58

2020 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
Page 58

Benefit Description

Alternative/Manipulative Treatment (cont.)

Note: See page 48 for our coverage of acupuncture when provided as anesthesia for covered maternity care.

Manipulative treatment limited to:
- Osteopathic manipulative treatment to any body region
- Chiropractic spinal and/or extraspinal manipulative treatment

See Section 5(c), page 78, for facility benefits.

You Pay
See previous page

Benefit Description
Not covered:

Biofeedback
Self-care or self-help training

You Pay
All charges

Benefit Description

Educational Classes and Programs

Smoking, tobacco, and E-cigarette cessation treatment including:
- Individual counseling for smoking, tobacco, and E-cigarette use cessation
  
  Note: Benefits are not available for group counseling.
- Smoking, tobacco, and E-cigarette cessation classes
  
  Note: See Section 5(f) for our coverage of smoking, tobacco, and E-cigarette cessation drugs.

You Pay
Preferred: Nothing (no deductible)

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

Benefit Description

Diabetic education

Note: See pages 40, 43, and 47 for our coverage of nutritional counseling services that are not part of a diabetic education program.

You Pay
Preferred: 30% of the Plan allowance

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

Benefit Description
Not covered:

Marital, family, educational, or other counseling or training services, or applied behavior analysis (ABA), when performed as part of an educational class or program
Premenstrual syndrome (PMS), lactation (except as described on page 48), headache, eating disorder (except as described on page 40), and other educational clinics
Recreational or educational therapy, and any related diagnostic testing except as provided by a hospital as part of a covered inpatient stay
Services performed or billed by a school or halfway house or a member of its staff

You Pay
All charges