2026 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Page 44

 

Benefit Description

Family Planning (cont.)
 
  • Implantable contraceptives
     
  • Salpingectomy
     
  • Tubal ligation or tubal occlusion/tubal blocking procedures only
     
  • Vasectomy

Notes:
 
  • We also provide benefits for professional services associated with tubal ligation/occlusion/blocking procedures, vasectomy, and with the fitting, insertion, or removal of the contraceptives as shown on the previous page including counseling and follow-up care at the payment levels shown here. The contraceptive benefit includes at least one option in each of the HRSA-supported categories of contraception (as well as the screening, education, and follow up care). Any voluntary sterilization surgery that is not already available without cost-sharing can be accessed through the contraceptive exceptions process. Simply visit www.fepblue.org, type in family planning and look for the exception form under our voluntary family planning services, or you may call the number on the back of your ID card and request a form. If you have difficulty accessing contraceptive coverage or other reproductive healthcare, you can contact contraception@opm.gov.
     
  • When billed by a facility, such as the outpatient department of a hospital, we provide benefits as shown here, according to the contracting status of the facility.
     
  • See additional Family Planning and Prescription drug coverage in Section 5(f), or 5(f)(a) if applicable.


You Pay
Preferred: Nothing (no deductible)

Non-preferred (Participating/Non-participating): You pay all charges

 

Benefit Description
 
  • Oral and transdermal contraceptives
    Note: We waive your cost-share for generic oral and transdermal contraceptives when you purchase them at a Preferred retail pharmacy; see Section 5(f), or 5(f)(a) if applicable.


You Pay
Preferred: 30% of the Plan allowance (deductible applies)

Non-preferred (Participating/Non-participating): You pay all charges

 

Benefit Description

Not covered:
 
  • Reversal of voluntary surgical sterilization
     
  • Contraceptive devices not described above
     
  • Over-the-counter (OTC) contraceptives, except as described in Section 5(f), or 5(f)(a) if applicable.


You Pay
All charges

 

Benefit Description

Reproductive Services
Members who meet our definition of infertility in Section 10, are eligible for the following reproductive services:
  • Artificial insemination (AI)
     
    • Intracervical insemination (ICI)
       
    • Intrauterine insemination (IUI)
       
    • Intravaginal insemination (IVI)

Note:  We also provide the benefits seen here when these services are billed by an outpatient facility. See Section 5(f) or 5(f)(a), Prescription Drug Benefits, for your cost-shares associated with drugs for covered AI procedures.

Fertility preservation for iatrogenic infertility:
 
 
You Pay
Preferred: 30% of the Plan allowance (deductible applies)

Non-preferred (Participating/Non-participating): You pay all charges

 

Reproductive Services - continued on next page