2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(d). Emergency Services/Accidents
Page 84
Section 5(d). Emergency Services/Accidents
Page 84
Benefit Description
Medical Emergency (cont.)
Note: Benefits for crutches, splints, braces, etc. when billed by a provider other than the urgent care center are stated in Section 5(a), page 53.
You Pay
Preferred urgent care center: $25 copayment per visit (no deductible)
Non-preferred (Participating/Non-participating): You pay all charges
Medical Emergency (cont.)
- Urgent care centers, not licensed as or permitted to provide emergency services and supplies, including professional providers’ services, diagnostic studies, radiology services, laboratory tests and pathology services, when billed by the provider
Note: Benefits for crutches, splints, braces, etc. when billed by a provider other than the urgent care center are stated in Section 5(a), page 53.
You Pay
Preferred urgent care center: $25 copayment per visit (no deductible)
Non-preferred (Participating/Non-participating): You pay all charges
Benefit Description
Not covered: Emergency room professional charges for shift differentials
You Pay
All charges
Not covered: Emergency room professional charges for shift differentials
You Pay
All charges