2026 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5. FEP Blue Focus Benefits

 

Section 5. FEP Blue Focus Benefits

 

See Section 2 for how our benefits changed this year. See near the end of the brochure for a summary of benefits for this plan and Section 5 provides an overview of FEP Blue Focus.

 

Section 5. FEP Blue Focus Overview - 34
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals - 35
Diagnostic and Treatment Services - 36
Lab, X-ray and Other Diagnostic Tests - 37
Preventive Care, Adult - 38
Preventive Care, Child - 40
Maternity Care - 42
Family Planning - 43
Reproductive Services - 44
Allergy Care - 45
Treatment Therapies - 46
Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy - 47
Hearing Services - 47
Vision Services (Testing, Treatment, and Supplies) - 48
Foot Care - 49
Orthopedic and Prosthetic Devices - 49
Durable Medical Equipment (DME) - 50
Medical Supplies - 51
Home Health Services - 51
Alternative/Manipulative Treatments - 52
Educational Classes and Programs - 52
Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals - 53
Surgical Procedures - 54
Reconstructive Surgery - 55
Oral and Maxillofacial Surgery - 56
Organ/Tissue Transplants - 57
Anesthesia - 61
Section 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services - 62
Inpatient Hospital - 63
Maternity - Facility - 64
Outpatient Hospital or Ambulatory Surgical Center - 66
Residential Treatment Center - 69
Extended Care Benefits/Skilled Nursing Care Facility Benefits - 70
Hospice Care - 70
Ambulance - 73
Section 5(d). Emergency Services/Accidents - 74
Accidental injury - 75
Medical Emergency - 76
Ambulance - 77
Section 5(e). Mental Health and Substance Use Disorder Benefits - 78
Professional Services - 78
Inpatient Hospital or Other Covered Facility - 80
Residential Treatment Center - 80
Outpatient Hospital or Other Covered Facility - 80
Section 5(f). Prescription Drug Benefits - 82
Covered Medications and Supplies - 86
Section 5(f)(a). FEP Medicare Prescription Drug Program - 88
Covered Medications and Supplies - 92
Section 5(g). Dental Benefits - 99
Accidental Injury Benefit - 99
Inpatient and Outpatient Facility Care - 100
Section 5(h). Wellness and Other Special Features - 101
Health Tools - 101
Services for the Deaf and Hearing Impaired - 101
Web Accessibility for the Visually Impaired - 101
Travel Benefit/Services Overseas - 101
Healthy Families - 101
Blue Health Assessment - 101
Hypertension Management Program - 101
MyBlue® Customer eService - 102
National Doctor & Hospital Finder - 102
Care Management Programs - 102
Flexible Benefits Option - 103
Telehealth Services - 103
Routine Annual Physical Incentive Program - 104
The fepblue Mobile Application - 104
Weight Loss Management Program - 104
Section 5(i) Services, Drugs, and Supplies Provided Overseas - 105
Non-PSHB Benefits Available to Plan Members - 108