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


Note: The calendar year deductible applies to almost all benefits in this Section. We say "(No deductible)" when it does not apply.
 
Benefit Description

Alternative/Manipulative Treatment
Benefits for manipulative treatment and acupuncture are subject to a combined limit of 10 visits per person per calendar year

 
  • Acupuncture is covered when performed and billed by a healthcare provider who is licensed or certified to perform acupuncture by the state where the services are provided, and who is acting within the scope of that license or certification. See page 16 for more information.

    Note: See page 71 for our coverage of acupuncture when provided as anesthesia for covered surgery.
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
Preferred: $25 copayment per visit (no deductible)

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

Note: You pay 30% of the Plan allowance for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 131 for more information about “agents.”)
 
Benefit Description
Not covered:

 
  • Biofeedback
     
  • Self-care or self-help training

You Pay
All charges
 

List Item:

alternative
manipulative
treatment
acupuncture
osteopathic
chiropractive
spinal
extraspinal
biofeedback
self-care
self-help
training