2026 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Page 133

 

No Surprises Act (NSA) - 29-30
NON-CORE benefits - 127
Non-member facilities - 127-128
Non-participating providers - 29, 127-128
Non-preferred providers - 14-15, 17, 29
Nurse - 52-53, 72-74, 97
Nutritional counseling - 36-42, 65-68, 99
Observation care - 127
Obstetrical care - 42-43, 66-68
Occupational therapy - 47, 68-74
Office visits - 36-37, 80-81
Oral surgery - 58
Organ/tissue transplants - 58-63
Orthopedic devices - 49-50, 68-71
Osteoporosis screening - 129
Ostomy and catheter supplies - 51
Out-of-pocket expenses - 30, 128
Outpatient facility services - 68-71, 96, 126
Outpatient professional services - 36-37, 80-81
Overpayments - 31
Overseas Assistance Center - 101
Overseas services, drugs, supplies and claims - 101-103
Oxygen - 51, 65-74
Pap tests - 38-42
Participating providers - 127-128
Patient Safety and Quality Monitoring (PSQM) program - 87
Personal Health Record - 97
PET scans - 37, 68-71
Pharmacotherapy - 36-37, 46-47
Physical examinations - 38-42, 100
Physical therapy - 47, 68-74
Physician - 14-15, 129
Plan allowance - 127-128
PPO - 14-15, 17-19, 129
Pre-admission testing - 65-66
Precertification - 20, 129
Preferred providers - 14-15, 17, 19, 29
Pregnancy (see: Maternity care)
Prescription drugs
Brand-name drugs - 86, 88-89
Drugs from other sources - 94
Generic drugs - 86, 88-89
Preferred retail pharmacies - 85, 88-93, 108
Retail Pharmacy Program - 84-85, 87, 102-103
Self-injectable drugs - 35, 55, 64, 68-71
Specialty Drug Pharmacy Program - 84-86, 88-89, 94, 102-103, 108
Specialty drugs - 84-86, 88-89, 130
Preventive care
Adult - 38-40, 129
Child - 40-42
Primary care provider (PCP) - 34
Prior approval - 20-23, 25, 58-59, 62, 87
Professional providers - 17
Prostate cancer - 38-40
Prosthetic devices - 49-50, 65-66, 68-71
Psychotherapy - 80-83
Pulmonary rehabilitation - 20-23, 46-47, 68-71
Radiation therapy - 20-23, 46-47, 68-71
Reconsiderations - 27, 110-112
Replacement coverage - 12-13
Reproductive services - 20-23, 45
Assisted reproductive technology (ART) - 45, 123
Residential treatment center (RTC) - 17-20, 26, 71-72, 82
Rights and responsibilities - 14-15
Room and board - 65-68, 71-72, 82
Routine Annual Physical Incentive Program - 100
Screening services - 129
Second surgical opinion - 36-37
Self-injectable drugs - 35, 55, 64, 68-71
Skilled nursing facility (SNF) care - 51, 72, 124
Smoking cessation - 53-54, 90-93
Social worker - 98-99
Specialty Drug Pharmacy Program - 84-85, 88-89, 94, 108
Specialty drugs - 86, 88-89, 130
Speech therapy - 47, 68-74
Speech-generating devices - 50-51
Stem cell transplants - 59-61
Sterilization procedures - 44
Subrogation - 114-115, 130
Substance use disorder - 17, 35, 80-83
Surgery
Assistant surgeon - 35, 42-43, 55-57
Eye: cataract, amblyopia, strabismus - 48-49, 56-57
Multiple procedures - 55-57
Oral and maxillofacial - 58
Outpatient - 64, 127
Reconstructive - 57-58
Sterilization, reversal of voluntary - 44, 56-57
Surgical implants - 49-50, 68-71
Surgical treatment of severe obesity - 20-23, 56-57
Transplants - 20-23, 46-47, 58-63
Syringes - 88-89
Telehealth
Dermatology - 17, 36-37, 99, 130
Mental health/substance use disorder - 17, 80-83, 99
Minor acute conditions - 17, 36-37, 99, 127
Nutritional counseling - 17, 38-42, 99
Temporary Continuation of Coverage (TCC) - 12
Tobacco cessation - 53-54, 90-93
Transplants - 20-23, 58-63
Travel benefit - 62, 97
Treatment therapies - 46-47
TRICARE - 113-114
Ultrasounds - 37, 68-71
Urgent care center - 76-79
Urgent care claims - 26, 130
VA facility - 121
Vaccines - 38-42, 90-93
Verbal statements - 4, 27, 98-99
Vision services - 48-49, 115
Waivers - 29
Weight control - 20-23, 38-42, 100
Wheelchairs - 20-23, 50-51
Wigs - 49-50
WRAP benefits - 131
X-rays - 37, 68-71