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2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Table of Contents
Page 1
 
Table of Contents
 
Introduction - 4 
Plain Language - 4 
Stop Healthcare Fraud! - 4 
Discrimination is Against the Law - 5 
Preventing Medical Mistakes - 6 
FEHB Facts - 9 
Coverage information - 9 
• No pre-existing condition limitation - 9 
• Minimum essential coverage (MEC) - 9 
• Minimum value standard - 9 
• Where you can get information about enrolling in the FEHB Program - 9 
• Enrollment types available for you and your family - 9 
• Family member coverage - 10 
• Children’s Equity Act - 10 
• When benefits and premiums start - 11 
• When you retire - 11 
When you lose benefits - 11 
• When FEHB coverage ends - 11 
• Upon divorce - 12 
• Temporary Continuation of Coverage (TCC) - 12 
• Finding replacement coverage - 12 
• Health Insurance Marketplace - 12 
Section 1. How This Plan Works - 13 
General features of our Standard and Basic Options - 13 
We have a Preferred Provider Organization (PPO) - 13 
How we pay professional and facility providers - 13 
Your rights and responsibilities - 14 
Your medical and claims records are confidential - 14 
Section 2. Changes for 2025 - 15 
Changes to our Standard Option only - 15 
Changes to our Basic Option only - 15 
Changes to both our Standard and Basic Options - 16 
Section 3. How You Get Care - 17 
Identification cards - 17 
Where you get covered care - 17 
Balance Billing Protection - 17 
• Covered professional providers - 17 
• Covered facility providers - 17 
What you must do to get covered care - 19 
• Transitional care - 20 
• If you are hospitalized when your enrollment begins - 20 
You need prior Plan approval for certain services - 20 
• Inpatient hospital admission, inpatient residential treatment center admission, or skilled nursing facility admission - 21 
• Other services - 21 
• Surgery by Non-participating providers under Standard Option - 24 
How to request precertification for an admission or get prior approval for Other services - 24 
• Non-urgent care claims - 24 
• Urgent care claims - 25 
 
Go to Inside cover.  Go to page 2.