2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Index
Page 167
Index
Page 167
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 - 47-48, 136-137
Accidental injury - 19-20, 90-93, 123-124, 157
Acupuncture - 60-61, 73-74
Affordable Care Act (ACA) - 116-121
Allergy care - 51-52
Allogeneic transplants - 69-71
Alternative treatments - 60-61
Ambulance - 88-89
Ambulatory surgical center - 78-82
Anesthesia - 73-74
Angiographies - 40-41, 78-82
Appeals - 27, 142-144
Applied behavior analysis (ABA) - 52-53, 78-82
Assistant surgeon - 19-20, 62-64
Autism spectrum disorder - 52-53, 78-82
Autologous transplants - 69-71
Average wholesale price (AWP) - 104-108, 161-163
Biopsies - 63-64, 78-82
Birthing centers - 17-19
Blood and blood plasma - 58-59, 78-82
Blood or marrow stem cell transplants - 68-73
Blue Distinction Centers - 17-19, 72-73, 82-83 Blue Health Assessment - 127-128,159
Bone density tests - 40-41, 78-82
Brand-name drugs - 100-101, 104-108, 110-111
Breast pump and supplies - 47-48
Breast reconstruction - 64-66Breastfeeding support and supplies - 47-48
Cancer Tests - 42-44
Cardiac rehabilitation - 52-53, 78-82
Cardiovascular monitoring - 40-41, 78-82
Care Management Programs - 129-130
Case management - 85-87, 129-131
Casts - 76-82
Catastrophic protection - 33-34, 112-113, 170, 172
Cervical cancer screening - 42-46
CHAMPVA - 146-147
Changes for 2025 - 16
Chemotherapy - 52-53, 78-82
Children’s Equity Act - 11
Chiropractic manipulative treatment - 60
Cholesterol tests - 42-44
Circumcision - 47-48, 63-64
Claims and claims filing - 138-141
Clinic visits - 39-40, 95-96
Clinical trials - 71, 148-149
Cognitive rehabilitation - 53-54, 78-82
Coinsurance - 29-32
Colorectal cancer tests - 42-44Confidentiality - 14-15
Congenital anomalies - 63-64, 158
Consultations - 39-40, 95-96
Contact lenses - 54-55
Contraceptive devices and drugs - 49-50, 104-108, 113-121
Coordination of benefits - 146-156
Copayments - 28
Cosmetic surgery - 63-66, 158
Cost-sharing - 28
Costs for covered services - 28-34
Coverage information - 9
Covered facility providers - 17-19
Covered professional providers - 17
CT scans - 40-41, 78-82
Custodial care - 76-78, 83-85, 96-98, 158
Daily Habits - 127
Deductible - 28
Definitions - 157-166
Dental care - 123-126
Diabetes Management Program - 127
Diabetic education - 61, 78-82
Diabetic supplies - 57-59, 116-121
Diagnostic tests - 40-41, 94-98
Dialysis - 52-53, 57-58, 78-82
Disease Management - 129-130
Disputed claims process - 142-144
Divorce - 12
DNA analysis of stool samples - 42-44
Donor expenses (transplants) - 71-72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 57-58 Educational Classes and Programs - 61
EEGs - 40-41, 78-82
EKGs - 40-41, 78-82
Emergency - 88-93
Enrollment - 9-10
Exception situations - 19-21
Exclusions - 136-137
Experimental or investigational - 136-137, 159
Extended care benefits - 84-85
Eyeglasses - 54-55
Facility Providers - 17-19
Family planning - 49-50
Fecal occult blood test - 42-44
FEDVIP - 123, 148
fepblue mobile application - 131
fepblue.org - 4
Flexible benefits option - 130-131
Foot care - 56
Formulary/Preferred drug list - 100-101, 110-111
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility - 17-19, 68
Fraud - 4-5
Freestanding ambulatory facilities - 17-19
Gender Affirming Care - 64-66
Generic drugs - 100-101, 110-111
Generic Incentive Program - 102-104
Genetic screening/testing - 40-41, 78-82
Health Insurance Marketplace - 13
Health Tools - 127
Healthy Families - 127
Hearing aids and hearing services - 54, 56-57, 135
Home health services - 59 -60
Home nursing care (maternity) - 47-48, 59-60
Hospice care - 85-87
HospitalHuman papillomavirus (HPV) tests - 42-46
Hypertension Management Program - 128
Immunizations - 42-46, 116-121
Inpatient hospital benefits - 76-78
Inpatient professional services - 39-40, 95-96
Insulin - 104-108, 113-116
Insulin pumps - 57-58
Laboratory and Pathology Services - 19-20
Low-dose CT screening - 164
Mail Service Prescription Drug Program - 99-101, 104-108, 113-116, 133-134, 139-140
Mammograms - 42-44
Manipulative treatment - 60, 78-82
Maternity care - 26, 47-48
Maxillofacial surgery - 67
Medicaid - 147
Medical emergency -76-78, 90, 92-93
Medical foods - 58-59, 102-108, 112-116, 160
Medical supplies - 58-59, 76-82, 85-87
Medically necessary - 5-6
Accidental injury - 19-20, 90-93, 123-124, 157
Acupuncture - 60-61, 73-74
Affordable Care Act (ACA) - 116-121
Allergy care - 51-52
Allogeneic transplants - 69-71
Alternative treatments - 60-61
Ambulance - 88-89
Ambulatory surgical center - 78-82
Anesthesia - 73-74
Angiographies - 40-41, 78-82
Appeals - 27, 142-144
Applied behavior analysis (ABA) - 52-53, 78-82
Assistant surgeon - 19-20, 62-64
Autism spectrum disorder - 52-53, 78-82
Autologous transplants - 69-71
Average wholesale price (AWP) - 104-108, 161-163
Biopsies - 63-64, 78-82
Birthing centers - 17-19
Blood and blood plasma - 58-59, 78-82
Blood or marrow stem cell transplants - 68-73
Blue Distinction Centers - 17-19, 72-73, 82-83 Blue Health Assessment - 127-128,159
Bone density tests - 40-41, 78-82
Brand-name drugs - 100-101, 104-108, 110-111
Breast pump and supplies - 47-48
Breast reconstruction - 64-66Breastfeeding support and supplies - 47-48
Cancer Tests - 42-44
Cardiac rehabilitation - 52-53, 78-82
Cardiovascular monitoring - 40-41, 78-82
Care Management Programs - 129-130
Case management - 85-87, 129-131
Casts - 76-82
Catastrophic protection - 33-34, 112-113, 170, 172
Cervical cancer screening - 42-46
CHAMPVA - 146-147
Changes for 2025 - 16
Chemotherapy - 52-53, 78-82
Children’s Equity Act - 11
Chiropractic manipulative treatment - 60
Cholesterol tests - 42-44
Circumcision - 47-48, 63-64
Claims and claims filing - 138-141
Clinic visits - 39-40, 95-96
Clinical trials - 71, 148-149
Cognitive rehabilitation - 53-54, 78-82
Coinsurance - 29-32
Colorectal cancer tests - 42-44Confidentiality - 14-15
Congenital anomalies - 63-64, 158
Consultations - 39-40, 95-96
Contact lenses - 54-55
Contraceptive devices and drugs - 49-50, 104-108, 113-121
Coordination of benefits - 146-156
Copayments - 28
Cosmetic surgery - 63-66, 158
Cost-sharing - 28
Costs for covered services - 28-34
Coverage information - 9
Covered facility providers - 17-19
Covered professional providers - 17
CT scans - 40-41, 78-82
Custodial care - 76-78, 83-85, 96-98, 158
Daily Habits - 127
Deductible - 28
Definitions - 157-166
Dental care - 123-126
Diabetes Management Program - 127
Diabetic education - 61, 78-82
Diabetic supplies - 57-59, 116-121
Insulin pumps - 57-58
Insulin, test strips, and lancets - 104-108, 113-116
Needles and disposable syringes - 104-108, 113-116
Diagnostic and treatment services - 39-40, 78-82 Insulin, test strips, and lancets - 104-108, 113-116
Needles and disposable syringes - 104-108, 113-116
Diagnostic tests - 40-41, 94-98
Dialysis - 52-53, 57-58, 78-82
Disease Management - 129-130
Disputed claims process - 142-144
Divorce - 12
DNA analysis of stool samples - 42-44
Donor expenses (transplants) - 71-72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 57-58 Educational Classes and Programs - 61
EEGs - 40-41, 78-82
EKGs - 40-41, 78-82
Emergency - 88-93
Enrollment - 9-10
Exception situations - 19-21
Exclusions - 136-137
Experimental or investigational - 136-137, 159
Extended care benefits - 84-85
Eyeglasses - 54-55
Facility Providers - 17-19
Family planning - 49-50
Fecal occult blood test - 42-44
FEDVIP - 123, 148
fepblue mobile application - 131
fepblue.org - 4
Flexible benefits option - 130-131
Foot care - 56
Formulary/Preferred drug list - 100-101, 110-111
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility - 17-19, 68
Fraud - 4-5
Freestanding ambulatory facilities - 17-19
Gender Affirming Care - 64-66
Generic drugs - 100-101, 110-111
Generic Incentive Program - 102-104
Genetic screening/testing - 40-41, 78-82
Health Insurance Marketplace - 13
Health Tools - 127
Healthy Families - 127
Hearing aids and hearing services - 54, 56-57, 135
Home health services - 59 -60
Home nursing care (maternity) - 47-48, 59-60
Hospice care - 85-87
HospitalHuman papillomavirus (HPV) tests - 42-46
Hypertension Management Program - 128
Immunizations - 42-46, 116-121
Inpatient hospital benefits - 76-78
Inpatient professional services - 39-40, 95-96
Insulin - 104-108, 113-116
Insulin pumps - 57-58
Laboratory and Pathology Services - 19-20
Low-dose CT screening - 164
Mail Service Prescription Drug Program - 99-101, 104-108, 113-116, 133-134, 139-140
Mammograms - 42-44
Manipulative treatment - 60, 78-82
Maternity care - 26, 47-48
Maxillofacial surgery - 67
Medicaid - 147
Medical emergency -76-78, 90, 92-93
Medical foods - 58-59, 102-108, 112-116, 160
Medical supplies - 58-59, 76-82, 85-87
Medically necessary - 5-6
Reimbursement account - 129