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2024 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

Medical Supplies
 
Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.

Benefit Description

Medical Supplies
Covered medical supplies include:

 
  • Medical foods and nutritional supplements when administered by catheter or nasogastric tubes
    Note: See Section 10 for the definition of medical foods.
     
  • Ostomy and catheter supplies
     
  • Oxygen
    Note: When billed by a skilled nursing facility, nursing home, or extended care facility, we pay benefits as shown here for oxygen, according to the contracting status of the facility. See Section 5(c) for outpatient services received while in a skilled nursing facility.
     
  • Blood and blood plasma, except when donated or replaced, and blood plasma expanders

Note: We cover medical supplies at Preferred benefit levels only when you use a Preferred medical supply provider. Preferred physicians, facilities, and pharmacies are not necessarily Preferred medical supply providers.


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

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

Not covered:

 
  • Infant formulas used as a substitute for breastfeeding
     
  • Diabetic supplies, except as described in Section 5(f) or when Medicare Part B is primary, or you are enrolled in the FEP Medicare Prescription Drug Program
     
  • Medical foods administered orally, except as described in Section 5(f)


You Pay
All charges