Document Number:
SB24-161
Revision #:
v1.0
Date Published:
1/1/2024
2024 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 - 46-48, 134-135
Accidental injury - 75-77, 87-92, 121-122, 152
Acupuncture - 59, 72-73
Affordable Care Act (ACA) - 8, 11, 44-46
Allergy care - 50
Allogeneic transplants - 72
Alternative treatments - 59
Ambulance - 20, 87-88, 92
Ambulatory surgical center - 18-19, 77-81
Anesthesia - 72-73, 75-77
Angiographies - 40-41, 77-81
Appeals - 25, 27, 139-141
Applied behavior analysis (ABA) - 21-24, 51-52, 77-81
Assistant surgeon - 20
Autism spectrum disorder - 51-52, 77-81
Autologous transplants -
Average wholesale price (AWP) - 114-119, 164
Biopsies - 42-44, 62-63, 77-81
Birthing centers - 18-19
Blood and blood plasma - 57-58, 77-81
Blood or marrow stem cell transplants - 71-72
Blue Distinction Centers - 18-19, 71-72, 81-82Blue Distinction Specialty Care - 18-19
Blue Health Assessment - 125-126
Bone density tests - 40-41, 77-81
Brand-name drugs - 99-102
Breast pump and supplies - 46-48
Breast reconstruction - 63-65Breastfeeding support and supplies - 46-48, 57-58
Cancer tests - 42-44
Cardiac rehabilitation - 51-52, 77-81
Cardiovascular monitoring - 40-41, 77-81
Care Management Programs - 127-128
Case management - 82-86, 95-96, 127-128
Casts - 62-63, 75-81
Catastrophic protection - 33, 164, 166
Cervical cancer screening - 42-46
CHAMPVA - 142-145
Changes for 2024 - 14-16
Chemotherapy - 51-52, 77-81
Children’s Equity Act - 9-10
Chiropractic manipulative treatment - 51-52, 58-59
Cholesterol tests - 42-44, 114-119
Circumcision -46-48, 62-63
Claims and claims filing - 12-13, 25-27, 127, 131-132, 136-141, 153, 158-160
Clinic visits - 39-40, 77-81, 94-95
Clinical trials - 21-24, 134-135, 145, 152-154
Cognitive rehabilitation - 52-53, 77-81, 83-84
Coinsurance - 12-13, 20, 29, 33, 153
Colorectal cancer tests - 42-44Confidentiality - 12-13, 154
Congenital anomalies - 21-24, 62-63, 74, 153
Consultations - 39-40, 94-95
Contact lenses - 53-54, 133
Contraceptive devices and drugs - 48, 114-119
Coordination of benefits - 114-119, 142
Copayments - 12-13, 28, 33, 142, 145-147
Cosmetic surgery - 62-65, 153
Cost-sharing - 28, 33, 153
Costs for covered services - 28-34
Coverage information - 8
Covered facility providers - 18-19
Covered professional providers - 17
CT scans - 40-41, 77-81, 152
Custodial care - 18-19
Deductible - 28, 37
Definitions - 152-160
Dental care - 66, 121-124, 164
Diabetes Management Program - 125
Diabetic education - 59-60, 77-81
Diabetic suppliesDiagnostic and treatment services - 42-46, 77-81
Diagnostic tests - 40-41, 46-49, 95-96
Dialysis - 51-52, 56-57, 77-81, 83-84
Disease Management - 127-128
Disputed claims process - 139-141
Divorce - 8-9, 11
DNA analysis of stool samples - 42-44
Donor expenses (transplants) - 72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 56-57, 153Educational classes and programs - 59-60
EEGs - 40-41, 77-81
EKGs - 40-41, 77-81
Emergency - 20, 26, 87-92, 121-122
Enrollment - 8, 10-11
Exception situations - 20-21
Exclusions - 134-135
Experimental or investigational - 153-154
Extended care benefits - 83-84
Eyeglasses - 53-54
Facility providers - 18-19
Family planning - 48
Fecal occult blood test - 42-44
FEDVIP - 121, 145
fepblue mobile application - 129
fepblue.org - 4
Flexible benefits option - 128-129
Foot care - 54-55
Formulary/Preferred drug list - 98-120
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility -
Fraud - 4
Freestanding ambulatory facilities - 18-19
Gender affirming care - 21-24, 55-56, 62-63
Generic drugs - 99-102
Generic Incentive Program - 102-103
Genetic screening/testing - 40-41
Health Insurance Marketplace - 11
Health tools - 125
Healthy Families - 125
Hearing aids and hearing services - 53, 55-56
Home health services - 58
Home nursing care (maternity) - 46-48
Hospice care - 84-86
HospitalHuman papillomavirus (HPV) tests - 42-46
Hypertension Management Program - 126
Immunizations - 42-46, 77-81, 114-119
Inpatient hospital benefits - 75-77, 81-82
Inpatient professional services - 21, 26, 39-40, 75-77
Insulin - 114-119
Insulin pumps - 56-57, 114-119
Laboratory and pathology services - 20
Low-dose CT screening - 158
Mail Service Prescription Drug Program - 99-103, 114-119, 131-132, 137-138, 164, 166
Mammograms - 42-44
Manipulative treatment - 58-59, 77-81
Maternity care - 26, 46-48
Maxillofacial surgery - 66
Medicaid - 143
Medical emergency - 20, 89, 91-92
Medical foods - 57-58, 114-119, 155
Medical supplies - 57-58, 75-81, 84-86
Accidental injury - 75-77, 87-92, 121-122, 152
Acupuncture - 59, 72-73
Affordable Care Act (ACA) - 8, 11, 44-46
Allergy care - 50
Allogeneic transplants - 72
Alternative treatments - 59
Ambulance - 20, 87-88, 92
Ambulatory surgical center - 18-19, 77-81
Anesthesia - 72-73, 75-77
Angiographies - 40-41, 77-81
Appeals - 25, 27, 139-141
Applied behavior analysis (ABA) - 21-24, 51-52, 77-81
Assistant surgeon - 20
Autism spectrum disorder - 51-52, 77-81
Autologous transplants -
Average wholesale price (AWP) - 114-119, 164
Biopsies - 42-44, 62-63, 77-81
Birthing centers - 18-19
Blood and blood plasma - 57-58, 77-81
Blood or marrow stem cell transplants - 71-72
Blue Distinction Centers - 18-19, 71-72, 81-82Blue Distinction Specialty Care - 18-19
Blue Health Assessment - 125-126
Bone density tests - 40-41, 77-81
Brand-name drugs - 99-102
Breast pump and supplies - 46-48
Breast reconstruction - 63-65Breastfeeding support and supplies - 46-48, 57-58
Cancer tests - 42-44
Cardiac rehabilitation - 51-52, 77-81
Cardiovascular monitoring - 40-41, 77-81
Care Management Programs - 127-128
Case management - 82-86, 95-96, 127-128
Casts - 62-63, 75-81
Catastrophic protection - 33, 164, 166
Cervical cancer screening - 42-46
CHAMPVA - 142-145
Changes for 2024 - 14-16
Chemotherapy - 51-52, 77-81
Children’s Equity Act - 9-10
Chiropractic manipulative treatment - 51-52, 58-59
Cholesterol tests - 42-44, 114-119
Circumcision -46-48, 62-63
Claims and claims filing - 12-13, 25-27, 127, 131-132, 136-141, 153, 158-160
Clinic visits - 39-40, 77-81, 94-95
Clinical trials - 21-24, 134-135, 145, 152-154
Cognitive rehabilitation - 52-53, 77-81, 83-84
Coinsurance - 12-13, 20, 29, 33, 153
Colorectal cancer tests - 42-44Confidentiality - 12-13, 154
Congenital anomalies - 21-24, 62-63, 74, 153
Consultations - 39-40, 94-95
Contact lenses - 53-54, 133
Contraceptive devices and drugs - 48, 114-119
Coordination of benefits - 114-119, 142
Copayments - 12-13, 28, 33, 142, 145-147
Cosmetic surgery - 62-65, 153
Cost-sharing - 28, 33, 153
Costs for covered services - 28-34
Coverage information - 8
Covered facility providers - 18-19
Covered professional providers - 17
CT scans - 40-41, 77-81, 152
Custodial care - 18-19
Deductible - 28, 37
Definitions - 152-160
Dental care - 66, 121-124, 164
Diabetes Management Program - 125
Diabetic education - 59-60, 77-81
Diabetic suppliesDiagnostic and treatment services - 42-46, 77-81
Diagnostic tests - 40-41, 46-49, 95-96
Dialysis - 51-52, 56-57, 77-81, 83-84
Disease Management - 127-128
Disputed claims process - 139-141
Divorce - 8-9, 11
DNA analysis of stool samples - 42-44
Donor expenses (transplants) - 72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 56-57, 153Educational classes and programs - 59-60
EEGs - 40-41, 77-81
EKGs - 40-41, 77-81
Emergency - 20, 26, 87-92, 121-122
Enrollment - 8, 10-11
Exception situations - 20-21
Exclusions - 134-135
Experimental or investigational - 153-154
Extended care benefits - 83-84
Eyeglasses - 53-54
Facility providers - 18-19
Family planning - 48
Fecal occult blood test - 42-44
FEDVIP - 121, 145
fepblue mobile application - 129
fepblue.org - 4
Flexible benefits option - 128-129
Foot care - 54-55
Formulary/Preferred drug list - 98-120
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility -
Fraud - 4
Freestanding ambulatory facilities - 18-19
Gender affirming care - 21-24, 55-56, 62-63
Generic drugs - 99-102
Generic Incentive Program - 102-103
Genetic screening/testing - 40-41
Health Insurance Marketplace - 11
Health tools - 125
Healthy Families - 125
Hearing aids and hearing services - 53, 55-56
Home health services - 58
Home nursing care (maternity) - 46-48
Hospice care - 84-86
HospitalHuman papillomavirus (HPV) tests - 42-46
Hypertension Management Program - 126
Immunizations - 42-46, 77-81, 114-119
Inpatient hospital benefits - 75-77, 81-82
Inpatient professional services - 21, 26, 39-40, 75-77
Insulin - 114-119
Insulin pumps - 56-57, 114-119
Laboratory and pathology services - 20
Low-dose CT screening - 158
Mail Service Prescription Drug Program - 99-103, 114-119, 131-132, 137-138, 164, 166
Mammograms - 42-44
Manipulative treatment - 58-59, 77-81
Maternity care - 26, 46-48
Maxillofacial surgery - 66
Medicaid - 143
Medical emergency - 20, 89, 91-92
Medical foods - 57-58, 114-119, 155
Medical supplies - 57-58, 75-81, 84-86