You need prior Plan approval for certain services

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2025 PSHB Standard and Basic Options brochure

Cover Page and Inside Cover

Table of Contents

Introduction/Plain Language/Advisory

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(f)(a). FEP Medicare Prescription Drug Plan

5(g). Dental Benefits

5(h). Wellness and Other Special Features

5(i). Services, Drugs, and Supplies Provided Overseas

Non-PSHB Benefits Available to Plan Members

Summary of Benefits – FEP Blue Focus

2025 Rate Information

Blue Cross and Blue Shield Service Benefit Plan Brochure - 2025

PSHB FEP Blue Focus

You need prior Plan approval for certain services

You need prior Plan approval for certain services

Inpatient hospital admission, inpatient residential treatment center admission

Special prior authorization situations related to coordination of benefits (COB)

Prior notification - Maternity care

How to request precertification for an admission or get approval for Other services

Non-urgent care claims

Urgent care claims

Concurrent care claims

Emergency inpatient admission

If your hospital stay needs to be extended

If your treatment needs to be extended

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