01/01/2023
FBF23.05h.12 Telehealth Services v1.0 01/01/2023
FBF23.05h.13 Routine Annual Physical Incentive Program v1.0 01/01/2023
FBF23.05h.14 The fepblue Mobile Application v1.0 01/01/2023
FBF23.05i.0 Section 5(i). Services, Drugs, and Supplies Provided Overseas v1.0 01/01/2023
FBF23.05N.0 Non-FEHB Benefits Available to Plan Members v1.0 01/01/2023
FBF23.06 Section 6. General Exclusions - Services, Drugs, and Supplies We Do Not Cover v1.0 01/01/2023
FBF23.07 Section 7. Filing a Claim for Covered Services v1.0 01/01/2023
FBF23.08 Section 8. The Disputed Claims Process v1.0 01/01/2023
FBF23.09.1.0 When you have other health coverage v1.0 01/01/2023
FBF23.09.1.1 TRICARE and CHAMPVA v1.0 01/01/2023
FBF23.09.1.2 Workers' Compensation v1.0 01/01/2023
FBF23.09.1.3 Medicaid v1.0 01/01/2023
FBF23.09.2 When other Government agencies are responsible for your care v1.0 01/01/2023
FBF23.09.3 When others are responsible for injuries v1.0 01/01/2023
FBF23.09.4 When you have Federal Employees Dental and Vision Insurance Plan (FEDVIP) v1.0 01/01/2023
FBF23.09.5 Clinical trials v1.0 01/01/2023
FBF23.09.6.1 When you have Medicare v1.0 01/01/2023
FBF23.09.6.2 The Original Medicare Plan (Part A or Part B) v1.0 01/01/2023
FBF23.09.6.3 Tell us about your Medicare coverage v1.0 01/01/2023
FBF23.09.6.4 Private contract with your physician v1.0 01/01/2023
FBF23.09.6.5 Medicare Advantage (Part C) v1.0 01/01/2023
FBF23.09.6.6 Medicare prescription drug coverage (Part D) v1.0 01/01/2023
FBF23.09.6.7 Medicare prescription drug coverage (Part B) v1.0 01/01/2023
FBF23.09.6.8 Primary payor chart v1.0 01/01/2023
FBF23.09.7 When you are age 65 or over and do not have Medicare v1.0 01/01/2023
FBF23.09.8 Physicians Who Opt-Out of Medicare v1.0 01/01/2023
FBF23.09.9 When you have the Original Medicare Plan (Part A, Part B, or both) v1.0 01/01/2023
FBF23.09.95 Cost-share when Medicare is your primary payor v1.0 01/01/2023
FBF23.10 Section 10. Definitions of Terms We Use in This Brochure v1.0 01/01/2023
FBF23.11 Index v1.0 01/01/2023
FBF23.12 Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - 2023 v1.0 01/01/2023
FBF23.13 2023 Rate Information for the Blue Cross and Blue Shield Service Benefit Plan v1.0 01/01/2023
FBF23.14 Entire brochure in page-number order v1.0 01/01/2023
FBF23-000-1 Cover page v1.0 01/01/2023
FBF23-000-2 Inside cover v1.0 01/01/2023
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