2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Page 140
Index
Page 140
Index
Abortion - 111-112
Accidental injury - 77-78, 101, 131
Acupuncture - 53, 63, 68-71
Affordable Care Act (ACA) - 13, 96-99
Allergy care - 46
Allogeneic transplants - 60-62
Alternative treatments - 53
Ambulance - 75
Ambulatory surgical center - 17-18, 68-71
Anesthesia - 63
Angiographies - 38, 68-71
Appeals - 28, 116-118
Applied behavior analysis (ABA) - 20-23, 47, 68-71
Assistant surgeon - 19, 55-56
Autism spectrum disorder - 47, 68-71
Autologous transplants - 59-62
Biopsies - 39-41, 55-56, 68-71
Birthing centers - 17-18
Blood and blood plasma - 52, 68-71
Blood or marrow stem cell - 59-62
Blue Distinction Centers - 17-18, 59-60
for Transplants - 58-60, 62
Blue Distinction Specialty Care - 17-18
Blue Health Assessment - 103-104
Bone density tests - 38, 68-71
Brand-name drugs - 84-86, 88-89, 91-92, 94-95
Breast pump and supplies - 43-44
Breast reconstruction -56-57
Cardiac rehabilitation - 47, 68-71
Cardiovascular monitoring - 38, 68-71
Care Management Programs - 104-105
Case management - 72-74, 104-105
Casts - 54-55, 65-66, 68-71
Catastrophic protection - 31-32, 93-94
Cervical cancer screening - 39-43
CHAMPVA - 120-121
Changes for 2025 - 16
Chemotherapy - 47, 68-71
Children’s Equity Act - 11
Chiropractic manipulative treatment - 53, 68-71
Cholesterol tests - 38-41
Circumcision - 55-56
Claims and claims filingClinical trials - 60-62, 123, 132
Cognitive rehabilitation - 48, 68-72
Coinsurance - 29, 31-32
Colonoscopy - 39-41, 55-56, 68-71
Colorectal cancer testsCongenital anomalies - 55-56, 132
Consultations - 37-38, 80-81
Contact lenses - 49
Contraceptives - 44-45, 68-71, 88-89, 94-99
Coordination of benefits - 24-25, 120-130
Copayments - 29, 31-32
CORE benefits - 35, 132
Cosmetic surgery - 55-57, 132
Cost-share/cost-sharing - 29
Costs for covered services - 29-32
Coverage information - 9
Covered facility providers - 17-18
Covered professional providers - 17
CT scans - 38, 68-71
Custodial or long term care - 111-112, 132
Daily Habits - 103
Deductible - 29
Definitions - 131-139
Dental care - 101-102
Diabetic education - 53, 68-71
Diabetic supplies
Dialysis - 47, 51-52, 68-52, 71
Disease Management - 104-105
Disputed claims - 116-118
Divorce - 12
DNA analysis of stool samples - 39-41
Donor expenses - 62
Drugs (see: Prescription drugs)
Durable medical equipment - 51-52, 68-71, 132-133Educational classes and programs - 53
EEGs - 38, 68-71
EKGs - 38, 68-71
Emergency - 27, 76-79
Enrollment - Inside cover, 9-10
Exception situations - 19-20
Exclusions - 111-112
Experimental or investigational - 133
Extended care benefits - 72
Eyeglasses - 49
Facility providers - 17-18
Family planning - 44-45
Fecal occult blood test - 39-41
FEDVIP - 101, 122
fepblue mobile application - 106
fepblue.org - 4
Flexible benefits option - 105
Foot care - 50
Formulary/Preferred drug list - 84 -86, 90-92
Fraud - 4
Gender affirming care - 56-57
Generic drugs - 86-89, 94-95
Generic equivalents - 86-87, 92-93
Genetic screening/testing - 38, 68-71
Health Insurance Marketplace - 13
Health tools - 103
Healthy Families - 103
Hearing aids and hearing services - 48, 50, 111-112
Home health services - 52-53
Home nursing care (maternity) - 52-53
Hospice care - 72-74
Hospital - Human papillomavirus (HPV) tests - 39-43
Hypertension Management Program - 103-104
Identification cards - 17
Immunizations - 39-43, 96-99
Inpatient hospital benefits - 65-66
Inpatient professional services - 37-38, 80-81
Insulin - 88-89, 94-95
Insulin pumps - 51-52
Laboratory and pathology services - 38, 65-66, 68-71, 77-79
Low-dose CT screening - 138
Mammograms - 39-41
Manipulative treatment - 53, 68-71
Maternity care - 25, 27, 43-44, 66-68
Maxillofacial surgery - 58
Medicaid - 121
Medical emergency - 76-79
Medical foods - 52, 87-88, 93-94, 134
Medical supplies - 52, 65-66, 72-74
Medically necessary - 20, 27, 51-52, 71-72, 75
Medicare - Inside cover, 24-25, 120-130
Medications and supplies - 88-89, 94-99
Medications to promote better health - 96-99
Member facilities - 14-15
Mental health/substance use disorder - 80-83, 105
MRIs - 38, 68-71
Multiple procedures - 54 -55
MyBlue Customer eService - 104
Accidental injury - 77-78, 101, 131
Acupuncture - 53, 63, 68-71
Affordable Care Act (ACA) - 13, 96-99
Allergy care - 46
Allogeneic transplants - 60-62
Alternative treatments - 53
Ambulance - 75
Ambulatory surgical center - 17-18, 68-71
Anesthesia - 63
Angiographies - 38, 68-71
Appeals - 28, 116-118
Applied behavior analysis (ABA) - 20-23, 47, 68-71
Assistant surgeon - 19, 55-56
Autism spectrum disorder - 47, 68-71
Autologous transplants - 59-62
Biopsies - 39-41, 55-56, 68-71
Birthing centers - 17-18
Blood and blood plasma - 52, 68-71
Blood or marrow stem cell - 59-62
Blue Distinction Centers - 17-18, 59-60
for Transplants - 58-60, 62
Blue Distinction Specialty Care - 17-18
Blue Health Assessment - 103-104
Bone density tests - 38, 68-71
Brand-name drugs - 84-86, 88-89, 91-92, 94-95
Breast pump and supplies - 43-44
Breast reconstruction -56-57
Breast prostheses and surgical bras - 50
Cancer tests - 39-41Cardiac rehabilitation - 47, 68-71
Cardiovascular monitoring - 38, 68-71
Care Management Programs - 104-105
Case management - 72-74, 104-105
Casts - 54-55, 65-66, 68-71
Catastrophic protection - 31-32, 93-94
Cervical cancer screening - 39-43
CHAMPVA - 120-121
Changes for 2025 - 16
Chemotherapy - 47, 68-71
Children’s Equity Act - 11
Chiropractic manipulative treatment - 53, 68-71
Cholesterol tests - 38-41
Circumcision - 55-56
Claims and claims filingClinical trials - 60-62, 123, 132
Cognitive rehabilitation - 48, 68-72
Coinsurance - 29, 31-32
Colonoscopy - 39-41, 55-56, 68-71
Colorectal cancer testsCongenital anomalies - 55-56, 132
Consultations - 37-38, 80-81
Contact lenses - 49
Contraceptives - 44-45, 68-71, 88-89, 94-99
Coordination of benefits - 24-25, 120-130
Copayments - 29, 31-32
CORE benefits - 35, 132
Cosmetic surgery - 55-57, 132
Cost-share/cost-sharing - 29
Costs for covered services - 29-32
Coverage information - 9
Covered facility providers - 17-18
Covered professional providers - 17
CT scans - 38, 68-71
Custodial or long term care - 111-112, 132
Daily Habits - 103
Deductible - 29
Definitions - 131-139
Dental care - 101-102
Diabetic education - 53, 68-71
Diabetic supplies
Diabetic Meter Program - 96-99
Insulin pumps - 51-52
Insulin, test strips, and lancets - 88-89, 94-99
Needles and disposable syringes - 88-89, 94-95
Diagnostic tests - 38, 43-44, 49, 80-83Insulin pumps - 51-52
Insulin, test strips, and lancets - 88-89, 94-99
Needles and disposable syringes - 88-89, 94-95
Dialysis - 47, 51-52, 68-52, 71
Disease Management - 104-105
Disputed claims - 116-118
Divorce - 12
DNA analysis of stool samples - 39-41
Donor expenses - 62
Drugs (see: Prescription drugs)
Durable medical equipment - 51-52, 68-71, 132-133Educational classes and programs - 53
EEGs - 38, 68-71
EKGs - 38, 68-71
Emergency - 27, 76-79
Enrollment - Inside cover, 9-10
Exception situations - 19-20
Exclusions - 111-112
Experimental or investigational - 133
Extended care benefits - 72
Eyeglasses - 49
Facility providers - 17-18
Family planning - 44-45
Fecal occult blood test - 39-41
FEDVIP - 101, 122
fepblue mobile application - 106
fepblue.org - 4
Flexible benefits option - 105
Foot care - 50
Formulary/Preferred drug list - 84 -86, 90-92
Fraud - 4
Gender affirming care - 56-57
Generic drugs - 86-89, 94-95
Generic equivalents - 86-87, 92-93
Genetic screening/testing - 38, 68-71
Health Insurance Marketplace - 13
Health tools - 103
Healthy Families - 103
Hearing aids and hearing services - 48, 50, 111-112
Home health services - 52-53
Home nursing care (maternity) - 52-53
Hospice care - 72-74
Hospital - Human papillomavirus (HPV) tests - 39-43
Hypertension Management Program - 103-104
Identification cards - 17
Immunizations - 39-43, 96-99
Inpatient hospital benefits - 65-66
Inpatient professional services - 37-38, 80-81
Insulin - 88-89, 94-95
Insulin pumps - 51-52
Laboratory and pathology services - 38, 65-66, 68-71, 77-79
Low-dose CT screening - 138
Mammograms - 39-41
Manipulative treatment - 53, 68-71
Maternity care - 25, 27, 43-44, 66-68
Maxillofacial surgery - 58
Medicaid - 121
Medical emergency - 76-79
Medical foods - 52, 87-88, 93-94, 134
Medical supplies - 52, 65-66, 72-74
Medically necessary - 20, 27, 51-52, 71-72, 75
Medicare - Inside cover, 24-25, 120-130
Medications and supplies - 88-89, 94-99
Medications to promote better health - 96-99
Member facilities - 14-15
Mental health/substance use disorder - 80-83, 105
MRIs - 38, 68-71
Multiple procedures - 54 -55
MyBlue Customer eService - 104