Blue Cross and Blue Shield Service Benefit Plan Brochure - 2020

FEP Blue Focus


Document list

Document Number Document Name Version Date Published
FBF20.00.1.1 Cover page v1.0
FBF20.00.1.2 Inside cover v1.0
FBF20.00.1.3 Table of Contents v1.0
FBF20.00.2.1 Introduction v1.0
FBF20.00.2.2 Plain Language v1.0
FBF20.00.2.3 Stop Health Care Fraud v1.0
FBF20.00.2.4 Discrimination is Against the Law v1.0
FBF20.00.2.5 Preventing Medical Mistakes v1.0
FBF20. No pre-existing condition limitation v1.0
FBF20. Minimum essential coverage (MEC) v1.0
FBF20. Minimum value standard v1.0
FBF20. Where you can get information about enrolling in the FEHB Program v1.0
FBF20. Types of coverage available for you and your family v1.0
FBF20. Family member coverage v1.0
FBF20. Children's Equity Act v1.0
FBF20. When benefits and premiums start v1.0
FBF20. When you retire v1.0
FBF20. When FEHB coverage ends v1.0
FBF20. Upon divorce v1.0
FBF20. Temporary Continuation of Coverage (TCC) v1.0
FBF20. Finding replacement coverage v1.0
FBF20. Health Insurance Marketplace v1.0
FBF20.01.0 Overview v1.0
FBF20.01.1 General features of FEP Blue Focus v1.0
FBF20.01.2 How we pay professional and facility providers v1.0
FBF20.01.3 Your rights and responsibilities v1.0
FBF20.01.4 Your medical and claims records are confidential v1.0
FBF20.02 Section 2. Changes for 2020 v1.0
FBF20.03.1 Identification cards v1.0
FBF20.03.2.0 Where you get covered care v1.0
FBF20.03.2.1 Covered professional providers v1.0
FBF20.03.2.2 Covered facility providers v1.0
FBF20.03.3.0 What you must do to get covered care v1.0
FBF20.03.3.1 Transitional care v1.0
FBF20.03.3.2 If you are hospitalized when your enrollment begins v1.0
FBF20.03.4.00 You need prior Plan approval for certain services v1.0
FBF20.03.4.01 Inpatient hospital admission, inpatient residential treatment center admission v1.0
FBF20.03.4.02 Other services v1.0
FBF20.03.4.03 Special prior authorization situations related to coordination of benefits (COB) v1.0
FBF20.03.4.04 Prior notification - Maternity care v1.0
FBF20.03.4.05 How to request precertification for an admission or get approval for Other services v1.0
FBF20.03.4.06 Non-urgent care claims v1.0
FBF20.03.4.07 Urgent care claims v1.1
FBF20.03.4.08 Concurrent care claims v1.0
FBF20.03.4.09 Emergency inpatient admission v1.0
FBF20.03.4.10 Maternity care v1.0
FBF20.03.4.11 If your facility stay needs to be extended v1.0
FBF20.03.4.12 If your treatment needs to be extended v1.0
FBF20.03.5.0 If you disagree with our pre-service claim decision v1.0
FBF20.03.5.1 To reconsider a non-urgent care claim v1.0
FBF20.03.5.2 To reconsider an urgent care claim v1.0
FBF20.03.5.3 To file an appeal with OPM v1.0
FBF20.03.5.4 The Federal Flexible Spending Account Program – FSAFEDS v1.0
FBF20.04.01 Cost-share/Cost-sharing v1.1
FBF20.04.02 Copayment v1.0
FBF20.04.03 Deductible v1.0
FBF20.04.04 Coinsurance v1.0
FBF20.04.05 If your provider routinely waives your cost v1.0
FBF20.04.06 Waivers v1.0
FBF20.04.07 Differences between our allowance and the bill v1.0
FBF20.04.08 Important notice about Non-participating providers! v1.0
FBF20.04.09 Your costs for other care v1.0
FBF20.04.10 Your catastrophic protection out-of-pocket maximum for deductibles, coinsurance, and copayments v1.0
FBF20.04.11 Carryover v1.0
FBF20.04.12 If we overpay you v1.0
FBF20.04.13 When Government facilities bill us v1.0
FBF20.05.0.1 Section 5. Benefits - Table of Contents v1.0
FBF20.05.0.2 FEP Blue Focus Overview v1.0
FBF20.05a.0 Section 5(a) Overview v1.0
FBF20.05a.01 Diagnostic and Treatment Services v1.0
FBF20.05a.02 Lab, X-ray and Other Diagnostic Tests v1.0
FBF20.05a.03 Preventive Care, Adult v1.0
FBF20.05a.04 Preventive Care, Child v1.0
FBF20.05a.05 Maternity Care v1.0
FBF20.05a.06 Family Planning v1.0
FBF20.05a.07 Reproductive Services v1.0
FBF20.05a.08 Allergy Care v1.0
FBF20.05a.09 Treatment Therapies v1.0
FBF20.05a.10 Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy v1.0
FBF20.05a.11 Hearing Services v1.0
FBF20.05a.12 Vision Services (Testing, Treatment, and Supplies) v1.0
FBF20.05a.13 Foot Care v1.0
FBF20.05a.14 Orthopedic and Prosthetic Devices v1.0
FBF20.05a.15 Durable Medical Equipment (DME) v1.0
FBF20.05a.16 Medical Supplies v1.0
FBF20.05a.17 Home Health Services v1.0
FBF20.05a.18 Alternative/Manipulative Treatment v1.0
FBF20.05a.19 Educational Classes and Programs v1.0
FBF20.05b.0 Section 5(b) Overview v1.0
FBF20.05b.1 Surgical Procedures v1.0
FBF20.05b.2 Reconstructive Surgery v1.0
FBF20.05b.3 Oral and Maxillofacial Surgery v1.0
FBF20.05b.4 Organ/Tissue Transplants v1.0
FBF20.05b.5 Anesthesia v1.0
FBF20.05c.0 Section 5(c) Overview v1.0
FBF20.05c.1 Inpatient Hospital v1.0
FBF20.05c.2 Maternity - Facility v1.0
FBF20.05c.3 Outpatient Hospital or Ambulatory Surgical Center v1.0
FBF20.05c.4 Residential Treatment Center v1.0
FBF20.05c.5 Extended Care Benefits/Skilled Nursing Care Facility Benefits v1.0
FBF20.05c.6 Hospice Care v1.0
FBF20.05c.7 Ambulance v1.0
FBF20.05d.0 Section 5(d) Overview v1.0
FBF20.05d.1 Accidental Injury v1.0
FBF20.05d.2 Medical Emergency v1.0
FBF20.05d.3 Ambulance v1.0
FBF20.05e.0 Section 5(e) Overview v1.0
FBF20.05e.1 Professional Services v1.0
FBF20.05e.2 Inpatient Hospital or Other Covered Facility v1.0
FBF20.05e.3 Residential Treatment Center v1.0
FBF20.05e.4 Outpatient Hospital or Other Covered Facility v1.0
FBF20.05f.0 Section 5(f) Overview v1.0
FBF20.05f.1 Covered Medications and Supplies v1.0
FBF20.05g.0 Section 5(g) Overview v1.0
FBF20.05g.1 Accidental Injury Benefit v1.0
FBF20.05g.2 Inpatient and Outpatient Facility Care v1.0
FBF20.05h.01 Health Tools v1.0
FBF20.05h.02 Services for the Deaf and Hearing Impaired v1.0
FBF20.05h.03 Web Accessibility for the Visually Impaired v1.0
FBF20.05h.04 Travel Benefit/Services Overseas v1.0
FBF20.05h.05 Healthy Families v1.0
FBF20.05h.06 Blue Health Assessment v1.0
FBF20.05h.07 Hypertension Management Program v1.2 05/19/2020
FBF20.05h.08 MyBlue Customer eService v1.0
FBF20.05h.09 National Doctor & Hospital Finder v1.0
FBF20.05h.10 Care Management Programs v1.0
FBF20.05h.11 Flexible Benefits Option v1.0
FBF20.05h.12 Telehealth Services v1.0
FBF20.05h.13 Routine Annual Physical Incentive Program v1.0
FBF20.05h.14 The fepblue Mobile Application v1.0
FBF20.05i.0 Section 5(i). Services, Drugs, and Supplies Provided Overseas v1.0
FBF20.05N.0 Non-FEHB Benefits Available to Plan Members v1.0
FBF20.06 Section 6. General Exclusions - Services, Drugs, and Supplies We Do Not Cover v1.0
FBF20.07 Section 7. Filing a Claim for Covered Services v1.0
FBF20.08 Section 8. The Disputed Claims Process v1.0
FBF20.09.1.0 When you have other health coverage v1.0
FBF20.09.1.1 TRICARE and CHAMPVA v1.0
FBF20.09.1.2 Workers' Compensation v1.0
FBF20.09.1.3 Medicaid v1.0
FBF20.09.2 When other Government agencies are responsible for your care v1.0
FBF20.09.3 When others are responsible for injuries v1.0
FBF20.09.4 When you have Federal Employees Dental and Vision Insurance Plan (FEDVIP) v1.0
FBF20.09.5 Clinical trials v1.0
FBF20.09.6.1 What is Medicare? v1.0
FBF20.09.6.2 Should I enroll in Medicare? v1.0
FBF20.09.6.3 The Original Medicare Plan (Part A or Part B) v1.0
FBF20.09.6.4 Tell us about your Medicare coverage v1.0
FBF20.09.6.5 Private contract with your physician v1.0
FBF20.09.6.6 Medicare Advantage (Part C) v1.0
FBF20.09.6.7 Medicare prescription drug coverage (Part D) v1.0
FBF20.09.6.8 Medicare prescription drug coverage (Part B) v1.1
FBF20. Primary payor chart v1.0 02/05/2020
FBF20.09.7 When you are age 65 or over and do not have Medicare v1.0
FBF20.09.8 Physicians Who Opt-Out of Medicare v1.0
FBF20.09.9 When you have the Original Medicare Plan (Part A, Part B, or both) v1.0
FBF20.09.95 Cost-share when Medicare is your primary payor v1.0
FBF20.10 Section 10. Definitions of Terms We Use in This Brochure v1.0
FBF20.11 Index v1.0
FBF20.12 Summary of Benefits for the Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - 2020 v1.0
FBF20.13 2020 Rate Information for the Blue Cross and Blue Shield Service Benefit Plan v1.0
FBF20-000-1 Cover page v1.0
FBF20-000-2 Inside cover v1.0
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