2026 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Page 138

 

Neurological testing - 37, 66-69
Never Events - 6-8, 132
Newborn care - 10, 26-27, 36-37, 42-43, 64-66
No Surprises Act (NSA) - 29-30
NON-CORE benefits - 132
Non-member facilities - 133-134
Non-participating providers - 29, 133-134
Non-preferred providers - 14-15, 17, 29
Non-PSHB benefits - 108
Nurse - 51-52, 70-72, 101
Nutritional counseling - 17, 36-42, 63-64, 103
Observation care - 132
Obstetrical care - 42-43, 64-66
Occupational therapy - 47, 66-72
Office visits - 36-37, 78-79
Oral surgery - 56
Organ/tissue transplants - 20-23, 56-58, 60
Orthopedic devices - 49, 66-69
Osteoporosis screening - 135
Ostomy and catheter supplies - 51
Out-of-pocket expenses - 30-31
Outpatient facility services - 44-45, 66-69, 100
Outpatient professional services - 36-37, 78-79
Overpayments - 31
Overseas Assistance Center - 73, 105
Overseas services, drugs, supplies and claims - 105-107
Oxygen - 50-51, 63-72
Pap tests - 38-42
Participating providers - 29, 133-134
Patient Safety and Quality Monitoring (PSQM) program - 84-85
Personal Health Record - 101
PET scans - 37, 66-69
Pharmacotherapy - 36-37, 46
Physical examinations - 66-69, 109-110
Physical therapy - 47, 66-72
Physician - 14-15
Plan allowance - 29, 133-134
PPO - 14-15, 134
Pre-admission testing - 63-64
Precertification - 20, 25, 134
Preferred providers - 14-15
Pregnancy (see: Maternity care)
Prescription drugs
Brand-name drugs - 83-84, 86-87, 89-90, 92-93
Drugs from other sources - 98
Generic drugs - 83-87, 89-93
Preferred retail pharmacies - 14-15, 83-84, 86-87, 112
Retail Pharmacy Program - 82-84, 106-107, 111
Self-injectable drugs - 35, 53, 62, 66-69
Specialty Drug Pharmacy Program - 82-84, 86-87, 106-107, 112
Specialty drugs - 83-84, 86-87, 89-90, 92-93, 135
Preventive care
Adult - 38-40
Child - 40-42
Primary care provider (PCP) - 136
Prior approval - 20-23
Professional providers - 14-15, 17
Prostate cancer - 38-40
Prosthetic devices - 49, 63-64, 66-69
Psychotherapy - 78-81
Pulmonary rehabilitation - 46, 66-69
Radiation therapy - 46, 66-69
Reconsiderations - 27, 114-116
Replacement coverage - 13
Reproductive services - 44-45
Assisted reproductive technology (ART) - 128
Residential treatment center (RTC) - 17-18, 26, 69-70, 80
Rights and responsibilities - 14-15
Room and board - 63-66, 69-70, 80
Routine Annual Physical Incentive Program - 104
Screening services - 135
Second surgical opinion - 36-37
Self-injectable drugs - 35, 53, 62, 66-69
Skilled nursing facility (SNF) care - 70
Smoking cessation - 52, 94-98
Social worker - 102-103
Specialty Drug Pharmacy Program - 82-84, 86-87, 106-107, 112
Specialty drugs - 83-84, 86-87, 89-90, 92-93
Speech therapy - 47, 66-72
Speech-generating devices - 50-51
Stem cell transplants - 57-60
Sterilization procedures - 43-44
Subrogation - 119-120, 135
Substance use disorder - 17, 78-81, 103
Surgery
Assistant surgeon - 19, 35, 53-55
Eye: cataract, amblyopia, strabismus - 48, 54-55
Multiple procedures - 53-55
Oral and maxillofacial - 56
Outpatient - 53-61, 66-69
Reconstructive - 55
Sterilization, reversal of voluntary - 43-44, 54-55
Surgical implants - 49, 66-69
Surgical treatment of severe obesity - 20-23
Transplants - 20-23, 56-60
Syringes - 86-87, 92-93
Telehealth
Dermatology - 17, 36-37, 103
Mental health/substance use disorder - 17, 103
Minor acute conditions - 17, 36-37, 103
Nutritional counseling - 17, 103
Temporary Continuation of Coverage (TCC) - 12-13
Tobacco cessation - 52, 94-98
Transplants - 20-23, 56-60
Travel benefit - 60, 101
Treatment therapies - 46-47
TRICARE - 118-119
Ultrasounds - 37, 66-69
Urgent care center - 75-77
Urgent care claims - 26, 136
VA facility - 31, 126
Vaccines - 38-42
Verbal statements - 4, 27
Vision services - 48, 120
Waivers - 29
Weight control - 38-42, 101
Wheelchairs - 50-51
Wigs - 49
WRAP benefits - 136
X-rays - 19, 37, 66-69