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 47
 
Benefit Description

Preventive Care, Child (cont.)

 
Note: U.S. FDA licensure may restrict the use of certain vaccines to specific age ranges, frequencies, and/or other patient-specific indications, including gender.
 
  • Nutritional counseling
    Note: Benefits are limited to individual nutritional counseling services. We do not provide benefits for group counseling services.

    Note: When nutritional counseling is via the contracted telehealth provider network, we provide benefits as shown here for Preferred providers. Refer to Section 5(h), Wellness and Other Special Features, for information on how to access a telehealth provider.

     
Preventive care benefits for each of the services listed below are limited to one per calendar year:
 
  • Screening for hepatitis B for children age 13 and over
  • Screening for chlamydial infection
  • Screening for gonorrhea infection
  • Cervical cancer screening tests
    • Pap tests of the cervix
    • Human papillomavirus (HPV) tests of the cervix
  • Screening for human immunodeficiency virus (HIV) infection
  • Screening for syphilis infection
  • Screening for latent tuberculosis infection for children ages 18 through 21

Notes:
 
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