2026 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
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 - 133-134
Accidental injury - 88-91, 120-121, 151
Acupuncture - 60, 72-73
Affordable Care Act (ACA) - 113-118
Allergy care - 51-52
Allogeneic transplants - 68-70
Alternative treatments - 60
Ambulance - 32, 86-87
Ambulatory surgical center - 18-20, 77-81
Anesthesia - 72-73
Angiographies - 40-41, 77-81
Appeals - 27, 137
Applied behavior analysis (ABA) - 52-53, 77-81
Assistant surgeon - 20-21, 63-64
Autism spectrum disorder - 52-53, 77-81
Autologous transplants - 68-70
Average wholesale price (AWP) - 155-156
Biopsies - 63-64, 77-81
Birthing centers - 18-20
Blood and blood plasma - 58-59, 77-81
Blood or marrow stem cell transplants - 67-70
Blue Distinction Centers - 18-20, 81-82Blue Distinction Specialty Care - 18-20
Blue Health Assessment - 124-125
Bone density tests - 40-41, 77-81
Brand-name drugs - 98-101, 107-110
Breast pump and supplies - 47-48
Breast reconstruction - 64-65Breastfeeding support and supplies - 47-48
Cancer tests - 42-44
Cardiac rehabilitation - 52-53, 77-81
Cardiovascular monitoring - 40-41, 77-81
Care Management Programs - 126-127
Case management - 126-127
Casts - 63-64, 75-81
Catastrophic protection - 33, 107-110, 163, 165
Cervical cancer screening - 42-46
CHAMPVA - 141-142
Changes for 2026 - 15-17
Chemotherapy - 52-53
Children’s Equity Act - 10-11
Chiropractic manipulative treatment - 59-60
Cholesterol tests - 42-44
Circumcision - 47-48, 63-64
Claims and claims filing - 37, 135
Clinic visits - 39-40, 93-94
Clinical trials - 22-25, 70, 144
Cognitive rehabilitation - 53-54, 74-87
Coinsurance - 28-29
Colorectal cancer testsConfidentiality - 13-14
Congenital anomalies - 63-64, 152
Consultations - 39-40
Contact lenses - 54-55
Contraceptive devices and drugs - 49-50, 102-106, 110-118
Coordination of benefits - 141-150
Copayments - 28
Cosmetic surgery - 63-64, 152
Cost-sharing - 28
Costs for covered services - 28-34
Coverage information - 9
Covered facility providers - 18-20
Covered professional providers - 18
Cryopreservation - 50-51
CT scans - 40-41, 77-81
Custodial care - 18-20
Daily Habits - 124
Deductible - 28
Definitions - 151-159
Dental care - 65-66, 120-123
Diabetes Management Program - 124
Diabetic education - 60-61, 77-81
Diabetic suppliesDiagnostic and treatment services - 39-40, 77-81
Diagnostic tests - 40-41, 47-48, 93-95
Dialysis - 18-20, 52-53, 57-58, 77-81, 83-84
Disease Management - 126-127
Disputed claims process - 138-140
Divorce - 12
DNA analysis of stool samples - 42-44
Donor expenses (transplants) - 70-72
Drugs (see: Prescription drugs)
Durable medical equipment (DME) - 57-58Educational classes and programs - 60-61
EEGs - 40-41, 77-81
EKGs - 40-41, 77-81
Emergency - 88-91
Enrollment - 9-10
Exception situations - 20-22
Exclusions - 133-134
Experimental or investigational - 133-134, 152-153
Extended care benefits - 83-84
Eyeglasses - 54-55
Facility providers - 18-20
Family planning - 49-50
Fecal occult blood test - 42-44
FEDVIP - 144
fepblue mobile application - 128
fepblue.org - 4
Flexible benefits option - 127-128
Foot care - 55-56
Formulary/Preferred drug list - 98-101, 107-110
Foundation for the Accreditation of Cellular Therapy (FACT) accredited facility - 18-20, 67
Fraud - 4-5
Freestanding ambulatory facilities - 18-20
Generic drugs - 98-101, 107-110
Generic Incentive Program - 101-102
Genetic screening/testing - 22-25, 40-41, 77-81
Health Insurance Marketplace - 12
Health tools - 124
Healthy Families - 124
Hearing aids and hearing services - 54, 56-57
Home health services - 59
Home nursing care (maternity) - 59
Hospice care - 84-86
HospitalHuman papillomavirus (HPV) tests - 42-46
Hypertension Management Program - 125
Iatrogenic infertility - 50-51
Immunizations - 42-46, 113-118
Inpatient hospital benefits - 75-77
Inpatient professional services - 39-40, 93-94
Insulin - 102-106, 110-113
Insulin pumps - 57-58
Laboratory and pathology services - 40-41, 75-81, 89-91
Low-dose CT screening - 157
Mail Service Prescription Drug Program - 97-106, 110-113, 136-137
Mammograms - 42-44
Manipulative treatment - 59-60, 77-81
Maternity care - 26-27, 47-48
Maxillofacial surgery - 65-66
Medicaid - 142
Medical emergency - 88, 90-91
Medical foods - 58-59, 101-102, 107-110, 154
Medical supplies - 58-59, 101-102
Medically necessary - 154
Medicare - 1, 141-150Medications and supplies - 102-106, 110-113
Member facilities - 13-14, 155-156
Mental health/substance use disorder - 92-96, 128
MRIs - 40-41, 77-81
Multiple procedures - 63-64
MyBlue Customer eService - 126
National Doctor & Hospital Finder - 13-14, 126
Neurological testing - 40-41, 77-81
Never Events - 6-8, 154
Newborn care - 26-27, 47-48
No Surprises Act (NSA) - 32
Non-member facilities - 13-14, 155-156
Non-participating providers - 13-14, 156-157
Non-preferred providers - 29-32
Nurse - 59, 124
Nutritional counseling - 42-46, 158
Observation care - 154
Obstetrical care - 47-48
Occupational therapy - 53-54, 84-86
Office visits - 39-40, 93-94
Oral surgery - 65-66
Organ/tissue transplants - 66-67, 71-72
Orthopedic devices - 56-57, 77-81
Osteopathic manipulative treatment - 59-60
Osteoporosis screening - 157
Ostomy and catheter supplies - 58-59
Out-of-pocket expenses - 29-33
Outpatient facility services - 81-82
Outpatient professional services - 39-40
Overpayments - 34
Overseas Assistance Center - 129
Overseas services, drugs, supplies and claims - 129-131
Oxygen - 57-59
Pap tests - 42-46
Participating providers - 13-14, 29-32, 155-156
Patient Safety and Quality Monitoring (PSQM) Program - 98-101
Personal Health Record - 124
PET scans - 40-41, 77-81
Pharmacotherapy - 39-40, 52-53
Physical examination - 42-46, 77-81
Physical therapy - 53-54, 84-86
Physician - 153, 157
Plan allowance - 155-156
PPO - 13-14
Pre-admission testing - 75-77
Precertification - 22
Preferred providers - 13-14, 29-32
Pregnancy (see: Maternity care)
Pregnancy Care Incentive Program - 125-126
Prescription drugsPreventive carePrimary care provider - 18
Prior approval - 22-25, 157
Professional providers - 18
Prostate cancer tests - 42-44
Prosthetic devices - 56-57, 77-81
Psychotherapy - 93-95
Pulmonary rehabilitation - 52-53, 77-81
Radiation therapy - 22-25, 52-53, 77-81
Reconsiderations - 27, 138-140
Renal dialysis - 52-53, 77-81
Replacement coverage - 11-12
Reproductive services - 50-51Residential Treatment Center (RTC) - 22, 82-83, 94-95
Retail Pharmacy Program - 97-98, 102-106, 130-131, 136-137
Rights and responsibilities - 13-14
Room and board - 75-77, 82-83, 94-95
Screening services - 157
Second surgical opinion - 39-40
Self-injectable drugs - 38, 62, 74, 77-81
Skilled nursing facility (SNF) care - 18-20
Smoking cessation - 60-61, 113-118, 124
Social worker - 126-127
Specialty Drug Pharmacy Program - 97-98, 102-106, 130-131, 136-137
Specialty drugs - 98-110, 136-137, 158
Speech therapy - 53-54, 77-81, 84-86
Speech-Generating Devices - 57-58
Stem Cell Transplants - 67-70
Sterilization procedures - 49-50
Subrogation - 142-143, 158
Substance use disorder - 18-20, 92-96, 128
SurgerySyringes - 102-106, 110-113
TelehealthTemporary Continuation of Coverage (TCC) - 12
Tobacco cessation - 60-61, 113-118, 124
Transplants - 22-25, 63-64, 66-72
Travel benefit - 71-72, 124
Treatment therapies - 52-53
TRICARE - 141-142
Ultrasounds - 40-41, 77-81
Urgent care center - 89-91
Urgent care claims - 158-159
VA facilities - 34, 149
Vision services - 54-55, 144
Waivers - 29
Weight control - 42-46, 124, 128
Wheelchairs - 57-58
Wigs - 56-57
X-rays - 20-21, 40-41, 77-81