FEHB Standard and Basic Options
2026 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 3. How You Get Care
What you must do to get covered care:
Transitional care
Section 3. How You Get Care
What you must do to get covered care:
Transitional care
• Transitional care
Specialty care: You may continue seeing your specialist and receiving any PPO benefits for up to
90 days if you are undergoing treatment for a chronic or disabling condition and you lose access to
your specialist because:
Contact us at the number on the back of your ID card or, if we drop out of the Program, contact
your new plan.
If you are pregnant and you lose access to your specialist based on the above circumstances, you
can continue to see your specialist and your Preferred benefits will continue until the end of your
postpartum care, even if it is beyond the 90 days.
Note: If you lose access to your specialist because you changed your carrier or plan option
enrollment, contact your new plan.
Sex-Trait Modification: If you are mid-treatment under this Plan, within a surgical or chemical
regimen for Sex-Trait Modification for diagnosed gender dysphoria, for services for which you
received coverage under the 2025 Plan brochure, you may seek an exception to continue care for
that treatment. If you have questions about the exception process, contact us using the customer
service phone number listed on the back of your ID card. If you disagree with our decision on your
exception, please see Section 8 of this brochure for the disputed claims process. Individuals under
age 19 are not eligible for exceptions related to services for ongoing surgical or hormonal treatment
for diagnosed gender dysphoria.
Specialty care: You may continue seeing your specialist and receiving any PPO benefits for up to
90 days if you are undergoing treatment for a chronic or disabling condition and you lose access to
your specialist because:
- we drop out of the Federal Employees Health Benefits (FEHB) Program and you enroll in another FEHB plan, or
- we terminate our contract with your specialist for reasons other than for cause,
Contact us at the number on the back of your ID card or, if we drop out of the Program, contact
your new plan.
If you are pregnant and you lose access to your specialist based on the above circumstances, you
can continue to see your specialist and your Preferred benefits will continue until the end of your
postpartum care, even if it is beyond the 90 days.
Note: If you lose access to your specialist because you changed your carrier or plan option
enrollment, contact your new plan.
Sex-Trait Modification: If you are mid-treatment under this Plan, within a surgical or chemical
regimen for Sex-Trait Modification for diagnosed gender dysphoria, for services for which you
received coverage under the 2025 Plan brochure, you may seek an exception to continue care for
that treatment. If you have questions about the exception process, contact us using the customer
service phone number listed on the back of your ID card. If you disagree with our decision on your
exception, please see Section 8 of this brochure for the disputed claims process. Individuals under
age 19 are not eligible for exceptions related to services for ongoing surgical or hormonal treatment
for diagnosed gender dysphoria.