2024 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Page 138
Index
Page 138
Index
Do not rely only on this page; it is for your convenience and may not show all pages where the terms appear. This Index is not an official statement of benefits.
Abortion - 44 - 45, 67 - 69, 111 - 112
Accidental injury - 76 -79, 101
Acupuncture - 53 - 54, 69 - 72
Affordable Care Act (ACA) - 9, 12
Allergy care - 47
Allogeneic transplants - 61 - 63
Alternative treatments - 53 - 54
Ambulance - 21 - 24, 76
Ambulatory surgical center - 69 -72, 100
Anesthesia - 44 - 45, 66 - 72, 102
Angiographies - 39 -40, 69 - 72
Appeals - 29, 115 -118
Applied behavior analysis (ABA) - 21 -24, 47 -48, 69 -72, 111 - 112
Assistant surgeon - 20
Autism spectrum disorder - 47 - 48, 69 - 72, 111 - 112
Autologous transplants - 59 - 63
Biopsies - 40 -42, 56 - 57, 69 - 72
Birthing centers - 19 - 20, 26, 44 - 45, 66 - 69
Blood and blood plasma - 52 - 53, 69 - 72
Blood or marrow stem cell - 21 - 24, 47 - 48, 59 - 63
Blue Distinction Centers - 19 - 20 Blue Distinction Specialty Care - 19 - 24
Blue Health Assessment - 40 - 42, 103, 132
Bone density tests - 39 - 40, 69 - 72
Brand-name drugs - 96 - 99
BRCA - 21 - 24, 39 - 42
Breast pump and supplies - 44 - 45
Breast reconstruction - 57 - 59
Cancer tests - 40 - 42
Cardiac rehabilitation - 21 - 24, 47 - 48, 69 - 72
Cardiovascular monitoring - 39 - 40, 69 - 72
Care Management Programs - 104 - 105
Case management - 104 - 105
Casts - 56 - 57, 66 - 67, 69 - 72
Catastrophic protection - 32, 127 - 128, 142
Cervical cancer screening - 40 - 43
CHAMPVA - 119 - 120
Changes for 2021 - 15 - 17
Chemotherapy - 47 - 48, 63, 69 - 72
Children’s Equity Act - 10 - 11
Chiropractic manipulative treatment - 47 - 48, 53 - 54
Cholesterol tests - 39 - 42
Circumcision - 44 - 45, 56 - 57, 67 - 69
Claims and claims filingClinic visits - 38 - 39, 69 - 72, 81 - 82
Clinical trials - 21 - 24, 61 - 62, 122, 130
Cognitive rehabilitation - 48 - 49, 69 - 73, 113
Coinsurance - 30, 107, 130
Colonoscopy - 40 - 42 , 56 - 57, 69 - 72
Colorectal cancer testsConfidentiality - 13 - 14
Congenital anomalies - 21 - 24, 56 - 57, 130
Consultations - 38 - 39, 81 - 82
Contact lenses - 49 - 50, 110
Contraceptives - 45 - 46, 69 - 72, 96 - 99
Coordination of benefits - 119 - 128
Copayments - 30
CORE benefits - 36
Cosmetic surgery - 56 - 59, 130
Cost-share/cost-sharing - 30
Costs for covered services - 30 - 33
Coverage information - 9
Covered facility providers - 19 - 20
Covered professional providers - 18
CT scans - 39 - 40, 69-72, 129
Custodial or long term care - 130
Deductible - 30
Definitions - 129 - 137
Dental care - 101 - 102, 110, 121
Diabetic education - 54, 69 - 72
Diabetic supplies
Diagnostic tests - 39 - 40, 81 - 84
Dialysis - 47 - 48, 51 - 52, 69 - 72
Disease Management - 104 - 105
Disputed claims - 28 - 29, 116 - 118
Divorce - 12
DNA analysis of stool samples - 40 - 42
Donor expenses - 63
Drugs (see: Prescription drugs)
Durable medical equipment - 51 - 52, 69 - 72, 130 - 131 Educational classes and programs - 54
EEGs - 39 - 40, 69 - 72
EKGs - 39 - 40, 69 - 72
Emergency - 20, 27, 76 - 80, 101, 107
Enrollment - 9 - 10, 18, 20 - 21
Exception situations - 20
Exclusions - 111 - 112
Experimental or investigational - 59 - 60, 111 - 112, 131
Extended care benefits - 73
Eyeglasses - 49 - 50
Facility providers - 19 - 20
Family planning - 45 - 46
Fecal occult blood test - 40 - 42
FEDVIP - 101 - 121
fepblue mobile application - 106
fepblue.org - 4
Flexible benefits option - 105
Foot care - 50
Formulary/Preferred drug list - 87
Fraud - 4 - 5
Gender affirming care - 21 - 24, 51, 55 - 57, 65
Generic drugs - 96 - 99
Generic equivalents - 85 - 86
Genetic screening/testing - 21 - 24, 39 - 40, 69 -72
Health Insurance Marketplace - 12
Health tools - 103
Healthy Families - 103
Hearing aids and hearing services - 49
Home health services - 53
Home nursing care (maternity) - 44 - 45, 53
Hospice care - 73 - 75
Hospital - 19 - 20 Human papillomavirus (HPV) tests - 40 - 43
Hypertension Management Program - 103 - 104
Identification cards - 18
Immunizations - 40 - 43, 96 - 99
Inpatient hospital benefits - 66 - 67
Inpatient professional services - 38 - 39, 81 - 82
Insulin - 96 - 99
Insulin pumps - 51 - 52
Laboratory and pathology services - 20
Low-dose CT screening - 135
Mammograms - 40 - 42
Manipulative treatment - 53 - 54
Maternity care - 26, 28, 44 - 45
Maxillofacial surgery - 59
Medicaid - 120
Medical emergency - 77, 79 - 80
Medical foods - 52 - 53, 96 - 99, 132
Medical supplies - 52 - 53, 66 - 75, 96 - 99
Medically necessary - 21, 24, 28, 111 - 112, 132 - 133
Medicare - 1, 24 - 26, 119 - 128
Medications and supplies - 96 - 99
Medications to promote better health - 42 - 43, 96 - 99
Abortion - 44 - 45, 67 - 69, 111 - 112
Accidental injury - 76 -79, 101
Acupuncture - 53 - 54, 69 - 72
Affordable Care Act (ACA) - 9, 12
Allergy care - 47
Allogeneic transplants - 61 - 63
Alternative treatments - 53 - 54
Ambulance - 21 - 24, 76
Ambulatory surgical center - 69 -72, 100
Anesthesia - 44 - 45, 66 - 72, 102
Angiographies - 39 -40, 69 - 72
Appeals - 29, 115 -118
Applied behavior analysis (ABA) - 21 -24, 47 -48, 69 -72, 111 - 112
Assistant surgeon - 20
Autism spectrum disorder - 47 - 48, 69 - 72, 111 - 112
Autologous transplants - 59 - 63
Biopsies - 40 -42, 56 - 57, 69 - 72
Birthing centers - 19 - 20, 26, 44 - 45, 66 - 69
Blood and blood plasma - 52 - 53, 69 - 72
Blood or marrow stem cell - 21 - 24, 47 - 48, 59 - 63
Blue Distinction Centers - 19 - 20 Blue Distinction Specialty Care - 19 - 24
Blue Health Assessment - 40 - 42, 103, 132
Bone density tests - 39 - 40, 69 - 72
Brand-name drugs - 96 - 99
BRCA - 21 - 24, 39 - 42
Breast pump and supplies - 44 - 45
Breast reconstruction - 57 - 59
Breast prostheses and surgical bras - 51
Breastfeeding support and supplies - 44 - 45, 67 - 69 Cancer tests - 40 - 42
Cardiac rehabilitation - 21 - 24, 47 - 48, 69 - 72
Cardiovascular monitoring - 39 - 40, 69 - 72
Care Management Programs - 104 - 105
Case management - 104 - 105
Casts - 56 - 57, 66 - 67, 69 - 72
Catastrophic protection - 32, 127 - 128, 142
Cervical cancer screening - 40 - 43
CHAMPVA - 119 - 120
Changes for 2021 - 15 - 17
Chemotherapy - 47 - 48, 63, 69 - 72
Children’s Equity Act - 10 - 11
Chiropractic manipulative treatment - 47 - 48, 53 - 54
Cholesterol tests - 39 - 42
Circumcision - 44 - 45, 56 - 57, 67 - 69
Claims and claims filingClinic visits - 38 - 39, 69 - 72, 81 - 82
Clinical trials - 21 - 24, 61 - 62, 122, 130
Cognitive rehabilitation - 48 - 49, 69 - 73, 113
Coinsurance - 30, 107, 130
Colonoscopy - 40 - 42 , 56 - 57, 69 - 72
Colorectal cancer testsConfidentiality - 13 - 14
Congenital anomalies - 21 - 24, 56 - 57, 130
Consultations - 38 - 39, 81 - 82
Contact lenses - 49 - 50, 110
Contraceptives - 45 - 46, 69 - 72, 96 - 99
Coordination of benefits - 119 - 128
Copayments - 30
CORE benefits - 36
Cosmetic surgery - 56 - 59, 130
Cost-share/cost-sharing - 30
Costs for covered services - 30 - 33
Coverage information - 9
Covered facility providers - 19 - 20
Covered professional providers - 18
CT scans - 39 - 40, 69-72, 129
Custodial or long term care - 130
Deductible - 30
Definitions - 129 - 137
Dental care - 101 - 102, 110, 121
Diabetic education - 54, 69 - 72
Diabetic supplies
Diabetic Meter Program - 96 - 99
Insulin pumps - 51 - 52
Insulin, test strips, and lancets - 96 - 99
Needles and disposable syringes - 96 - 99
Diagnostic and treatment services - 38 - 39 Insulin pumps - 51 - 52
Insulin, test strips, and lancets - 96 - 99
Needles and disposable syringes - 96 - 99
Diagnostic tests - 39 - 40, 81 - 84
Dialysis - 47 - 48, 51 - 52, 69 - 72
Disease Management - 104 - 105
Disputed claims - 28 - 29, 116 - 118
Divorce - 12
DNA analysis of stool samples - 40 - 42
Donor expenses - 63
Drugs (see: Prescription drugs)
Durable medical equipment - 51 - 52, 69 - 72, 130 - 131 Educational classes and programs - 54
EEGs - 39 - 40, 69 - 72
EKGs - 39 - 40, 69 - 72
Emergency - 20, 27, 76 - 80, 101, 107
Enrollment - 9 - 10, 18, 20 - 21
Exception situations - 20
Exclusions - 111 - 112
Experimental or investigational - 59 - 60, 111 - 112, 131
Extended care benefits - 73
Eyeglasses - 49 - 50
Facility providers - 19 - 20
Family planning - 45 - 46
Fecal occult blood test - 40 - 42
FEDVIP - 101 - 121
fepblue mobile application - 106
fepblue.org - 4
Flexible benefits option - 105
Foot care - 50
Formulary/Preferred drug list - 87
Fraud - 4 - 5
Gender affirming care - 21 - 24, 51, 55 - 57, 65
Generic drugs - 96 - 99
Generic equivalents - 85 - 86
Genetic screening/testing - 21 - 24, 39 - 40, 69 -72
Health Insurance Marketplace - 12
Health tools - 103
Healthy Families - 103
Hearing aids and hearing services - 49
Home health services - 53
Home nursing care (maternity) - 44 - 45, 53
Hospice care - 73 - 75
Hospital - 19 - 20 Human papillomavirus (HPV) tests - 40 - 43
Hypertension Management Program - 103 - 104
Identification cards - 18
Immunizations - 40 - 43, 96 - 99
Inpatient hospital benefits - 66 - 67
Inpatient professional services - 38 - 39, 81 - 82
Insulin - 96 - 99
Insulin pumps - 51 - 52
Laboratory and pathology services - 20
Low-dose CT screening - 135
Mammograms - 40 - 42
Manipulative treatment - 53 - 54
Maternity care - 26, 28, 44 - 45
Maxillofacial surgery - 59
Medicaid - 120
Medical emergency - 77, 79 - 80
Medical foods - 52 - 53, 96 - 99, 132
Medical supplies - 52 - 53, 66 - 75, 96 - 99
Medically necessary - 21, 24, 28, 111 - 112, 132 - 133
Medicare - 1, 24 - 26, 119 - 128
Medications and supplies - 96 - 99
Medications to promote better health - 42 - 43, 96 - 99