162

2024 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Index
Page 162

Medically necessary - 21, 26, 134-135, 145, 155
Medicare - 1, 21, 83-84, 127, 142-151Medications and supplies - 114-119
Member facilities - 12-13, 18-19, 156-157
Mental health/substance use disorder - 46-48, 82-83, 93-97, 155
MRIs - 40-41, 77-81, 152 
Multiple procedures - 62-63
MyBlue Customer eService - 127
National Doctor & Hospital Finder - 127
Neurological testing - 40-41, 77-81
Never Events - 6-7, 155
Newborn care - 26, 39-40, 44-48
No Surprises Act (NSA) - 32
Non-member facilities - 12-13, 156-157
Non-participating providers - 12-13, 24, 32
Non-preferred providers - 29-33
Nurse - 18-19, 58, 84-86, 125, 127-128
Nutritional counseling - 42-46, 129
Observation care - 155
Obstetrical care - 46-48
Occupational therapy - 52-53, 84-86
Office visits - 37, 39-40, 94-95, 158, 164
Online Health Coach (OHC) - 125
Oral surgery - 66
Organ/tissue transplants - 21-24, 72
Orthopedic devices - 55-56, 77-81
Osteopathic manipulative treatment - 58-59
Osteoporosis screening - 158
Ostomy and catheter supplies - 57-58
Out-of-pocket expenses - 33, 37, 157-158
Outpatient facility services - 77-81
Outpatient professional services - 39-40
Overpayments - 34
Overseas Assistance Center - 130
Overseas services, drugs, supplies and claims - 130-132
Oxygen - 56-58
Pap tests - 42-44
Participating providers - 39-60, 62-66, 72-73, 89-92, 94-95, 124
Patient Safety and Quality Monitoring (PSQM) Program - 99-102
Personal Health Record - 125
PET scans - 40-41, 77-81, 152
Pharmacotherapy - 39-40, 51-52
Physical examination - 77-81, 134-135
Physical therapy - 39-40, 52-53,  84-86
Physician - 17, 21, 146, 150, 154, 163-166
Plan allowance - 156-157
PPO - 12-13, 158
Pre-admission testing - 75-77
Precertification - 21, 24-26, 154, 158
Preferred providers - 12-13, 20, 29-32
Pregnancy (see: Maternity care)
Pregnancy Care Incentive Program - 126-127
Prescription drugs - 114-119Preventive carePrimary care provider - 17, 37, 39-40, 44-46, 49-55, 59-60, 84-86
Prior approval - 21-25, 51-52, 61-66, 74, 84-86, 98-102, 114-119, 137-138, 153-154, 158
Professional providers - 17
Prostate cancer tests - 42-44
Prosthetic devices - 55-56, 62-65, 74-81
Psychotherapy - 94-97
Pulmonary rehabilitation - 51-52, 77-81
Radiation therapy - 51-52, 77-81
Reconsiderations - 27, 139-141
Renal dialysis - 18-19, 51-52, 77-81
Replacement coverage - 11
Reproductive services - 49, 152Residential Treatment Center (RTC) - 18-19, 21, 24-25, 82-83, 95-96, 127-128, 153
Retail Pharmacy Program - 37, 98-102, 114-119, 131-132, 136-138, 158, 164, 166
Rights and responsibilities - 12-13
Room and board - 21, 26, 39-40, 75-77, 82-84, 95-96
Screening services - 158
Second surgical opinion - 39-40
Self-injectable drugs - 114-119, 159
Skilled nursing facility (SNF) care - 18-19, 153
Smoking cessation - 59-60, 114-119, 125
Social worker - 127-128
Specialty Drug Pharmacy Program - 98-99, 114-119, 131-132, 137-138
Specialty drugs - 114-119, 159
Speech therapy - 52-53, 77-81, 84-86
Speech-Generating Devices - 56-57
Stem Cell Transplants - 
Sterilization procedures - 48, 62-63
Subrogation - 143-144, 159
Substance use disorder - 93-97, 164-165
Surgery - 24, 53-54, 61-73, 81-82, 153Syringes - 114-119
Telehealth - 159Temporary Continuation of Coverage (TCC) - 10-11
Tobacco cessation - 59-60, 114-119, 125
Transplants - 18-19, 21-24, 51-52, 72
Travel benefit - 71-72, 125
Treatment therapies - 51-52
TRICARE - 142-143 
Ultrasounds - 40-41, 77-81
Urgent care center - 90-92
Urgent care claims - 25, 159-160
VA facilities - 150
Vision services - 53-54, 145
Waivers - 29
Weight control - 125, 134-135
Wheelchairs - 56-57, 83-84, 87-88
Wigs - 55-56
X-rays - 40-41, 145

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