2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Index
Page 161
Index
Page 161
Index
Do not rely only on this page; it is for your convenience and may not show all pages where the terms appear. This Index is not an official statement of benefits.
Abortion - 46-47, 134-135
Accidental injury - 19-20, 89-92, 121-122, 152, 163, 165
Acupuncture - 59, 72-73
Affordable Care Act (ACA) - 114-119, 163, 165
Allergy care - 50-51
Allogeneic transplants - 68-71
Alternative treatments - 59
Ambulance - 31, 87-88
Ambulatory surgical center - 17-19, 77-81
Anesthesia - 72-73
Angiographies - 39-40, 77-81
Appeals - 26
Applied behavior analysis (ABA) - 51-52, 77-81
Assistant surgeon - 19-20, 62-63
Autism spectrum disorder - 51-52, 77-81
Autologous transplants - 68-71
Average wholesale price (AWP) - 156-157
Biopsies - 41-43, 62-63, 77-81
Birthing centers - 17-19
Blood and blood plasma - 57-58, 77-81
Blood or marrow stem cell transplants - 67-70
Blue Distinction CentersBlue Distinction Specialty Care - 17-19
Blue Health Assessment - 125-126
Bone density tests - 39-40, 77-81
Brand-name drugs - 103-107, 111-114
Breast pump and supplies - 46-47, 56-57
Breast reconstruction - 63-65Breastfeeding support and supplies - 46-47, 57-58
Cancer tests - 41-43
Cardiac rehabilitation - 51-52, 77-81
Cardiovascular monitoring - 39-40, 77-81
Care Management Programs - 127-128
Case management - 127-128
Casts - 62-63, 75-81
Catastrophic protection - 32-33, 150-151, 164, 166
Cervical cancer screening - 41-45
CHAMPVA - 142-143
Changes for 2025 - 15-16
Chemotherapy - 51-52, 77-81
Children’s Equity Act - 10-11
Chiropractic manipulative treatment - 58-59
Cholesterol tests - 41-43
Circumcision - 46-47, 62-63
Claims and claims filing - 24-25, 127, 131-132, 136-138
Clinic visits - 38-39, 94-95
Clinical trials - 70, 145
Cognitive rehabilitation - 52-53, 77-81
Coinsurance - 28
Colorectal cancer tests - 41-43Confidentiality - 13-14
Congenital anomalies - 62-63, 153
Consultations - 38-39, 94-95
Contact lenses - 53-54
Contraceptive devices and drugs - 48-49, 103-107, 111-119
Coordination of benefits - 142-151
Copayments - 27
Cosmetic surgery - 62-66, 153
Cost-sharing - 27
Costs for covered services - 27-33
Coverage information - 9
Covered facility providers - 17-19
Covered professional providers - 17
CT scans - 39-40, 77-81
Custodial care - 75-77, 134-135, 153
Daily Habits - 114-119, 125
Deductible - 27, 163
Definitions - 152-160
Dental care - 121-124
Diabetes Management Program - 125
Diabetic education - 59-60, 77-81
Diabetic supplies
Diagnostic tests - 39-40, 93-97
Dialysis - 51-52, 56-57, 77-81
Disease Management - 127-128
Disputed claims process - 139-141
Divorce - 12
DNA analysis of stool samples - 41-43
Donor expenses (transplants) - 70-72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 56-57Educational classes and programs - 59-60
EEGs - 39-40, 77-81
EKGs - 39-40, 77-81
Emergency - 19-20, 25, 31, 89-92, 163, 165
Enrollment - 9-10, 17
Exception situations - 19-21
Exclusions - 134-135
Experimental or investigational - 134-135, 153-154
Extended care benefits - 83-84
Eyeglasses - 53-54
Facility providers - 17-19
Family planning - 48-49
Fecal occult blood test - 41-43
FEDVIP - 33, 145
fepblue mobile application - 129
fepblue.org - 4
Flexible benefits option - 128-129
Foot care - 54-55
Formulary/Preferred drug list - 99-102, 108-111
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility - 17-19, 67
Fraud - 4
Freestanding ambulatory facilities - 17-19
Gender affirming care - 17, 21, 63-65
Generic drugs - 99-102, 108-111
Generic Incentive Program - 102-103
Genetic screening/testing - 39-40, 77-81
Health Insurance Marketplace - 12
Health tools - 125
Healthy Families - 125
Hearing aids and hearing services - 53, 55-56, 133
Home health services - 58
Home nursing care (maternity) - 58
Hospice care - 84-86
HospitalHuman papillomavirus (HPV) tests - 41-45
Hypertension Management Program - 126
Immunizations - 41-45, 114-119
Inpatient hospital benefits - 75-77
Inpatient professional services - 38-39, 94-95
Insulin - 103-107, 111-114
Insulin pumps - 56-57
Laboratory and pathology services - 39-40, 75-81, 89-92
Low-dose CT screening - 158
Mail Service Prescription Drug Program - 99-107, 111-119, 131-132, 137-138, 163-166
Mammograms - 41-43
Manipulative treatment - 58-59, 77-81
Maternity care - 25, 46-47, 75-77
Maxillofacial surgery - 66, 164, 166
Medicaid - 143
Medical emergency - 19-20, 75-77, 89-92, 163, 165
Medical foods - 57-58, 102-103, 108-111, 155
Medical supplies - 57-58
Accidental injury - 19-20, 89-92, 121-122, 152, 163, 165
Acupuncture - 59, 72-73
Affordable Care Act (ACA) - 114-119, 163, 165
Allergy care - 50-51
Allogeneic transplants - 68-71
Alternative treatments - 59
Ambulance - 31, 87-88
Ambulatory surgical center - 17-19, 77-81
Anesthesia - 72-73
Angiographies - 39-40, 77-81
Appeals - 26
Applied behavior analysis (ABA) - 51-52, 77-81
Assistant surgeon - 19-20, 62-63
Autism spectrum disorder - 51-52, 77-81
Autologous transplants - 68-71
Average wholesale price (AWP) - 156-157
Biopsies - 41-43, 62-63, 77-81
Birthing centers - 17-19
Blood and blood plasma - 57-58, 77-81
Blood or marrow stem cell transplants - 67-70
Blue Distinction CentersBlue Distinction Specialty Care - 17-19
Blue Health Assessment - 125-126
Bone density tests - 39-40, 77-81
Brand-name drugs - 103-107, 111-114
Breast pump and supplies - 46-47, 56-57
Breast reconstruction - 63-65Breastfeeding support and supplies - 46-47, 57-58
Cancer tests - 41-43
Cardiac rehabilitation - 51-52, 77-81
Cardiovascular monitoring - 39-40, 77-81
Care Management Programs - 127-128
Case management - 127-128
Casts - 62-63, 75-81
Catastrophic protection - 32-33, 150-151, 164, 166
Cervical cancer screening - 41-45
CHAMPVA - 142-143
Changes for 2025 - 15-16
Chemotherapy - 51-52, 77-81
Children’s Equity Act - 10-11
Chiropractic manipulative treatment - 58-59
Cholesterol tests - 41-43
Circumcision - 46-47, 62-63
Claims and claims filing - 24-25, 127, 131-132, 136-138
Clinic visits - 38-39, 94-95
Clinical trials - 70, 145
Cognitive rehabilitation - 52-53, 77-81
Coinsurance - 28
Colorectal cancer tests - 41-43Confidentiality - 13-14
Congenital anomalies - 62-63, 153
Consultations - 38-39, 94-95
Contact lenses - 53-54
Contraceptive devices and drugs - 48-49, 103-107, 111-119
Coordination of benefits - 142-151
Copayments - 27
Cosmetic surgery - 62-66, 153
Cost-sharing - 27
Costs for covered services - 27-33
Coverage information - 9
Covered facility providers - 17-19
Covered professional providers - 17
CT scans - 39-40, 77-81
Custodial care - 75-77, 134-135, 153
Daily Habits - 114-119, 125
Deductible - 27, 163
Definitions - 152-160
Dental care - 121-124
Diabetes Management Program - 125
Diabetic education - 59-60, 77-81
Diabetic supplies
Diabetic Meter Program - 103-107
Insulin pumps - 56-57, 103-107, 111-114
Insulin, test strips, and lancets - 103-107, 111-114, 125
Needles and disposable syringes - 103-107, 111-114
Diagnostic and treatment services - 38-39, 77-81Insulin pumps - 56-57, 103-107, 111-114
Insulin, test strips, and lancets - 103-107, 111-114, 125
Needles and disposable syringes - 103-107, 111-114
Diagnostic tests - 39-40, 93-97
Dialysis - 51-52, 56-57, 77-81
Disease Management - 127-128
Disputed claims process - 139-141
Divorce - 12
DNA analysis of stool samples - 41-43
Donor expenses (transplants) - 70-72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 56-57Educational classes and programs - 59-60
EEGs - 39-40, 77-81
EKGs - 39-40, 77-81
Emergency - 19-20, 25, 31, 89-92, 163, 165
Enrollment - 9-10, 17
Exception situations - 19-21
Exclusions - 134-135
Experimental or investigational - 134-135, 153-154
Extended care benefits - 83-84
Eyeglasses - 53-54
Facility providers - 17-19
Family planning - 48-49
Fecal occult blood test - 41-43
FEDVIP - 33, 145
fepblue mobile application - 129
fepblue.org - 4
Flexible benefits option - 128-129
Foot care - 54-55
Formulary/Preferred drug list - 99-102, 108-111
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility - 17-19, 67
Fraud - 4
Freestanding ambulatory facilities - 17-19
Gender affirming care - 17, 21, 63-65
Generic drugs - 99-102, 108-111
Generic Incentive Program - 102-103
Genetic screening/testing - 39-40, 77-81
Health Insurance Marketplace - 12
Health tools - 125
Healthy Families - 125
Hearing aids and hearing services - 53, 55-56, 133
Home health services - 58
Home nursing care (maternity) - 58
Hospice care - 84-86
HospitalHuman papillomavirus (HPV) tests - 41-45
Hypertension Management Program - 126
Immunizations - 41-45, 114-119
Inpatient hospital benefits - 75-77
Inpatient professional services - 38-39, 94-95
Insulin - 103-107, 111-114
Insulin pumps - 56-57
Laboratory and pathology services - 39-40, 75-81, 89-92
Low-dose CT screening - 158
Mail Service Prescription Drug Program - 99-107, 111-119, 131-132, 137-138, 163-166
Mammograms - 41-43
Manipulative treatment - 58-59, 77-81
Maternity care - 25, 46-47, 75-77
Maxillofacial surgery - 66, 164, 166
Medicaid - 143
Medical emergency - 19-20, 75-77, 89-92, 163, 165
Medical foods - 57-58, 102-103, 108-111, 155
Medical supplies - 57-58