2020 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Index
Index
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.
Accidental injury - 83-85, 103, 131
Acupuncture - 57-58, 71, 76-79
Allogeneic - 65-68
Ambulance - 72-83
Anesthesia - 59-71, 104
Applied behavior analysis (ABA) - 51-52, 76-79
Assistant surgeon - 18
Autologous - 64-70
Biopsy - 60-63
Birthing facilities - 48-49, 73-79
Blood and blood plasma - 56-57, 76-79
Blood or marrow stem cell - 64-70
Blue Distinction Centers - 16-17, 68-70
Blue Health Assessment - 105, 133
BRCA - 19-22, 40-46
Breast reconstruction - 63-64
Case management - 79-82, 106-107
Casts - 60-63, 73-74, 76-79
Catastrophic protection - 30, 143
Chemotherapy - 51-52, 68-70, 76-79
Circumcision - 48-49, 60-63, 74-76
Claims filing - 115-116
Coinsurance - 28, 109, 131
Colonoscopy - 41-46, 60-63, 76-79
Colorectal cancer tests - 41-46
Confidentiality - 13-14
Congenital anomalies - 60-63, 132
Contraceptives - 49-50, 76-79, 95-102
Coordinating benefits - 121-130
Copayments - 28, 132
Cosmetic surgery - 60-64, 132
Cost-share/cost-sharing - 28
Costs for covered services - 28-31
Covered facility providers - 16-17
Covered professional providers - 16
Custodial or long term care - 132
Deductible - 28
Dental care - 103-104, 112, 123
Diabetic education - 58, 76-79
Diabetic supplies - 95-102
Dialysis - 51-52, 55-56, 76-79
Disputed claims - 27, 118-120
Donor expenses - 68-70
Durable medical equipment - 55-56, 76-79, 132
Emergency - 18, 26, 83-86, 103, 109
Enrollment - 9-10, 16, 18, 124-125
Exclusions - 113-114
Experimental or investigational - 64-65, 113-114, 133
Eyeglasses - 53-54
Fecal occult blood - 41-46
Foot care - 54
Freestanding ambulatory facility - 16-17
Gender reassignment surgery - 19-22, 55, 59-63, 72
Generic equivalents - 91-92
Genetic testing - 19-22, 40-41, 76-79
Hearing services - 53
Home nursing care - 57, 115
Hospice care - 80-82
Hospital - 16-17, 19, 39-40, 72-83, 85-86, 89-90, 106, 109
Identification cards - 16
Immunizations - 41-47, 95-102
Inpatient professional services - 39-40, 87-88
Laboratory and pathology services - 18
Mammograms - 41-46
Maternity care - 24, 26, 48-49
Medicaid - 122
Medical foods - 56-57, 95-102, 134
Medical supplies - 56-57, 73-82, 95-102
Medically necessary - 134
Medications to promote better health - 46-47, 95-102
Member/Non-member facilities - 72-83, 87-90
Mental health - 87-90, 107, 134, 138
Multiple procedures - 60-63
Never events - 6-8, 134
Newborn care - 26, 39-40, 46-49, 74-76
Nutritional counseling - 39-47, 60-63, 73-76
Observation care - 134-135
Obstetrical care - 48-49, 74-76
Occupational therapy - 52-53, 76-82
Office visits - 39-40, 87-88
Orthopedic devices - 55, 63-64, 76-79
Ostomy and catheter supplies - 56-57
Out-of-pocket expenses - 30, 136-137
Outpatient - 19-22, 76-79, 90, 134-135
Overpayments - 31
Overseas claims - 30, 109-111
Oxygen - 55-57, 73-82
Patient Safety and Quality Monitoring program - 91-92
Pharmacotherapy - 39-40, 51-52
Physical examinations - 76-79, 113-114
Physical therapy - 52-53, 76-82
Physician - 16, 126, 129, 133, 137
Plan allowance - 29, 135-136
PPO/Participating/Non-participating providers - 13-14
Pre-admission testing - 73-74
Precertification - 19-22, 24-26, 59-60, 72, 79-80, 87, 89, 137
Prior approval - 19-22, 24-25, 40-46, 51-52, 55-56, 59-65, 68-70, 72, 76-83, 87-88, 91-92, 137
Prostate cancer - 41-46
Prosthetic devices - 55, 60-63, 73-74, 76-79
Psychotherapy - 87-90
Pulmonary rehabilitation - 51-52, 76-79
Radiation therapy - 51-52, 76-79
Reproductive services - 50-51, 131
Residential treatment center - 16-17, 19, 24-26, 79-80, 89
Rights and responsibilities - 13-14
Room and board - 73-74, 79-80, 89
Second surgical opinion - 39-40
Smoking cessation - 58, 95-102
Specialty drugs - 91-102, 138
Sterilization - 49-50, 60-63
Subrogation - 122-123, 138
Substance use - 79-80, 87-90, 107, 137-138
Surgery - 16-17, 19-22, 53-55, 59-72, 132
Surgical implants - 76-79
Syringes - 95-102
Temporary Continuation of Coverage (TCC) - 11-12
Tobacco cessation - 58, 95-102
Transplants - 16-17, 19-22, 51-52, 64-70
TRICARE - 121-124
Urgent care center - 85-86
VA facility - 129
Vaccines - 41-47, 95-102
Verbal statements - 4, 27, 106-107
Vision services - 53-54
Weight control - 19-22, 60-63
Wheelchairs - 55-56
Workers’ compensation - 122
X-rays - 40-41, 76-79
Accidental injury - 83-85, 103, 131
Acupuncture - 57-58, 71, 76-79
Allogeneic - 65-68
Ambulance - 72-83
Anesthesia - 59-71, 104
Applied behavior analysis (ABA) - 51-52, 76-79
Assistant surgeon - 18
Autologous - 64-70
Biopsy - 60-63
Birthing facilities - 48-49, 73-79
Blood and blood plasma - 56-57, 76-79
Blood or marrow stem cell - 64-70
Blue Distinction Centers - 16-17, 68-70
Blue Health Assessment - 105, 133
BRCA - 19-22, 40-46
Breast reconstruction - 63-64
Case management - 79-82, 106-107
Casts - 60-63, 73-74, 76-79
Catastrophic protection - 30, 143
Chemotherapy - 51-52, 68-70, 76-79
Circumcision - 48-49, 60-63, 74-76
Claims filing - 115-116
Coinsurance - 28, 109, 131
Colonoscopy - 41-46, 60-63, 76-79
Colorectal cancer tests - 41-46
Confidentiality - 13-14
Congenital anomalies - 60-63, 132
Contraceptives - 49-50, 76-79, 95-102
Coordinating benefits - 121-130
Copayments - 28, 132
Cosmetic surgery - 60-64, 132
Cost-share/cost-sharing - 28
Costs for covered services - 28-31
Covered facility providers - 16-17
Covered professional providers - 16
Custodial or long term care - 132
Deductible - 28
Dental care - 103-104, 112, 123
Diabetic education - 58, 76-79
Diabetic supplies - 95-102
Dialysis - 51-52, 55-56, 76-79
Disputed claims - 27, 118-120
Donor expenses - 68-70
Durable medical equipment - 55-56, 76-79, 132
Emergency - 18, 26, 83-86, 103, 109
Enrollment - 9-10, 16, 18, 124-125
Exclusions - 113-114
Experimental or investigational - 64-65, 113-114, 133
Eyeglasses - 53-54
Fecal occult blood - 41-46
Foot care - 54
Freestanding ambulatory facility - 16-17
Gender reassignment surgery - 19-22, 55, 59-63, 72
Generic equivalents - 91-92
Genetic testing - 19-22, 40-41, 76-79
Hearing services - 53
Home nursing care - 57, 115
Hospice care - 80-82
Hospital - 16-17, 19, 39-40, 72-83, 85-86, 89-90, 106, 109
Identification cards - 16
Immunizations - 41-47, 95-102
Inpatient professional services - 39-40, 87-88
Laboratory and pathology services - 18
Mammograms - 41-46
Maternity care - 24, 26, 48-49
Medicaid - 122
Medical foods - 56-57, 95-102, 134
Medical supplies - 56-57, 73-82, 95-102
Medically necessary - 134
Medications to promote better health - 46-47, 95-102
Member/Non-member facilities - 72-83, 87-90
Mental health - 87-90, 107, 134, 138
Multiple procedures - 60-63
Never events - 6-8, 134
Newborn care - 26, 39-40, 46-49, 74-76
Nutritional counseling - 39-47, 60-63, 73-76
Observation care - 134-135
Obstetrical care - 48-49, 74-76
Occupational therapy - 52-53, 76-82
Office visits - 39-40, 87-88
Orthopedic devices - 55, 63-64, 76-79
Ostomy and catheter supplies - 56-57
Out-of-pocket expenses - 30, 136-137
Outpatient - 19-22, 76-79, 90, 134-135
Overpayments - 31
Overseas claims - 30, 109-111
Oxygen - 55-57, 73-82
Patient Safety and Quality Monitoring program - 91-92
Pharmacotherapy - 39-40, 51-52
Physical examinations - 76-79, 113-114
Physical therapy - 52-53, 76-82
Physician - 16, 126, 129, 133, 137
Plan allowance - 29, 135-136
PPO/Participating/Non-participating providers - 13-14
Pre-admission testing - 73-74
Precertification - 19-22, 24-26, 59-60, 72, 79-80, 87, 89, 137
Prior approval - 19-22, 24-25, 40-46, 51-52, 55-56, 59-65, 68-70, 72, 76-83, 87-88, 91-92, 137
Prostate cancer - 41-46
Prosthetic devices - 55, 60-63, 73-74, 76-79
Psychotherapy - 87-90
Pulmonary rehabilitation - 51-52, 76-79
Radiation therapy - 51-52, 76-79
Reproductive services - 50-51, 131
Residential treatment center - 16-17, 19, 24-26, 79-80, 89
Rights and responsibilities - 13-14
Room and board - 73-74, 79-80, 89
Second surgical opinion - 39-40
Smoking cessation - 58, 95-102
Specialty drugs - 91-102, 138
Sterilization - 49-50, 60-63
Subrogation - 122-123, 138
Substance use - 79-80, 87-90, 107, 137-138
Surgery - 16-17, 19-22, 53-55, 59-72, 132
Surgical implants - 76-79
Syringes - 95-102
Temporary Continuation of Coverage (TCC) - 11-12
Tobacco cessation - 58, 95-102
Transplants - 16-17, 19-22, 51-52, 64-70
TRICARE - 121-124
Urgent care center - 85-86
VA facility - 129
Vaccines - 41-47, 95-102
Verbal statements - 4, 27, 106-107
Vision services - 53-54
Weight control - 19-22, 60-63
Wheelchairs - 55-56
Workers’ compensation - 122
X-rays - 40-41, 76-79